Low FODMAP Diet...Anyone following? tips/tricks/recommendations needed

[dmonterisi]

Hi everyone- i am about 2.5 weeks into an elimination diet, where i have cut out any number of food items. I'm trying to do a bit of a health reset after a bad year or two and also get som GI issues under control as I stare my 50th birthday down the barrel. So i have cut out for the time being alcohol, coffee, meat/poultry, wheat products, dairy (except for Kefir), artificial sweeteners and legumes. I have also started excluding most nuts other than almonds to this as some seem to be GI triggers for me (trying to minimize the TMI here sorry)...the almonds seem to be okay. One of the foods that are considered high in FODMAPs are onions and garlic. Now, cooking without these have been difficult and I'm hoping when i start adding foods back after a few more weeks to test my system that they will be okay. for now, i'm flavoring the oil with onion and garlic pieces and removing them as the irritants in the foods are water-soluble, not oil-soluble so i can get some flavor that way.

Anyway, curious if there are others who have adopted a low fodmap diet and what your experiences are. Any tips/tricks to keep away from inflammatory foods while maintaining an interesting diet would be appreciated

thanks!

Damon

 

[Delat]

We went through a similar thing for our daughter several years back - FODMAP plus one or two elimination diets whose names I forget. Anyway, sorry no suggestions but lots of sympathy. It was a very tough 3-4 weeks in terms of what I could cook.

 

[Jovidah]

I'll try to stay within the character limit... but if there's anything that requires clarification just ask. I'll start with ' the more general stuff '.

Just to give my background (so you can judge relevance); about 15 years ago I basically got a food poisonining overnight...that never really went away. Basically had diarrhea everyday for a full year before things slowly recovered a bit... but it's never been the same after.
Recovery was an uphill struggle since back then nutritional science was.... a lot worse than it is today, and a lot of the advice given to me was either useless or even counterproductive....FODMAP wasn't even known around here back then... so I basically had to figure everything out myself.

It's important to keep in mind a few things. First, be clear what the problem is you're trying to solve. Which can be a bit difficult because these days the conclusion seems to be more and more that ' everything is connected, especially to gut health / nutrition' ... but make sure that your solution fits your problem. Low-fodmap diet is an exclusion diet mostly meant for peopel who struggle with bloating, diarrhea, cramps and other related bowel problems.

Low-FODMAP is a great starting point since it... covers a lot of the important things (plenty of my trigger foods are on there), but it's not the be all and end all. For example there's plenty of stuff on there that I can tolerate reasonably well, and some things that aren't considered too bad in FODMAP terms that I cannot tolerate at all (for example brassica).

It's also worth keeping in mind that FODMAP is mostly a tool to basically reset and calm down your bowels, and to help you narrow down the list of things that give you problem. It's problematic to use as a long-term option if you really rule out the entire list because it's almost impossible to have healthy nutrition while doing so. It's quite a challenge to not end up in a diet that's has an overrepresentation of ' rice and potatoes' . Hence why I'd always try to use it as an ' emergency solution ', not a permanent end-state.

So what does FODMAP really focus on... in practise it focuses on (specific) carbs, and the effect they have on your bowels / gut flora. An important thing to keep in mind is that for most people this doesn't work the same way as a food allergy where even small amounts give a huge reaction. It's more about... the cumulative effect. So you might find out that small amounts can work fine, when bigger amounts of the same product do not. Or a combination of small amounts of different products becomes problematic when those amounts individually aren't a problem.
In the same vein... when my bowel system is doing better it can ' take more' ...whereas if it's already on the fritz I have to be more strict. So there's plenty of stuff that's on fodmap orange or red that I'll eat if I'm doing fine... but won't eat if I'm doing worse because I know it's far more likely to give me problems (onions and garlic are good examples of this).

Don't forget that everyone's bowel system tends to be different, so what works for person X does not necessarily work for person Y. Other people's experiences and programs like FODMAP are great for inspiration and pointers, but shouldn't supercede your own experience. I can't tolerate brassice or legumes but that doesn't mean you can't. I can tolerate apples reasonably well (if it's whole green apple, not apple juice), but that doesn't mean you can.

