So you’ve been told by your doctor that starting a low FODMAP diet may help your Irritable Bowel Syndrome (IBS). That’s great, because the low FODMAP diet can relieve symptoms in around 7 out of 10 people with IBS.
But this isn’t an easy diet to follow alone. And you don’t want to follow it using the wrong information or you’re going to be wasting your time. So what’s the best way to get your information so you can do it right and get the best results as quickly as possible?
Here’s your guide to starting a low FODMAP diet.
Start by making sure that a low FODMAP diet is the right option for you
A low FODMAP diet isn’t for everyone. So before you embark on this process, work through the following 3 steps to decide if a low FODMAP diet is for you.
Step 1: Make sure that you have IBS and not something else
The low FODMAP diet is specifically designed to manage the symptoms of IBS. So if you don’t have IBS, the low FODMAP diet isn’t for you. This isn’t about improving overall health, losing weight, or anything like that. It’s simply about relieving and managing the functional gut symptoms caused by IBS.
It’s therefore essential that you’ve first been diagnosed with IBS, otherwise you may do this diet for no reason. So hopefully, you’ve already been diagnosed with IBS. But if you haven’t, it’s time to make an appointment with your doctor. Because only a medical professional can diagnose IBS.
You might be wondering why this step even matters. I mean, it’s just a diet after all. Well this is why it matters:
- The symptoms of IBS cross over with other conditions that are much more severe and can seriously damage your body. So it’s important to have them ruled out first or you may be doing yourself irreversible long-term harm.
- A low FODMAP diet can change your gut microbiota. That’s because the diet removes essential fibres that gut bacteria need to survive. Since we don’t yet know the long-term consequences of this, it’s important to only go down this path if necessary.
- A low FODMAP diet is quite restrictive and can potentially cause nutritional imbalances. It is possible to have a balanced and healthy low FODMAP diet, but only if you substitute foods carefully. So it’s important not to restrict your diet unless it’s essential.
- The restrictive nature of the low FODMAP diet can make food choices difficult. While you can control your food at home, it’s much harder when someone else is preparing your food. This can make eating out and socialising around food a challenging experience.
For further reading, see What is a low FODMAP diet and who is it for?
Note: There are a few other gut conditions that may be helped by a low FODMAP diet, including ulcerative colitis and Crohn’s disease. However, research is still being done to see how effective the low FODMAP diet is in those conditions, so it’s not yet recommended as a strategy for people with Inflammatory Bowel Disease.
Step 2: Understand how a low FODMAP diet works
This is super critical because many people get this wrong and think that once they start a low FODMAP diet, they’re on it for life. But that’s not true. The low FODMAP diet isn’t a ‘forever diet’. It’s a learning diet designed to help you discover the foods that trigger your IBS. Because of this, a low FODMAP diet has 3 phases:
Phase 1: Elimination. In this initial phase, you remove as many FODMAPs from your diet as possible. If your IBS symptoms improve, this means that FODMAPs affect your IBS. This phase normally lasts for around 6 weeks, after which you should move onto phase 2.
Phase 2: Reintroduction. In this second phase, you test your tolerance to each of the FODMAPs by reintroducing them back into your diet. By introducing them one by one, you can see how each type of FODMAP affects your IBS symptoms. That way you’ll know which FODMAPs to continue avoiding and which you can eat again. This phase takes a couple of months to do, after which you should move onto phase 3.
Phase 3: Modification. In this final phase, you modify your diet to get it as close to normal as possible. You do this by returning the FODMAPs that you can tolerate, while continuing to restrict the FODMAPs that you can’t tolerate. This way you’ll keep your IBS symptoms under control while having as varied a diet as possible.
For further reading, see The 3 phases of a low FODMAP diet.
Step 3: Decide if you’re ready to commit to the process
FODMAPs are present in all 5 of the core food groups, plus many discretionary (treat) foods. So following a low FODMAP diet requires a substantial change to how you eat. You’ll have to stop eating many foods that you regularly eat and replace them with low FODMAP versions.
And this isn’t a diet you can choose to “cheat” on. That’s because every time you eat foods that are high in FODMAPs, you’ll trigger your IBS symptoms and affect the results. This is particularly important when you’re doing reintroductions. If you cheat during that time, you won’t get accurate results from your tolerance tests and you’ll have to do them again.
Of course, mistakes will happen and sometimes you’ll eat the wrong foods. But that’s different to deliberately having ‘cheat days’ or deciding that the diet is inconvenient for your plans.
For further reading, see Does it matter if I make a mistake on the low FODMAP diet?
The last thing to consider is that the full process of elimination and reintroduction (Phases 1 and 2) takes at least 3-4 months to complete. That’s a long time to commit to a restrictive diet, but it’s the only way to learn which FODMAPs affect your IBS. If however you do commit to it, the benefits to your IBS and quality of life are likely to be considerable. And, most people are happy to continue with the diet once they start experiencing the benefits.
Next, find yourself some reliable FODMAP resources
Once you’ve decided that a low FODMAP diet is the right option, you’ll need reliable information on following the diet. At a minimum, starting a low FODMAP diet requires the following things:
- Detailed information about the full process of the diet.
