Ok, so you've been diagnosed with irritable bowel syndrome (IBS). Your doctor has suggested you try the low FODMAP diet, and you left his or her office with a huge stack of information and some food lists.
You're feeling overwhelmed at the thought of a complete dietary overhaul, and maybe anxious about how to shop, plan meals and cook to support this big change. And your gut symptoms are getting even worse as a result.
NOW WHAT?!! Don't panic. I've got you covered.
Here's a few important steps to get yourself on the right path, and soon you'll be feeling better.
1. Find a Low FODMAP Trained Dietitian.
Yes, you can go it alone, but having a skilled partner who has navigated these waters for dozens upon dozens of individuals before you can help ensure you avoid pitfalls, unnecessary errors and over-thinking. This diet is complicated and the reintroduction phase can require some nuanced assessment of symptoms, as well as some skilled sleuthing to track down troublesome hidden FODMAPs in your diet. Good FODMAP trained dietitians are worth their weight in gold. And they can help you feel better as fast as possible. To find one near you, contact your doctor or gastroenterologist. If you aren't having any luck with that route, or perhaps you live in a rural area, there are many RDs (registered dietitians) who also offer online consultations.
Finally, click here, here or here to access lists of trained FODMAP dietitians in the US and Europe. You can also email me for a free 15-minute consult. I am a Monash University Certified Low FODMAP Dietitian, and have also completed Advanced FODMAP Training from Kings College of London.
2. Download the Monash University Low FODMAP App.
A team of researchers at Monash University created the low FODMAP diet and they are still the main go-to for updated research and information on the diet. The app is available for the Apple and Android platforms and can be downloaded from the appropriate app stores. It offers a wealth information about IBS, getting started with the diet, which foods contain FODMAPs, how to ensure a balanced diet and proper nutrition, and perhaps most importantly, a massive database of foods that have been tested for FODMAPs content. The app uses a "traffic light" system to identify which foods are low in FODMAPs (green), which have some FODMAPs but can be enjoyed in small quantities on occasion (yellow) and those which contain high amounts of FODMAPs and should be avoided (red).
The app contains specific portion sizes (in both imperial and metric measurements), so you know which foods you can eat and in which amounts. This is important because eating too much of even low FODMAP foods can accidentally become a high FODMAP situation (I'll talk about FODMAP "stacking" in a future post). For more information on the app, go to your app store or the Monash University website.
3. Pick a Start Date.
It doesn't have to be tomorrow, but you do want to get started on the path to feeling better, fast. Try to find a time period where you won't be traveling a lot and can take some extra time to plan meals and eat at home most days. This may not be 100% possible and that's ok. There are plenty of tips for eating out or with others! However, when you start the Elimination phase you're in learning mode, and it can be helpful to be able to focus on this without juggling restaurants, unfamiliar kitchens and social demands. Look at your calendar and pick a week that you'll get started, knowing that Elimination is a 2-8 week process* whereby you'll be eliminating all high FODMAP foods from your diet temporarily, to try to get good control of your GI symptoms.
*Now is also a good time to remind you (and emphasize) that the Elimination phase is intended to be temporary. Once you're feeling better, it's important to work more foods back into your diet, so you can be symptom free (or as close to it as possible!) AND have a diverse and nutritious diet. (See this article I wrote for FODMAP Everyday for a bit more on this topic).
4. Keep a Food & Symptom Journal.
The low FODMAP diet is a bit like being a detective: you're constantly trying to "sniff out" what food or combinations of food are the culprits behind your own specific gut issues. And sometimes it feels like no matter how carefully you follow the elimination instructions, you still get tripped up. This can happen for many reasons. Perhaps you ate out in a restaurant and there were hidden ingredients that weren't listed on the menu. Maybe you tried a new food product and didn't read the label closely and lo and behold there was a high FODMAP ingredient you didn't initially notice. Or, you're going through a really stressful period of life and your anxiety levels are through the roof, and this is also affecting your IBS. Still others may find that they feel pretty terrible after a hard or extended workout. How do you know what the actual culprit is?
Keeping track of your food intake, stress levels, physical activity and symptoms can be an important part of starting to once and for all assess your triggers for GI upset. There are a lot of ways to do this, from a paper diary to websites to mobile apps. Choose the method that works best for you and your lifestyle, and try to track during the entire elimination phase. Here's a couple links that might help get you started:
- Bowelle app: https://itunes.apple.com/app/id1002889997
- Cara: https://cara-app.com/
- IBS Diet Tracker: https://itunes.apple.com/gb/app/ibs-diet-tracker/id1053516418?mt=8
- mySymptoms: http://skygazerlabs.com/wp/
5. Create a Low FODMAP Shopping List. Start with your regular grocery list and use the Monash app (or one of the lists below, which are frequently updated) to find low FODMAP options for other foods you normally purchase and eat. Going into the grocery store well-prepared will reduce stress and ensure you have a pantry full of tasty and nutritious options, so you don't feel deprived. There are also a number of food manufacturers who have created low FODMAP products that you can seek out. Many of these are certified Low FODMAP by Monash or FODMAP Friendly (the other product testing and certifying body), so you know that you are in good hands if you purchase a certified product.
- Diet vs Disease Low FODMAP Shopping List: https://www.dietvsdisease.org/diy-low-fodmap-diet/
- FODMAP Everyday Trader Joe's Shopping List: https://www.fodmapeveryday.com/trader-joes-low-fodmap-shopping-list/
- FODY Foods Shopping List: https://www.fodyfoods.com/pages/low-fodmap-food-list
Food Brands & Products
- FODMAP Friendly: http://fodmapfriendly.com/certified-products/
- Monash Certified: https://www.monashfodmap.com/i-have-ibs/certified-products/
- FODY Foods: https://www.fodyfoods.com/
- Casa de Sante: https://casadesante.com/
- Stellar Labs Nutrition: https://www.stellarlabsnutrition.com/
- Bays Kitchen: https://bayskitchen.co.uk/
So what are you waiting for? You can do it! Get started on the low FODMAP diet. You (and your gut) will be glad you did!