5 ways to increase variety and enjoyment on the low FODMAP diet

20 October 2021

5 ways to increase variety and enjoyment on the low FODMAP diet

Article written by Helen Phadnis, Registered Dietitian and Nutrition Coach at The Bespoke Nutrition Coach

 

Once you’ve received a reliable diagnosis of IBS, one of the most common and effective treatments will be to follow a low FODMAP diet. This has been shown to provide symptom relief to 80% of IBS sufferers. Anyone who has attempted FODMAP restriction will know what an undertaking it is. FODMAPs do not fall into the usual food categories we’re familiar with such as carbs or protein, we were not educated about FODMAPs at school, and even when you are clear on which foods can be eaten we need to figure out how to turn these into tempting meals and snacks that meet our body’s needs. Added to this is the issue that there is a huge amount of information on the internet, some of it conflicting, and not all of it coming from registered healthcare professionals, making it unreliable.

 

The aim of the elimination phase of the low FODMAP diet is to become symptom free of IBS. This will vary from person to person but may mean eliminating suffering from pain, bloating, diarrhoea, constipation, wind, fatigue, and urgency. To have eliminated these symptoms will be a huge relief and achievement. Having battled to get on top of your condition it can be tempting to stick to a few limited meals you feel safe eating that have worked for you. However, it is important your diet remains as varied as possible for the following reasons:

    • A reduction in variety of plant foods can lead to a reduction and number of gut bacteria (your microbiome), which in turn can lead to poor mental health and immunity.
    • If not carefully replaced with low FODMAP ‘gentle fibre’ alternatives, eliminating high FODMAP foods can result in constipation.
    • We need variety in our diets for nutritional adequacy. The less varied our diet is the more likely you will become deficient in essential vitamins and minerals, which in turn can result in fatigue, poor immunity, and low mood.
    • When monotony and boredom kick in your willpower will fade. FODMAP exclusion is recommended for 4-6 weeks before the challenge/reintroduction phase, which itself can take 8 weeks. That’s a long time before reintroducing FODMAPs at a level you have found your gut can tolerate. Give yourself the best chance of sticking to the diet by properly planning a variety of options that you know you will find appetising.
    • With more options under your belt you will be able to minimise the impact on your life during the low FODMAP diet: work, meals out, and social gatherings can all still go ahead as planned.

 

So how do we achieve variety and enjoyment of food whilst “low FODMAPping”? The very first step has to be arranging an appointment with a registered dietitian trained in this area. Local provision varies but within the NHS the waiting list target for GP referral to specialist care is 18 weeks. If you have private medical insurance or can self-fund you might want to expedite this and see me in my online Zoom clinic. I offer a ‘3 appointment bundle’ for my IBS clients to help guide you through elimination, reintroduction and personalisation phases of the diet using a combination of Zoom appointments, WhatsApp nutrition coaching support, and a nutrient tracking app – alongside other necessary diet and lifestyle modification. Have a look at my website or book on for a free 15min discovery call to find out more. Other private practise UK registered dietitians can be found at the BDA Freelance Dietitians directory. In addition to dietitian support here are 5 guiding principles that will see you enjoying a low FODMAP diet full of variety:

 

  1. Menu plan

Plain and simple – if you don’t know what meals and snacks you are going to cook, it’s impossible to go out and buy the correct ingredients. Base this plan on what you would usually eat. There is no need to start from scratch, or have an entire new recipe to learn for each meal. Simple swaps can be all that is necessary. Here is an example for you:

 

  Usual diet Low FODMAP alternative
Breakfast Porridge with cow’s milk and frozen summer fruits Porridge with lactose-free milk and frozen blueberries
Lunch Regular bread ham salad sandwich Spelt sourdough ham salad sandwich
Evening meal Egg noodles with asparagus, mushroom and silken tofu stir-fry Soba or rice noodles with green beans, broccoli, beansprouts and firm tofu
snacks Cashews and pistachios

Digestive biscuits

Almonds and peanuts

flapjack

drinks Smoothies Diluted orange juice: 100ml topped up with water

 

            Once you have this menu plan you can highlight the foods you do not have in your cupboards and need to stock up on to inform your shopping list. Internet grocery shopping can then make ordering these ‘new’ foods easier and save you walking up and down the aisles trying to find them.

