If you have recently been diagnosed with Irritable Bowel Syndrome (IBS) and you have gastrointestinal symptoms that make your everyday life difficult, your doctor may have already advised you to try the Low FODMAP Diet. This is a specialized diet that you should only follow under the guidance and supervision of a registered and trained dietitian. Below you can find a list of foods and basic guidelines for the Low FODMAP Diet.
Disclaimer: The information below is provided only for information purposes and it has no intention of replacing or substituting your dietitian’s or physician’s advice and expertise. If you have been diagnosed with IBS, you should make changes to your diet and lifestyle according to your doctor’s and dietitian’s advice. If you have gastrointestinal symptoms and you suspect that you may be suffering from IBS, you must visit a gastroenterologist or general physician before attempting any change to your diet.
You can read more about FODMAPs and IBS here.
Which foods are low-FODMAP?
In the table below, you can see all the high-FODMAP foods that should be avoided from each food group and their low-FODMAP alternatives that you can include in your diet.
| FOOD GROUP | High FODMAP | Low FODMAP |
| Dairy products and dairy substitutes | Cow milk Goat milk Sheep milk Evaporated milk Sweetened condensed milk Buttermilk Kefir Soy milk (made from whole soy beans) Yogurt Butter Custard Ice cream Cottage cheese Cream cheese Mascarpone Ricotta Other soft unripened cheese types | Lactose-free milk Lactose-free yogurt Lactose-free milk products Almond milk* Oat milk* Rice milk* Soy milk (made from soy protein) Parmesan Cheddar Feta cheese Mozzarella Pecorino Swiss cheese Brie Camembert cheese Other hard ripened cheese types *Check for additives (see guidelines below) |
| Fruit | Apple Apricot Avocado Blackberry Cherry Fig Mango Nectarine Peach Pear Persimmon Plum Pomegranate Prune Watermelon Dried fruit* (See guidelines below.) | Banana (not too ripe) Blueberry Cranberry Cantaloupe Grapes Grapefruit Honeydew mellow Kiwi fruit Lemon Lime Orange Pineapple Raspberry Strawberry Tangerine |
| Vegetables | Artichoke Asparagus Beetroot Broccoli Brussel sprouts Cabbage Cauliflower Celery Fennel Garlic Green peas Leek Mushrooms Okra Onion Shallot Spring onion (white part) Sugar snap peas Sweet corn Sweet potato | Arugula Carrot Capsicum (Bell pepper) Cucumber Eggplant (Aubergine) Ginger Green beans Kale Lettuce Olives Potato Pumpkin Spinach Spring onion (green part) Squash Tomato Zucchini |
| Grains and cereal products | Wheat Rye Barley Wheat/rye/barley bread, pasta & cereal products | Gluten-free bread, pasta or cereal products* Rice Oats Corn flakes Quinoa Polenta (cornmeal) Millet Tapioca *Check for additives (see guidelines below) |
| Legumes / Pulses | Beans Chickpeas Lentils Soybeans | *The FODMAP content of most pulses can be reduced with proper preparation and cooking. (See guidelines below.) |
| Seafood / Meat products | Processed meat products* Marinated meats/poultry/seafood* *Check for additives (see guidelines below) | Plain cooked seafood/poultry/meat Eggs |
| Sweeteners / Food additives | Honey Fructose HFCS (High Fructose Corn Syrup) Sorbitol Mannitol Maltitol Xylitol Isomalt Inulin | Sugar Glucose Stevia* Sucralose Artificial sweeteners not ending in -ol Psyllium *Check for additives (see guidelines below) |
| Nuts / Seeds | Cashews Pistachios Almonds Hazelnuts | Chestnuts Macadamias Peanuts Pecans Pine nuts Walnuts Chia seeds Flaxseed Pumpkin seeds Sesame seeds Sunflower seeds |
General guidelines
The aim of the Low FODMAP diet is to reduce the intensity of IBS symptoms and try to pinpoint which foods actually trigger or worsen those symptoms. For the diet to be successful, there are some important things the patient needs to keep in mind.
