Turning down the gas

Low-FODMAP recipes.

These are fermentable carbohydrates found naturally in vegetables, fruit, grains, nuts, seeds, dairy food, as well as some additives, that for some people are a pain in the gut. Cauliflower, onions, garlic, apricots, chickpeas and yoghurt are just a few of the otherwise healthy foods that can cause problems for some sensitive people. These foods all contain types of carbs that we don’t digest and when they arrive in the large bowel undigested they ferment and create gas. “When there’s a lot of gas it puts pressure on the gut and the nerve endings of the bowel and this can make the brain overreact and register pain.” For most of us this is a non-event, but for the 15 per cent of people with IBS this gas can trigger bloating, discomfort and pain pain that’s occasionally bad enough to send people dashing to Accident and Emergency, says dietitian Dr Sue Shepherd of La Trobe University’s Department of Dietetics and Human Nutrition who first identified these carbs as culprits in IBS. Low-FODMAP recipes. These fermentable carbohydrates can also change how quickly the bowel works – in susceptible people they can lead to constipation and diarrhoea or a combination of both,” she says. The trick to taming these symptoms is having fewer fermentable carbohydrates in the diet research at both Monash University and London’s Kings College Hospital has found that this works for around 75 per cent of people with IBS. While a low FODMAP diet puts some healthy fibre-rich foods off limits, it doesn’t mean sacrificing fibre, says Shepherd, the author of Low FODMAP Recipes, a new cookbook to help people with IBS make meals that minimise the gassy effects of FODMAPS. Although wheat, rye, barley and many vegetables including peas and mushrooms can cause problems, there’s still brown rice, quinoa, oats and buckwheat, as well as plenty of other vegetables. Spelt, a form of wheat, is also a problem but some breads made with spelt flour (Ancient Grains and Healthybake, for instance) are low in FODMAPs. This is because fructans – one of these indigestible carbs – gets broken down in the manufacturing process, she adds. Low FODMAP eating can be harder on vegans for whom high FODMAP beans and lentils are a good source of protein, iron and zinc. “But you don’t have to cut legumes out entirely everyone with IBS has a different threshold of how much fermentation their gut can handle before the nerve endings start screaming,” says Shepherd.

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IBS? Could be the FODMAPs

In packaged foods, you’re most likely to encounter a fructan called inulin (aka chicory root extract). It’s an added fiber found in energy bars, granola bars, cereals, granolas, and even some yogurts to provide texture or increase the product’s fiber content. Galacto-oligosaccharides is a fancy term that refers to a type of carbohydrate found in beans and legumes. It’s the reason beans have their gassy reputation. If one or more FODMAPs is responsible for your digestive woes, it’s important to bear in mind that the effect of FODMAPs are both cumulative and dose-dependent. In other words, a susceptible person will have his or her own individual threshold of tolerance, and once that threshold is exceeded, symptoms appear. So, for example, if you are fructose intolerant and also react to sugar alcohols, you may be able to tolerate a small portion of fructose-rich fruit in an otherwise low-FODMAP breakfast. And you may also tolerate half of a Vitaminwater Zerowhich contains erythritolwith your otherwise low-FODMAP dinner 10 hours later. But if you had both items together within a shorter window of one another, the combined effect might push you over the edge symptomatically. The low-FODMAP dietand subsequent re-introductionis not easy to navigate without expert help. If you think you might benefit from such an approach, you’re best off consulting a dietitian who has experience with the low-FODMAP diet and can help you determine not just what to avoidbut also what you can eat. If you’re going it on your own, though, check out fellow dietitian Kate Scarlata’s excellent book, The Complete Idiot’s Guide to Eating with IBS, for food lists and recipes. You can also consult Monash University’s website to order a booklet on the low-FODMAP diet, written by the very researchers who developed it. Hungry for more? Write to eatandrun@usnews.com with your questions, concerns, and feedback.

url post http://health.usnews.com/health-news/blogs/eat-run/2012/08/28/ibs-could-be-the-fodmaps


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