 

  1. Use certified low FODMAP sauces and condiments

Since the low FODMAP diet was first published in 2005 it has become a core part of UK NICE guidelines that inform how medical professionals treat the condition. As an estimated 1 in 5 people suffer from IBS at some point in their lives this means there is a huge market for products to support following a low FODMAP diet, and there are now many companies that have been created to fill that demand. Slightly Different products are not only low FODMAP but also vegan and gluten-free, and range from salad dressings and table sauces to cooking sauces and condiments. Variety packs can be particularly useful when starting out on the low FODMAP diet. Fody foods have produced low FODMAP snack bars, spice mixes and marinades. There are more options at Bays Kitchen, which also offers a subscription service for your most commonly used low FODMAP products, and subsequent savings. FODMarket provides a low FODMAP online shop which stocks all these brands alongside other certified low FODMAP products.

 

  1. Use an app to scan product barcodes

Yes, it really can be that simple. If you need to grab food on the go you won’t need to spend hours deciphering food labels and lists of ingredients if you invest in a low FODMAP app. Just scan the barcode, and you will be informed if that food is low FODMAP or not. There are two main apps:

  • FODMAP by FM (£3.99), is based on King College London advice – the centre for low FODMAP research in the UK, and therefore contains many UK products and is the most suitable for use here.
  • Monash University FODMAP diet ($7.99) was created in Australia and therefore contains Australian foods and products, but is scientifically sound, and very user-friendly.

 

  1. Try some new recipes

There are many websites recommending recipes suitable for the low FODMAP diet. The best websites are assessed by registered dietitians who have received further training and work in this specialist area. They also often contain blogs which can address specific issues such as balancing low FODMAP with a vegan diet. Here are my favourite sources of recipe inspiration:

A Little Bit Yummy – Recipes alongside a subscription service for further reliable IBS management support from registered dietitians.

She Can’t Eat What – recipes include cake and pizza, Emma shows there is nothing ‘off the menu’.

FODMAP everyday – literally hundreds of recipes on here.

BBC good food –  low FODMAP recipes in the easy to use BBC Good Food format.

 

  1. Don’t over-restrict

It’s important to remember that the low FODMAP diet is not a FODMAP -free diet. Many foods are allowed within the diet up to a certain limit – for example a quarter of an avocado can be eaten, half a ripe banana, or up to 125ml of coconut milk. This could open up many more recipe opportunities. If you work with a dietitian you can see how restrictive you need to be from the start. For example, lactose in dairy products is a conditional FODMAP, you only need to exclude it if dairy products have brought on your symptoms in the past.

Also, it’s important to limit the length of time on the exclusion phase of the low FODMAP diet to 4-6 weeks, or shorter if completely. symptom free for 2 weeks, then reintroduction phase. The overall target is to identify which FODMAPs you are sensitive to, and at what dose. It is extremely unusual for IBS sufferers to be sensitive to all FODMAPS, there is usually a particular group e.g. fructans in wheat, or galacto-oligosaccharides in beans and pulses, which might be triggering IBS symptoms. Once you have reached your personalisation phase it’s also important to remember to re-challenge foods that were not tolerated when first challenged. Our guts are adaptable and sensitivity can improve over time. Wait for 3 months and then challenge with FODMAP foods you miss at 1/3 of a usual portion on day 1, building up to ½ portion day 2, and full portion day 3 only if the other portion sizes were tolerated.

 

 

These 5 tips will make the whole process of FODMAP modification enjoyable and less intimidating that when it can first appear. Enjoy a low FODMAP diet and a happier tummy!

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