I
f you’re one of the 12 million
people in Britain living with
Irritable Bowel Syndrome (IBS)
you might have heard of the low-
fodmap diet. For the uninitiated,
fodmap stands for fermentable
oligosaccharides, disaccharides,
monosaccharides and polyols –
quite a tongue-twister. But what is
it? The diet is now recognised by
medical professionals worldwide
as an effective treatment for IBS
symptoms, yet doctors and dietitians
are worried that, as its success
becomes more well known, the
low-fodmap approach is turning
into a potentially unhealthy diet fad.
They report growing numbers of
people with IBS, as well as some
with no real gut problems, puttingthemselves on the diet without
medical supervision or guidance.
Instead, they’re turning to Google
and a profusion of blogs and
websites that have popped up on
the topic, which are mostly written
by unqualified ‘experts’.
One website wrongly suggests
the low-fodmap approach works for
everyone: “If you’ve got an irritable
digestive tract, fodmaps are
definitely something you want to
avoid.” Another incorrectly frames
the low-fodmap approach as a
lifestyle choice rather than a
treatment: “Will low-fodmap be the
new gluten free?” Worryingly, many
websites falsely infer that the low-
fodmap approach involves going
on a highly restricted diet forever.WHAT ARE FODMAPS?
In simple terms, fodmaps are
a group of carbohydrates found
in a wide array of foods, including
fruit and vegetables, dairy, sugar
and syrups, grains and pulses.
They’re poorly absorbed by the
small intestine, so pass into the
large intestine, where they can
ferment and cause bloating,
abdominal pain and diarrhoea
in those with a sensitive gut.
The low-fodmap approach isn’t
a conventional diet but a three-step
process that helps people living
with IBS identify the carbohydrates
that trigger their symptoms.
Patients start by eliminating
high-fodmap foods for four to eightweeks. These are then gradually
reintroduced individually over a
period of months to identify which
ones trigger symptoms. In the final
stage, all non-triggering foods are
gradually reintroduced.
The approach is thought to
alleviate symptoms in around
70 per cent of IBS sufferers. But it’s
complex, highly restrictive in the
first phase and should be only one
part of a broader IBS treatment
plan. That’s why Britain’s National
Institute for Healthcare and
Excellence (NICE) guidelines state
the low-fodmap diet needs to be
undertaken with the supervision
of a healthcare professional.WHEN DIET TURNS TO FAD
Dr Megan Rossi, a registered
dietitian specialising in gut health
and author of Eat Yourself Healthy
(Penguin Life), says the low-fodmap
diet has been “a gamechanger” for
many people living with IBS. “But
it’s certainly turned into a trend, just
like we’ve seen with gluten free.”
Many patients who come to her
clinic have put themselves on
a restricted diet for years in the
mistaken belief that high-fodmap
foods are simply ‘bad’ for them.
“A low-fodmap diet is not ‘healthy’- it’s a short-term strategy for people
with a specific medical condition
and not for healthy people,” Dr
Rossi says. “It should be done for
a very short period of time and
shouldn’t be seen as a cool trend.”
There’s a new health
buzzword in town
Despite its clunky name, the fodmap diet, which is specifically designed to alleviate painful
digestive symptoms, is in danger of becoming the latest health bandwagon for the fad-dieters
to leap onto. What is it, who’s it for – and who should say no? Sue Quinn digests the facts
ILLUSTRATION:ISTOCK/GETTY IMAGES
BEHIND THE HEADLINES
- To learn more about IBS, visit theibsnetwork.
org, a national IBS charity - Dr Megan Rossi has a type of low-fodmap diet
in her book Eat Yourself Healthy (Penguin Life) - Professor Whorwell recommends the Fodmap
app by Food Maestro (from AppStore and
Google Play), developed with help from King’s
College London and Guy’s and St Thomas’ NHS
Trust. It’s designed to be used in conjunction
with advice from a dietitian. - If searching the internet for information
about the low-fodmap diet, ensure the site
you’re reading carries the NHS logo
WHERE TO GO FOR
RELIABLE INFORMATION