Getting started on the low FODMAP diet
So. You’ve decided you’re going to start the low FODMAP diet. Or perhaps you’re thinking of starting, but have no idea where to begin? Maybe you’ve searched “foods low in FODMAPs” on the internet and have come up with countless, sometimes conflicting lists. Which one is right? Do I really have to stop eating all those foods?! you’re asking yourself. And potentially, you’re so sick and tired of feeling sick and tired that you’re just desperate to try anything, anything that will help you feel better. Hopefully not, but don’t worry — I’ve been there too. Whatever the case, chances are you’re feeling just a little overwhelmed, so, I’ve got your back. Today we’re going to talk about some good places to start with the low FODMAP diet, and I’ll talk about two paths for moving forward.
The first thing to start is with your mindset. When I actually started the FODMAP diet (I don’t count the period of time where I kinda didn’t eat some things but kept eating others… like wheat…), I was in a pretty desperate place and felt miserable all the time. Now, while I wouldn’t wish that experience on anyone else, ever, it might help to be a little desperate when you start this. I’m gonna be real with you here: the low FODMAP diet is hard. It takes time, effort, and commitment. But. For me, the work of cutting a lot of foods out of my diet and finding new things to eat was so worth the way I felt and continue to feel. If you focus on how you feel — like, it’s been x days since I’ve felt bloated and miserable! — it will help keep things in perspective, and get you through the hard work. Eventually eating on the diet will become second nature, I promise.
Support + Resources
Another way to make starting the diet easier is to find someone (or a few someones) to support you. For me, this was Marc taking time to learn the science behind the diet with me, and just being another person in the room who understood what I could / couldn’t eat. The people I lived with at the time were also a wonderful support group, encouraging me to experiment with gluten free baked goods, and helping me eat them! My advise would be to find someone you know well who’s willing to learn a little about the diet — a significant other or a roommate are likely candidates.
That being said, there is no substitute for a postgraduate education, and I highly recommend seeking out a trained professional — that is, a trained dietitian — to help you as you embark on this journey. This shit is complicated, and I really wish I had gotten some outside help sooner in my life. Luckily, the low FODMAP diet is so much more widely recognized and accepted, so you should be able to find someone who’s at least heard of it.
For many more resources, read my original post on IBS where I link to people, organizations, books, and apps that have been helpful to me along the way!
Finally, a few concepts to keep in mind as you begin. The first two are serving size and accumulation. The FODMAP content of any food depends on it’s serving size — 10 almonds are considered low in FODMAPs but 15 or 20 are high and will most likely cause problems. Also, it’s important to consider your FODMAP content throughout the day. Ten almonds on their own are fine, but if you add in coffee with cow’s milk, and maybe chicken that’s been cooked in garlic, and some sweet potatoes, and a sugary dessert… well then chances are you’ve accumulated enough FODMAPs in your system to feel miserable.
Another really important concept that I wished people had been talking about more when I started all this: the low FODMAP diet is temporary. Yep, you heard me. TEMPORARY. The ultimate goal in eliminating food groups is to find YOUR OWN tolerance levels and reintroduce as much variety as you can. Keeping a restrictive diet for a long period of time can do some serious damage to your immune system — something I learned firsthand! So whichever method you choose, please don’t skip out on reintroducing foods.
Alright, so how does one start actually following the low FODMAP diet? There are a couple of ways to approach this, so I’ll explain them below:
Method #1: The Elimination Diet
This first method is the most popular and widely discussed. Pioneered by Patsy Catsos in her book IBS: Free at Last!, the elimination diet is pretty much what it sounds like. The idea is you cut out all foods with FODMAPs, and then one at a time, you test each group of FODMAPs to see which ones you’re sensitive to (remember, each letter in “FODMAP” refers to a type of carb). Spoiler alert: I did not follow this method. (More on that in method #2.) However, lots of people have found success with this approach, but it is time-consuming to test one FODMAP at a time.
Some reasons to do the elimination diet:
- You want to know exactly which types of FODMAPs bother you, and in what quantities.
- You have severe IBS symptoms or other food allergies and you know you’re going to have to be strict with the foods you eat.
- You want / need a step-by-step method to start the diet because you’ll respond best to that or won’t follow through otherwise
Reasons not to / Limitations:
- It’s time-consuming (2 weeks for total elimination, 1 week for each FODMAP = 7 weeks total)
- You need to cut out all FODMAPs so eating out and eating at social events is basically impossible
- IBS symptoms are provoked by other factors such as stress, hormones, exercise, etc. which means that the results you get from the elimination phase are only telling one part of the story, and can be affected by things other than food.
- You’re not a detail-oriented person, and recording what you eat, when you eat it, and how it made you feel sounds more miserable than your indigestion
The elimination diet is pretty time-consuming, but worth it if you want/need exact information about which groups of FODMAPs bother you.
Method #2: Wing it
Like I mentioned above, I did not follow the elimination diet. I am not a detail-oriented person, and after reading Patsy’s book I felt like the information I would gain from following the elimination method just wouldn’t be helpful to me — I wasn’t going to remember the details of what I ate and how it made me feel anyway! So after studying the diet pretty extensively and internalizing all that information, the understanding I developed was much more: All foods, to some extent, have FODMAPs — some more than others. To the best of my ability, I eat the least amount of FODMAPs as possible. By keeping my FODMAP ingestion low, I’m able to eat a little of whatever I want — a bite of garlic bread, half a homemade cookie, some ice cream… you get the point.
When I decided to commit fully to the low FODMAP diet, I did cut out everything, in a similar fashion to the elimination diet. I was desperate to feel better so I wanted nothing to do with FODMAPs. Gradually, as I started to feel better, I began to be a little more lax, but instead of introducing one FODMAP type at a time, I just ate what I wanted — a nibble of someone else’s sandwich, a coffee with cow’s milk. The crucial step here is that, if I ever start to feel bloated again, I think about what I’ve eaten that week. If I’ve been feeling miserable for a few days straight, I go back to no FODMAPs at all until I feel better. I’ve also gotten practiced at noting when I’m eating something that could be problem-causing. I’ve learned to subconsciously keep a running list of potential triggers in my head, and this helps me when I see a plate of homemade cookies: I can say, ‘no, that will make me feel gross,’ or ‘yeah, I’ll probably be ok if I eat that.’
Note: Dr. Megan Rossi details a similar approach in her book “Eat Yourself Healthy” that she calls the “FODMAP lite” approach — where you cut out some of the most common sources of FODMAPs (garlic, apples, milk, etc.) and then find your own tolerance. Give the book a read if you’d like to learn more!
Reasons to just wing it:
- You don’t have the mental energy or social schedule to follow a strict elimination diet
- You’re more of an intuitive person, especially when it comes to your diet
Reasons not to:
- Cutting out too many FODMAPs can lead to malnutrition (see paragraph above)
- You struggle with being in tune with how your body feels, and you would be better off following a more strict method
- You have severe IBS symptoms or other food allergies.
A less structured approach can be a great alternative to the elimination diet, but it does take some practice to be useful.
You made it! Thanks for reading this insanely long post!
I just want to conclude with a clarification: I know I’m obviously biased, but really truly, one method is not better than the other. These are just a few examples of what I and other people have done, but no two people are going to follow the diet the exact same way. And that’s the point of the low FODMAP diet, actually: you customize the diet to fit your body and your lifestyle. That can be overwhelming at first, so I hope this was helpful to get you started on the diet (or a nice reminder if you’ve been following it for awhile). Feel free to ask me any questions you have or share things you’ve found that have helped as well!
Cheers! (Anyone else really hungry for a cookie now??)
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