The main struggle I ran into is that plenty of products that shouldn't give me problems in theory still gave me problems. The best rule of fist against this is 'avoid processed foods' because they almost invariably gave me the most problems. I don't know if it's the additives, the lack of a natural matrix that makes it digest differently, or what, but the more processed stuff I eat, the more downhill it goes (most drinks that aren't water also tend to wreack havoc for me).

In fact the worst month for me was the month they put me on a ' no wheat - no soy ' products diet...and when I tried all the ' glutenfree alternatives' ... which are all processed crap. I literally improved when at the end of a month I said ' **** this ****' and just started eating chocolate and potato crisps.

The biggest challenge IMO is the ' non-dinner' moments. I always found it a lot easier to replace breakfast / lunch, than dinner... Honestly ' just making more dinner and eating leftovers' has been the most practical.

 

[dmonterisi]

We went through a similar thing for our daughter several years back - FODMAP plus one or two elimination diets whose names I forget. Anyway, sorry no suggestions but lots of sympathy. It was a very tough 3-4 weeks in terms of what I could cook.

Thanks. it really hasn't been too bad, so far. I'm enjoying the focus on seafood and i'm eating a lot of fruit that fits within the diet. eating out or ordering takeout while following this diet is almost impossible though. basically salads or sushi.

 

[TheDza]

I recommend low FODMAP to certain patients who have recurrent or chronic GI symptoms. The one thing that I always stress is that it can be a very restrictive diet if you use it correctly. A lot of times (especially if you want to do a full low fodmap diet) I refer them to a registered dietitian who can really walk them through the ins and outs of that diet. Otherwise it can be difficult or ineffective if not done properly.

 

[More_Gyutos]

I had food poisoning and went a few tough months afterward. I didn’t strictly follow FOODMAP, but I did pay attention and limit or eliminate what was clearly having a negative effect. I found FOODMAP to be way too restrictive. Align probiotic pills were very helpful in encouraging healthy gut bacteria and I credit that with helping me get back to normal much faster. I tried yogurt as well, but I didn’t tolerate it early on. I also heard that real pickles are good for your gut biome. Indeed, everyone is different so I don’t know if probiotic pills will help you. Sorry I don’t have more diet advice. I hope you feel better soon.

 

[Jovidah]

So on to some more practical stuff, mostly related to what you wrote:

-Cutting out alcohol is never a bad idea. I basically can't tolerate wheat anymore...and wine is at best a crapshoot (sometimes it goes well, sometimes it doesn't; probably because of unlabelled additives). What I (and others I knew wiht similar problems) could tolerate best was hard liquor... but its still something that tends to set back your bowel system.

-I never drank coffee so I can't say... but experimenting with ' no caffeine' is probably not the worst idea and worth a shot. Generally speaking caffeine withdrawal is at most 2 weeks. Those 2 weeks can be ******, but that's about as long as it'll take. But I think technically it's considered non-problematic within FODMAP.

-If you're doing FODMAP I think cutting out meat is a  really bad idea. Because for me meats are actually one of my safety foods, something I could always eat that wouldn't negatively affect my bowels...and it's also the one category that is relatively untouched in the FODMAP lists. FODMAP is already difficult to do (or to do healthy) if you eat meat... if you take out the meat you're really setting yourself up for a bad time. You'll invariably end up carb-stacking... and even if they aren't FODMAPs that's still a bad idea.

-If you want to play it safe on meat...cut out processed meats. Especially stuff that got nitrates/nitrates added (though for me they don't give me short-term problems)... but also other processed / marinated stuff; when it's been messed with you no longer control it and these small additions can actually be the problem. For example plain potato chips are one of my 'emergency foods' whereas plenty of flavored chips make sick.

Also, when it comes to stuff like inflamation... when people have problem it's usually pork... so if you want to cut something I'd cut that one...but never poultry. Grassfed beef has a slightly healthier profile than grainfed but it's a marginal difference... I personally never noticed a (short-term) difference between organic and non-organic - but I live in Europe; no clue if it would be the same if I lived in the US.

