It’s a way of eating that’s helped change the way doctors treat the abdominal pain, bloating, constipation and diarrhoea that can go with irritable bowel syndrome. FODMAPs is shorthand for the tongue twisting ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols’. 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.
Fodmap diet shows promise taming stomachs
“We expect to launch an additional 20 products and formulations this year and have more than 30 clinical studies,” Abbott said Oct. 17, when it reported third-quarter earnings. Shepherd said she’s sold almost 200,000 copies of her eight cookbooks, which include “Irresistibles for the Irritable,” that help people choose bowel-friendlier foods. The recipes avoid sugars that aren’t well-absorbed in some people’s bowels, found in products ranging from onions to yogurts. These foods can cause bloating, excess gas, abdominal discomfort and diarrhea in some people hallmarks of irritable bowel syndrome experienced by at least 10 percent to 15 percent of adults, according to the International Foundation for Functional Gastrointestinal Disorders, a research and education group in Milwaukee, Wis. “I pieced together what was an experimental diet,” said Shepherd, who began teaching the regimen in her private dietetics practice in early 1997. “I wasn’t randomly picking these foods. They all had something in common: They were all potentially not absorbed in the small intestine.” Peter Gibson, gastroenterology professor at Melbourne’s Monash University, helped coin the term Fodmap to describe the molecules people with irritable bowel syndrome have difficulty stomaching: fermentable oligosaccharides, disaccharides, monosaccharides and polyols found in dozens of everyday things from apples and wheat to milk, high-fructose corn syrup and sugarless chewing gum. Shepherd, who has celiac disease, tested her diet on 25 people, preparing all their meals herself for 22 weeks in a study that formed part of a Ph.D. thesis at Monash. She found the diet quelled symptoms in at least 70 percent of participants, compared with 12 percent given a placebo meal resembling typical Australian fare. “I honestly nearly fell off my chair because it looked just too good to be true,” said Shepherd, who now employs 13 dietitians in a practice that sees about 4,000 people a year. “I still pinch myself at how successful it is and how big it’s become.
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