Skip to main content

Potential Harm of Low FODMAP Diet

So, What is a FODMAP?

FODMAP stands for Fermentable Oligsaccharides Disaccharides Monosaccharides and Poloys.  These compounds are carbohydrates (sugars) and poloys that easily ferment in the gut, and are not easily absorbed.  Because of this they frequently cause gas, bloating, and diarrhea.  It's no wonder then, that a diet low in these compounds known as a low FODMAP diet is often recommended to IBS patients and people with gastric distress ranging from exercise induced gastric discomfort to Crohn's disease.  But have we jumped the gun on this dietary protocol?

FODMAPs are found in dietary items including diary products, gluten containing products (cereals, breads, etc.), legumes (including soy), most fruits, and some vegetables.  Often, FODMAPs are also added into processed foods as sweeteners or thickeners. On a low FODMAP diet, these dietary items are limited or eliminated.  Some versions of the diet eliminate all FODMAPs for a short period of time before reintroducing them slowly.

Why is a Low FODMAP Diet Potentially Harmful?

FODMAPs Have Positive Effects on the Body

FODMAPs are not all bad.  These nutrients play a vital role in the microbiom that is the gut and the long term effects of drastically limiting or eliminating them entirely is still unknown.  The fermentation of FODMAPs aids in the growth of specific prebiotic microflora.  It also produces fatty acid chains that in turn increase energy and protect the colon from cancer.  FODMAPs also effect immune function, and calcium absorption.  They add bulk to bowel movements, and can lower levels of cholesterol and other fats.

Nutritional Risks

A FODMAP diet is very limited.  It eliminates or restricts whole food groups and that can be a nutritional issue.  People following this diet may be at risk of a diet deficient in a number of antioxidants, vitamins from the B and D groups, iron, calcium, zinc, and folate.  Furthermore, some of the nutritional substitutes and alternatives required to reach a full nutritional range under this diet can be very expensive.  This puts people who may have trouble affording these alternative dietary products at a greater risk of a nutritional deficiency while following this diet plan.

Does the Diet Work?

The problem is, it can be hard to say.  There have been a number of studies but there are a few issues with the ability of these studies to truly evaluate the diet's efficacy.  For one thing, the diet is hard to stick to because it is so limiting, so subjects have a hard time complying especially during longitudinal studies.  Also, there is no test for FODMAP intolerance so it is hard to evaluate whether or not individuals are being effected by FODMAPs or if something else is occurring, especially because there is still so much we don't understand about the gut as a microbiom.

Moreover, how exactly is low FODMAP defined?  What amounts of these foods are allowed and which ones, and does that make a difference as to the efficacy in relieving gastric distress?  There are so many foods containing FODMAPs and it is a diverse group of compounds.  Is there any way to conclude that it is more effective than the standard IBS diet or Crohn's diet already recommended?

Personal Experience

I have been on the IBS diet which is similar to the low FODMAP diet and had a small amount of relief from my IBS-C symptoms.  Recently, however, I have been on a diet very close to the low FODMAP diet.  I avoid carbohydrates including fruits although I eat a limited amount for nutritional purposes.  I have also cut out refined sugars, yeast, alcohol, caffeine, diary, and a few select foods that I showed an immune response to.  This diet along with prescription probiotics and antifungals to prohibit yeast overgrowth in my gut, have very much improved my digestive health.

I realize that there is still a vast amount left to learn about the gut as a mocrobiom and the interactions of the microorganisms that take place there.  I respect the complexity and power of my body, but I also believe that sometimes it needs to be helped along.  My nutrition is better now than before I was on this limited diet because before my stomach was always in so much pain that it was difficult to eat much of anything except bread.  I had pain, nausea, reflux, and vomiting constantly, but now I can eat a salad without fear, and I think that is much better for my nutrition.  I was in a crisis digestively when I started my (sort of) low FODMAP diet and it helped me regain gastric health, but I can understand why this diet should not be taken lightly or be seen as a cure-all fad for more minor digestive complaints.  Knowledge is power and every treatment has side effects (unfortunately).

Source

Catassi, G.; Lionetti, E.; Gatti, S.; Catassi, C. The Low FODMAP Diet: Many Question Marks for a Catchy Acronym. Nutrients 2017, 9(3), 292; doi:10.3390/nu9030292.http://www.mdpi.com/2072-6643/9/3/292

Sending You Healing Hugs And Hope,

 

Comments

Popular posts from this blog

The Mascots of Chronic Illness

Have you ever heard of the yuru-chara?
If you haven't... They are mascots Japan created for places, industries, and events both public and private.

The idea was to boost tourism, and although the goal wasn't quite achieved, people around the globe have fallen in love with these goofy, adorable characters.

They have a mascot for just about everything.
So I got to thinking... What if there was a mascot for Chronic Illness? What would a Chronic Illness Mascot look like?  What traits would this mascot have?

Well, I am proud to announce that I have worked diligently on behalf of the chronic illness community to create a number of mascot suggestions.

Introducing, THE The Sensory Overload Ostrich
When it is all too overwhelming and you can feel absolutely everything (and all of those everythings hurt), your chronic illness mascot is the Sensory Overload Ostrich.

If this bird gets too overwhelmed he buries his head in the sand and says "Nope!" "not today."

It is …

Personal Experience with Saline Infusions for POTS

I've been pretty sick.  From the very beginning of February until very recently, I was essentially bed bound.

My Postural Orthostatic Tachycardia Syndrome (POTS) symptoms were completely out of control. So...

I started getting intravenous (IV) hydration a.k.a. saline infusions once a week. My cardiologist, who specializes in POTS, prescribed them and faxed the prescription to my local primary care doc who also doubles as my migraine specialist.

My local doc rewrote the prescription so I could have the infusions locally, as my cardiologist is about three hours away.

That would not be a convenient weekly drive.

It wasn't horribly fun to get a liter of saline over 3 hours once a week, but I only did it four times.  
I went to two different infusion center locations, the first in the downtown hospital location, and the second at the newer more suburban hospital location.

The downtown location had nurses more skilled at starting the IV, but the newer location had private rooms and…

Medication Organization 101

Organizing your medications can be a daunting task especially if, like most people with a chronic illness, you take multiple medications at different times throughout the day.  I've tried everything to keep my prescriptions and other medications organized.  I think I've owned every pill organizer ever created.  It can be rough managing refills or even just trying to find physical space for all the bottles.

Here are some pro tips to make this process a bit more manageable.
This post contains affiliate links, for more information see the full disclosure under "links to other sites" or scroll to the very bottom of the page.

Keep All Your Medications  Especially Prescription Bottles  in One Place 
This may seem at first like a no brainer, but it can be easy to scatter small bottles around the house.

Pretty soon, if you aren't careful to corral your bottles into a single designated area, you start to lose them in your car, a purse, a suitcase.

Basically, it doesn'…