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Low FODMAP diets – recommendations

FODMAPs refer to a group of small chained carbohydrates which are poorly absorbed in the small intestine and so pass into the large intestine where they are fermented by gut bactieria(1). Grain foods and legumes contain FODMAPs including fructans found in wheat and rye, and galacto-oligosaccharides (GOS) found in legumes(1). Fructans and GOS, together with other FODMAPs, may cause symptoms such as gas and bloating in people that suffer from irritable bowel syndrome (IBS)(1,2).

Recent research from Monash University has concluded that a low FODMAP diet can effectively reduce the symptoms of Irritable Bowel Syndrome (IBS)(3). As a treatment for IBS, people may follow a low FODMAP diet that excludes foods containing fructans and GOS (i.e. wheat, rye and legumes) for a period of time.

GLNC supports the findings of the valuable research conducted by Monash University and appreciates that to manage symptoms of IBS, people may follow a low FODMAP diet for a short period of time. However, GLNC also recognises that a low FODMAP diet is not recommended as a long term diet, nor is it recommended for the general population.

A low FODMAP diet is designed to be followed for a 2-6 week period to alleviate symptoms associated with IBS, after which individuals are advised to slowly re-introduce foods containing FODMAPs, under the guidance of an Accredited Practising Dietitian, to identify their tolerance level of these foods to maintain a healthy diet.

Research indicates that FODMAPs are probably essential for maintaining a healthy population of gut bacteria which has implications on long term health(4,5). Grain-based foods are important sources of protein, dietary fibre, vitamins and minerals. Whole grain and high fibre grain foods and legumes also contain essential nutrients and phytonutrients that promote health and help protect against disease(6).

For this reason, GLNC maintains that a low FODMAP diet is not a diet for the long-term, nor is it a diet recommended for the general population. Australians should eat a wide variety of grains and legumes as part of a balanced diet(3); grain foods 3 – 4 times a day, choosing at least half as whole grain or high fibre grain foods and legumes at least 2 – 3 times each week.

GLNC recommends that individuals with symptoms of IBS see an Accredited Practising Dietitian experienced in IBS management.

References

  1. Biesiekierski JR, Rosella O, Rose R, et al. Quantification of fructans, galacto-oligosacharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet. 2011;24:154-176.
  2. Gibson et al. J Gastroenterol Hepatol. 2010;25(2):252-8
  3. Gibson PR, Barrett JS, Muir JG. Functional bowel symptoms and diet. Internal Medicine Journal. 2013;43(10):1067-74.
  4. Staudacher et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. Journal of Nutrition, 2012;142;1510-8
  5. Dr Jane Muir, J et al. Conference Presentation: What are the risks/benefits of fermentable carbohydrates? The FODMAP story. Accessed online http://www.glnc.org.au/4th/events/ilsi-presentations/ 4th April 2013.
  6. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.

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