- Food lists with foods to eat (low FODMAP foods) and foods to avoid (high FODMAP foods).
- Meal ideas so that you know what to eat for each meal and snack of the day.
- Tips for replacing high FODMAP ingredients with low FODMAP ones.
- Guidance on how to change your cooking practices so that you can start making low FODMAP meals.
- An understanding of what could go wrong on the diet so you’ll know when to seek help.
- Access to someone that you can answer your questions and provide assistance if you need it.
If your IBS gets better following the elimination phase of the low FODMAP diet, you’ll need these resources to move onto the next two phases:
- A protocol for reintroducing FODMAPs and testing your personal tolerance levels.
- An understanding of how to modify your diet after testing.
But before you start searching the internet for these items, it’s important to know that not all of the information that’s out there is reliable. So, when you start looking for resources, make sure that you also look at who’s providing them. Start by checking for nutrition qualifications to be sure that the person providing the resources truly understands the low FODMAP diet. Next, check to see how old the information is, because anything that’s more than a few years old is out of date and could have errors.
Here’s some trustworthy resources to get you started…
Resource 1: Low FODMAP diet apps
The best way to get a list of foods that are low FODMAP and high FODMAP is to use a smartphone app that’s regularly updated with newly tested foods. There are quite a few apps on the market now, but the best two are:
These are the apps that I use both personally and in my nutrition practice with my clients.
Resource 2: Low FODMAP recipes
A quick Google search will bring up lots of low FODMAP recipes and cookbooks, but you need to be ultra careful to check that they’re made using reliable resources. Many of unfortunately based on out of date food lists and so don’t meet current standards for a low FODMAP diet. So unless you’re sure you can trust the recipe creator, make sure you check the recipes against your food lists.
These are the low FODMAP diet recipe books that I use and recommend:
- The Low-FODMAP Cookbook by Dianne Fastenow Benjamin
- The FODMAP Friendly Kitchen by Emma Hatcher
- The Low FODMAP Meal Builder by Glenda Bishop (yes, I wrote this). Note: this ebook doesn’t contain recipes; instead teaches you how to adapt your own favourite recipes to make them low FODMAP. That way you can enjoy the food that you like best without upsetting your tummy.
You can also find loads of free Low FODMAP Recipes here on A Less Irritable Life.
Resource 3: FODMAP dietary specialists
Ideally, everyone who’s starting a low FODMAP diet should first be seen by a dietary specialist to be assessed. Firstly, this helps to make sure that the diet really is right for you. But it also checks to see if anything else needs to be considered when adjusting your diet. This is because FODMAPs aren’t the only things that can trigger IBS, so your eating plan may need some extra tweaks.
However, not everyone chooses to see a dietary specialist and instead may choose to work through the low FODMAP diet with the help of books or online courses. The downside to doing it on your own is that you don’t get the personalised advice and feedback that a dietary specialist can give you.
A third approach is to see a FODMAP dietary specialist at key points along the way, but to rely on the other resources for most of your journey. This compromise gives personalised assistance when needed, but provides independence at other times.
But ultimately this is a choice that you will need to make based on your personal circumstances and preferences.
If you do choose to see a FODMAP dietary specialist, start by screening them before making an appointment. This is what you want to check for:
- Make sure that they’re qualified in nutrition. Check their qualifications to see that they’re a dietitian or a university-qualified nutritionist.
- Check to see if they understand FODMAPs and have experience taking people with IBS through a low FODMAP diet. This is important because FODMAPs still aren’t taught in much detail in nutrition or dietetics courses, so additional training and experience is needed.
- Make sure that they will personalise your sessions based on your needs and won’t give you a cookie-cutter approach that doesn’t suit you. If all they do is give you a list and send you on your way, you may as well use a book or course instead.
If you’re a dietitian or nutritionist wanting to use the low FODMAP diet with your clients, here are two resources to help you with the process:
- Bringing the Low FODMAP Diet into Your Nutrition Practice is a unique online course specifically designed to enable nutrition professionals to gain the knowledge and practical skills they need to work with people who have IBS and require a low FODMAP diet.
- Low FODMAP Diet Practice Resource Kit contains the tools that you’ll need to get the best results for your clients who are following a low FODMAP diet. That way you don’t need to make your own resources and can spend more time working with your clients.
Before you get started, take some time to do a little planning
While you may be eager to get started straight away, it’s better to get everything set up beforehand. The low FODMAP diet is complicated, but you can uncomplicate it by being prepared. What you shouldn’t do is make a snap decision that you’re starting a low FODMAP diet and beginning with your next meal. This is because if you don’t plan ahead, the odds of mistakes are high. So work through the following steps and get it right from the start.
Step 1: Work out what you can and can’t eat
Now that you have reliable resources, you need to take some time to understand them. Most importantly, you need to get familiar with the foods that are high FODMAP that you’ll need to avoid. But after that you need to start focussing on the foods that are low FODMAP that you can still eat.