-Wheat products are Russian roulette for me, and while they're never 100% good for me, I can tolerate certain specific brands / types much better than others (for breads basically the ones that do long ferment sourdough without any additives, and for pasta I can tolerate italian brands using proper durum wheat go much better than other pastas). Though in both cases if I'm honest I do better without wheat products, and if I eat them I basically limit them to once a day. It's the dosage that makes the poison. You mostly want to avoid 'stacking fodmaps' (or even more general, carb-stacking).

-Diary is ... something where you see a lot of person to person variation. For me fermented products generally work best (proper greek yoghurt, proper cheese) because there's less / almost no lactose present (which is what tends to give the most problems. However I also have to watch out with the ' funkier' cheeses... for example the most stinky cheeses don't really go that well anymore, and of the ones I do still eat I generally cut the rinds off.

-Avoiding artificial sweeteners is a really good idea; plenty of people have problems for them, and there's plenty of research to support the assertion that they're not as innocent as we thought.

-Legumes is something I also had to strip out because they invariably gave me problems, but it's why I again stress that I don't think cutting out meat is a good idea. Because if you cut out meat, diary, legumes and wheat... congratulations you basically stripped all your protein from your diet. That's likely to make things worse, not better.

-Nuts can give different responses from nut to nut... so it's worth experimenting with. Also worth trying if you can for example at least eat peanuts (since they're not a true nut)....even if only to keep some variety in your diet.

-As you already found out yourself, the best solution to the onion/ garlic (really... all alliums to be honest; leek also give me issues) problem is to infuse fats with. You can simplify this process a lot by simply making larger batches; every now and then I simply make a liter of infused olive oil with a ton of garlic. You can do this with garlic, onion, or both... just make sure to take the solids out after at most a few days since there's a botulism risk if you leave stuff in long-term.

-I probably said it before but I can't stress this enough: try to stick to whole unprocesssed foods... that really helped me more than nitpicking every little item on the list. How you eat a product makes a difference... the impact on your system of a raw unprocessed apple is very different from apple juice, because it's in a very different matrix. In that sense fruit juices are pretty much all ' poison' if you have bowel issues, whereas most of the whole fruits go just fine for me.

-My basic ' emergency foods ' / stuff I eat when my bowels need to recover:
-anything with potatoes (I usually do roasted but even fried actually goes fine... just dont eat too much at a time...and yes that even includes simple plain salted potato crisps)
-rice + meat (usually poultry)+root veg like carrots. i usually do simple risottos because I actually find it easier, especially if you want to make a larger batch so you can just reheat batches. Admittedly I don't add all the extra butter people normally add; so this is a rather plain version.
-Root veg / tubers are generally the safest veg option FODMAP wise... so yes I eat a lot of carrots.
-if I'm really having massive diarrhea and it just won't stop... flat cola (just shake the bubbles off) + salt sticks ... it's basically ORS in regular food & drink form but always works miracles for me.
-sometimes it's better to simply not eat anything at all. If the system is on the fritz, simply giving it some time off can help. In the same vein, intermittent fasting regimes (where you for example cluster your eating moments on just 8 hours of the day) can have a positive effect, and for me it tends to calm down my bowels.
-probiotics like yakult can actually have a beneficial effect and are worth trying.

 

[dmonterisi]

thanks everyone. my experience tracks alot with @Jovidah and @More_Gyutos. Had a food poisoning episode that lasted like 4 solid days. afterwards, my system would sometimes be okay, sometimes not. it was a really unhealthy time for me in a lot of ways, i had gained weight, was drinking too much and was eating poorly. so this elimination diet stage I'm in now is just a temporary reset. I'm 2.5 weeks in and I did not begin it with the intention of going low fodmap, but as i started this and i realized i was getting infrequent but sudden triggers that caused GI distress, i decided to focus more on restricting the fodmaps for informational purposes. There is no doubt that it has had a dramatic and quick impact on my gut health.

I really appreciate what you are saying, @Jovidah regarding how it's not one item that causes a massive reaction...it's the cumulative impact of a series of poor food choices and the impact on the gut. so my goal with this is about another 2 weeks of this most restrictive phase and then start adding some things back. i hear what you are saying on meats, but i am getting solid amounts of protein right now through seafood. i will be adding poultry, then other meats back in a couple of weeks but i can hang with this diet of tuna, salmon, snapper, shrimp and scallops.

I can see the dangers of carb stacking you are talking about and i'm mindful of them. I have been constantly hungry for the last 10 days or so. I am focused on getting through the next couple of weeks then adjusting.

One of the things that made me focus on fodmaps was that i think i developed a sensitivity to avocado. i began cooking almost exclusively with avocado oil and i think the sugar alcohol content in avocados has an impact on me. since i have cut out avocados and avo oil 2 weeks ago, everything has settled down dramatically. like you said, some foods affect people, others do not. i have been okay with some garbanzo beans, but i have stayed away so far from black beans and lentils which are my favs. i hope lentils end up being okay for me.

I think i'm coming to the realization like you said, the cumulative impacts are significant and i will be able to navigate this by allowing splurges around stretches of more conscientious eating. I'm pretty happy to have figured out that the change could be pretty easy to obtain.

I'm focusing on fermented foods to regenerate a healthier gut biome, so probiotics, kefir, yogurt, kimchi, pickles, kombucha are all now staples of my diet. I guess due to my bowel distress, it's turned me into a psuedo LA IG food influencer.

 

[thebradleycrew]

Highly recommend this book, @dmonterisi - it helped me a lot when I did a very restrictive program for food allergies, most of which I've had since I was a kid. I don't treat the book as gospel, but found loads of a. information and knowledge and b. a general path/program I could follow on my own (subject to my own self control).
https://www.amazon.com/Paleo-Approach-Reverse-Autoimmune-Disease/dp/1936608391

 

[Jovidah]

The problem with identifying trigger foods is that the effect isn't always the same, nor is the effect always instantaneous.
Food diaries can help with figuring that out if you keep struggling.

Extremely limiting diets can often have dramatic effects in a few weeks, the main challenge is to move on from that towards a long term dirt that is healthy and actually sustainable...and that doesn't feel like a culinary penal colony.
Generally speaking the whole eating pattern is just as important as avoiding specific trigger foods.

Also its not necessarily that you made 'poor food choices' its just that some choices might not work for you. Brassica, legumes and alliums are generally healthy and good food - they just don't work for me.
If your bowels are ****** you sometimes have to make choices that are counterintuitive and that don't necessarily align with the general mainstream advice.

 

[mengwong]

I bet future research will find food poisoning and colonoscopy prep have an unexpected benefit in common: flushing the gut creates an opportunity to reset the micro-biome, and that could go in a negative direction … or positive.

During my most recent bout with oysters prescription-strength probiotics got me through the worst of it in a record two days.

Ever since, I’ve been trying to increase fiber from leafy greens, which is the one thing that every diet in the world seems to agree on. Besides, it is hilarious to watch a gallon-size box of spinach cook down to fit on a single Kunz spoon.

Discipline around sugar and processed carbs (typically highly correlated with gluten) was a lot easier 15 years ago when I was living like a hermit. Living in society it’s hard to avoid cake as an OSI Layer One physical medium transporting higher-level interpersonal phatics.

 

[aporigine]

The problem with identifying trigger foods is that the effect isn't always the same, nor is the effect always instantaneous.
Food diaries can help with figuring that out if you keep struggling.

Extremely limiting diets can often have dramatic effects in a few weeks, the main challenge is to move on from that towards a long term dirt that is healthy and actually sustainable...and that doesn't feel like a culinary penal colony.
Generally speaking the whole eating pattern is just as important as avoiding specific trigger foods.

Also its not necessarily that you made 'poor food choices' its just that some choices might not work for you. Brassica, legumes and alliums are generally healthy and good food - they just don't work for me.
If your bowels are ****ed you sometimes have to make choices that are counterintuitive and that don't necessarily align with the general mainstream advice.

to the bolded: the feedback time can be a month plus.

 

[Jovidah]

Discipline around sugar and processed carbs (typically highly correlated with gluten) was a lot easier 15 years ago when I was living like a hermit. Living in society it’s hard to avoid cake as an OSI Layer One physical medium transporting higher-level interpersonal phatics.

Any food you don't prepare yourself is a potential risk and if you want to be stringent on an elimination diet really the only way is to prepare all your food yourself and to read each and every ingredient label.