You have just been diagnosed with IBS by your doctor and told to try a low FODMAP diet. You then start frantically Googling and very quickly become overwhelmed by all the foods you are now not allowed to eat. You have no idea where to even begin.
This is a common scenario that I’m sure many people with IBS can remember experiencing when they were first recommended a FODMAP diet. This is why working with a FODMAP trained dietitian is so valuable, especially in the beginning when you are trying to work out not only want you can’t eat, but what you actually CAN eat. At this early stage, it is important to keep in mind that the first step of the diet (low FODMAP) only lasts for 2-6 weeks, so these initial food restrictions are only temporary. Even so, if the initial step of the diet still seems like an impossible task, you will be relieved to learn that there is another option…
A ‘gentle’ FODMAP diet may be something that you consider or your dietitian recommends for several reasons. But first, what exactly is a ‘gentle’ FODMAP diet? As the name suggests, this is basically a more relaxed version of the low FODMAP diet that focuses only on removing a number of key, very high FODMAP foods from your diet rather than restricting every high FODMAP food. This can make the diet much easier to follow for those who might struggle with, or do not require the standard version. So, when should a ‘gentle’ FODMAP diet be considered?
The table below is a guide to key foods that are restricted on a ‘gentle’ FODMAP diet. Speak to a Monash FODMAP Trained dietitian for individualized recommendations.
| Grains | Wheat and rye-based products |
|---|---|
| Vegetables | Onion, garlic, leek, cauliflower and mushrooms |
| Fruit | Apple, pear, dried fruit, stone fruit, watermelon |
| Dairy | Milk and yoghurt |
| Meat/alternatives | Legumes |
1. Try keeping a food diary for 2-3 days and then use the Monash FODMAP App to identify the very high FODMAP foods in your current diet. These are typically food that are rated ‘red’ in the app even in very small amounts (e.g. onion) and don’t have a ‘green’ serve listed. Write a list of these key foods to help you keep track.
2. Using your list and the Monash FODMAP App, find similar, low FODMAP alternatives for the key high FODMAP foods that you have identified – for example swap the apple (high FODMAP) you have every day for an orange (low FODMAP) instead.
Always try to find low FODMAP replacements that are from the same food group as the food you are restricting. This will help ensure that your diet remains nutritionally balanced. Work with a Monash FODMAP Trained Dietitian if you can to help you find low FODMAP replacements that suit your individual needs, preferences and local food availability.
3. After 2-6 weeks, move onto step 2 of the diet (reintroduction) and start reintroducing the key high FODMAP foods you have been restricting. You can do this by reintroducing the foods one at a time, over a 3-day period to test your tolerance. Try starting with a small amount on the first day (for example 1/3 of your usual serving of the food) and slowly increasing this over the next two days as tolerated. You can use the ‘Diary’ feature in the Monash FODMAP app to keep a record of your food challenges and symptoms during this time.
4. Once you have completed your food challenges, it is time to add back in the high FODMAP foods that were well tolerated (step 3 of the diet – personalization). Any foods that were not tolerated can continue to be substituted with low FODMAP alternatives from the same food group – however consider repeating food challenges with these foods again in 3-6 months’ time to see if your tolerance has changed.
References:
1. Halmos, E. P., and Gibson, P. R. ( 2019) Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome. Journal of Gastroenterology and Hepatology, 34: 1134– 1142. https://doi.org/10.1111/jgh.14650.