But since meals are made of many ingredients, you also need to understand how to choose the right low FODMAP ingredients to go in your meal. And particularly, how to replace your usual high FODMAP ingredients with low FODMAP ones. Sometimes this is easy to do, such as adding strawberries to your breakfast rather than peaches. But other times it will be more challenging unless you know how to swap ingredients.
For further reading, here’s 4 tips for making your favourite recipes low FODMAP.
Step 2: Plan out some meals that you’d be happy to eat
The next thing to do is to start making a list of low FODMAP meals that you’d be happy to eat for each meal of the day. Do this for breakfast, lunch, dinner, snacks and drinks. And come up with about 5-10 options for each meal. If you’re stuck on ideas, search for low FODMAP recipes in your resources.
Once you have your lists, plan out your meals for about a week. Not everyone’s big on meal planning so you may not want to plan that far ahead. But at least plan a few meals ahead so that you don’t end up starving with nothing available to eat. That’s how FODMAP mistakes happen.
And if you cook for a family, you may want to be selective on which meals you make low FODMAP and which you don’t. There’s no need for the entire family to eat a low FODMAP diet, only the person who needs it. But you don’t want to be cooking two sets of meals every day either. So you’ll need to think ahead about how to make this work best for your situation.
For further reading, see Planning family meals when only you need a low FODMAP diet.
Step 3: Make sure you have the ingredients you need
Now that you have a meal plan, you need to make sure you have the specific ingredients required. Check your pantry, fridge and freezer for all the ingredients you need. If you’re missing anything, write them on your shopping list so you can buy them. Then it’s time to go shopping.
The first time you go shopping may be a little hard and will likely take you considerably more time than you’re used to. That’s because you’re going to have to do a lot of label reading to check that packaged foods are safe to eat. After a while this gets easier and you’ll learn the safe brands in your area, but be prepared for some frustration for the first few weeks.
For further reading, here’s 5 essential tips for low FODMAP label reading.
Step 4: Keep it simple, especially at first
Since you’re making a major change to how you eat, the best advice I can give you is to keep it simple at first. Stick to simple meals and recipes and don’t mess around with things that you wouldn’t normally cook. Once you get the hang of things, you can start trying new recipes or ingredients to expand your food choices. But there’s honestly nothing wrong with a simple meat and veg meal for dinner until you’re comfortable with changing recipes.
For further reading, here’s 4 tips for making a low FODMAP diet easier.
Step 5: Track your food and symptoms
Set up a system to track your food intake and IBS symptoms. This will help you to stay on track and make sure you aren’t making mistakes by choosing high FODMAP foods. It will also help you to see how much your IBS is improving as you change your diet.
Another reason to keep a food and symptom diary is in case you need to seek further help from a dietary specialist. They will need this info to work out where you’re going wrong and what changes should be made to further improve your symptoms.
Lastly, have a backup plan in case you need extra help
Even with the best resources and the best planning, a low FODMAP diet has its challenges. Some people can manage it on their own if they have the right resources to start with, but most people will need extra help at some point. When that happens, it’s best to work with a FODMAP-specialised nutrition professional who can assess your situation and provide personalised advice.
But what if there’s no FODMAP specialists near where you live?
Location is quite irrelevant these days, especially when it comes to dietary assistance. You don’t need to physically be in the same place as the person who’s helping you. With the wonders of modern technology, you can connect with a FODMAP specialist who lives in the next town, state, or a different country.
I provide consultations using video calls or phone calls and my clients have no problems getting the help they need. So in my experience, this process works very well.
What if you can’t afford to see a FODMAP specialist?
Most people don’t like to talk about money, especially when there isn’t enough, but this conversation needs to be had. I know that working with a FODMAP specialist doesn’t come cheap – no health professional does – but we’re not talking about entertainment or other luxuries here. We’re talking about your health and ability to function.
This is where you need to ask yourself what it’s worth to you to get your IBS sorted. Think about how much easier your life would be if your IBS was under control.
If money is tight for you, try putting away a small amount each week, as much as you can afford to spare. It may take you a month or two to save enough cash, but remember that this is about improving your quality of life. Also, managing IBS is a long game. So it might be preferable to get help now, IBS isn’t damaging your body so it can wait for another month if needed.
And if you’re already on the low FODMAP diet, making some changes to the foods you eat could help you to save even more cash. That’s because low FODMAP alternatives are often more expensive than higher FODMAP foods. But if you choose cheaper alternatives, that could give you more spare money.
For further reading, here’s 4 tips for making a low FODMAP diet budget friendly.
Then, when you’ve enough saved for an appointment, do these things:
- Choose someone who knows what they’re doing. See the tips above for choosing a FODMAP dietary specialist.
- Keep a food and symptom diary for at least one week so that you can get proper feedback to suit your needs. This is particularly important if you need a specialist to troubleshoot problems, but not essential if you’re just starting out.
- Make a list of all the questions that you want answered, in order of the most important to the least important. That way you won’t forget anything important and can get the most out of your session.
So now it’s up to you to get started on your low FODMAP diet. I hope it gives you great results and helps you to get your IBS under control.