1. For the whole duration of the Low FODMAP Diet, it is really important that you follow an overall healthy lifestyle. Adequate sleep, regular exercise, healthy ways of cooking, balance and moderation in all aspects of life will definitely help with the success of the diet.
2. Stress is one of the known triggers of IBS symptoms. During the Low FODMAP Diet, it is advisable to try to avoid known stressors in your life. If this is easier said than done as it is for most people, you could at least try to make some time in your day for things that you know will help you relax and release tension.
3. The effect of foods containing FODMAPs on the digestive system of people with IBS is portion sensitive. That means that the same food that won’t cause any symptoms in a small amount could cause really bad symptoms if you eat it in a larger quantity. The foods that appear in orange in the above list can actually be consumed in small amounts even though they are high in FODMAPs. For example, a small handful of almonds, about 6-8, will probably not cause any harm but a whole bowl of them will result in a really high FODMAP consumption.
4. Reading food labels is important for every consumer, but it is really crucial for someone who follows the Low FODMAP diet. Many of the simple carbohydrates that belong to the FODMAP category are used by the food industry as sweeteners and food additives. So even if a packaged, processed food is generally considered safe, we can only be sure after we check the ingredients’ list and make sure there are no additives like polyols, lactose, fructose, grain extracts, etc.
5. Milk substitutes like rice milk, oat milk and almond milk are generally safe to consume. However, many of them are artificially sweetened and we should check the ingredients to make sure that allowed sweeteners have been used.
6. Dried fruit should be avoided during the Low FODMAP diet, even the ones that belong to the low FODMAP category when they are fresh. The reason is that the dehydration process causes the percentage of FODMAPs, like fructose, to actually increase. So, even if grapes, for example, are low FODMAP fruit, raisins aren’t.
7. Gluten is not a FODMAP but it is found in grains that are also high in FODMAPs. Gluten-free products are not manufactured for IBS patients but for patients with coeliac disease. Even though they are generally considered safe to consume in a Low FODMAP Diet, we should always check the ingredients’ list before buying them. Some of them contain legume flours like chickpea flour or lupin flour which are among the highest FODMAP foods. Cereals and cereal bars may contain sweeteners or honey. Additionally, in order to help people with coeliac disease increase their fiber intake, food manufacturers may add inulin to gluten-free products which is also not allowed in a Low FODMAP diet.
8. Most pulses and legumes like lentils, chickpeas, soy and almost all kinds of beans are high in FODMAPs. But they are also high-protein foods and for many people, especially those who follow a vegan lifestyle, they can be the main source of protein. Fortunately, we can make them more easily digestible and significantly lower their FODMAP content if we soak them for 12-24 hours prior to cooking. We can also change the boiling water after the first 5-10 minutes of boiling them and then continue to cook them as usual. And, of course, we must not forget that their FODMAP effects are also portion sensitive.
9. Meat, poultry, fish and seafood do not contain FODMAPs. However, processed meat like sausages, ham and other luncheon meats usually contain additives. We should always check the ingredients’ list.
10. Stevia is a natural low FODMAP sweetener. But stevia products are most of the time mixtures of stevia and other sweeteners like maltitol, isomalt and sorbitol. In many cases, the content percentage of the other sweetener is much higher than that of stevia so you should choose your sweetener carefully.
11. Pay special attention to products like chewing gums, candy, confectionery and packaged products that are labelled no-sugar or light. They tend to contain big amounts of sweeteners and you need to know what kind before you consume them.
Conclusion
The Low FODMAP Diet is a specialized dietary plan that can help you manage your IBS symptoms and find the foods that may worsen your condition. It should always be followed under the guidance and supervision of a registered dietitian and only if you have been medically diagnosed with IBS. Adherence to the diet guidelines and to a healthier lifestyle overall will help you and your dietitian create a personalized nutrition plan that can help you manage your condition in the long term.
Resources
https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/
https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome
