A Low FODMAP diet
Fermentable, oligosaccharides, disaccharides, monosaccharides and polysols is a mouthful in more ways than one.
This group of foods is poorly absorbed by people who suffer from irritable bowel syndrome or what is commonly referred to as IBS.
Most people have something that bothers them when they eat it, and they know that abstaining will keep them from the bloating, pain or reflux it may cause. But for those diagnosed with IBS, there is an entire group of foods, commonly referred to as FODMAPs, that triggers IBS symptoms.
"The lumen of the intestine, the pipe itself, becomes distended," says Dr. Stephen Strohlein, a gastroenterologist with St. Luke's Health Network. "It's a visceral hypersensitivity that people without IBS wouldn't even feel."
Those with IBS are much more sensitive to these changes. Most patients report abdominal pain, change in motility (diarrhea, constipation or both) and bloating, says Strohlein.
One of the ways that health care professionals are helping IBS patients is by prescribing a low FODMAP diet.
"Foods that contain certain short-chain carbohydrates, glycol alcohol, are very small molecules," said Strohlein. "In the system they change liquid content very quickly. This causes poor absorption, quickly ferment and create a lot of gas and water in the gut. This is what causes the pain and bloating."
Strohlein said stress also plays a big factor in IBS.
"Stress doesn't cause IBS, but your brain and your gut are hooked up. By dealing with stress and diet, we can control the symptoms to some degree."
Strohlein says the low FODMAP diet has been around for a long time. Studies have shown that when a patient is true to the diet, there is a 74 percent improvement in symptoms. In his own practice, he has seen an improvement rate of closer to 70 percent.
"It takes a team of dedicated health care professionals to properly diagnosis and treat IBS," he says. "The primary care physician needs to refer the patient to a gastroenterologist to rule out other pathologic issues, like colitis and Crohn's disease. There also has to be someone to help with diet and lifestyle changes."
Strohlein refers his patients to a nutritionist for help with diet. Some patients are also referred to mental health professionals for help dealing with stress and anxiety.
Rhianna Cenci is a registered dietitian at ShopRite of Brodheadsville. She often meets with those who have been given the diet and come to her for assistance.
"The diet can get a little confusing, since some fruits and vegetables are limited due to the different carbohydrates they contain," she says. "FODMAPs are different carbohydrates (or sugars) found in food that are not digested or absorbed as well as others. FODMAPs include fructose, lactose, fructans, galactans and polyols."
For example, an orange is a low FODMAP food, but an apple is not. You can eat broccoli, but not cauliflower; cantaloupe, but not watermelon.
"Most proteins are low in FODMAPs, so make sure to include lean protein sources like fish, chicken or turkey into your meals and snacks, as well as nuts, nut butters and seed," said Cenci. "Pair natural almond butter with a banana for a balanced low-FODMAP snack."
Cenci suggests that when starting out on a low FODMAP diet you eliminate all of the foods on the list for one to two weeks. Once symptoms have stopped, reintroduce some of the foods to see what your body can tolerate and which are causing your symptoms.
Cenci says that the low FODMAP diet is a good starting place for anyone who is experiencing stomach pains or bloating after eating. If you think it might help, she suggests giving it a try.
ShopRite offers Cenci's services free of charge. She can be reached by contacting the store to set up an appointment for individualized nutrition counseling and recipe ideas. Or contact your health care professional for a referral to a nutritionist.
There are also several food companies that have introduced lines of food geared to low FODMAP users. Most recently Nestle has introduced a line of meal replacement shakes called PRONURISH which are advertised specifically for low FODMAP diets.
Amazon carries a number of different companies which makes shopping on one site more convenient, but it is more expensive than going directly to the manufacturer's site in the case of FODY Food Company.
The following recipes are dietician-approved for use in a low FODMAP diet.
Frittata
Makes 2 to 4 servings.
1 medium zucchini, sliced thin
1 bunch scallions, only the green tops, sliced
4 strips cooked bacon, crumbled
3 large eggs
¼ cup grated Parmesan cheese
2 teaspoons olive oil
Nonstick cooking spray
Salt and Pepper
Add olive oil to a heated sauté pan. Add zucchini and green onion tops and cook till zucchini is almost translucent, careful to avoid over browning. Lightly season with salt and pepper. In a separate bowl, add eggs, cheese and a pinch of salt and pepper. Whisk together. Add the sautéed zucchini mixture to egg mixture and stir in bacon crumbles. Heat a clean, ovenproof sauté pan and spray with cooking spray. Add final mixture to the pan and cook on medium-heat until set. Finish in a 400 F oven for about 10 minutes. The finished frittata should slide out onto a serving dish.
Grab 'N' Go Bars
2 cups vegan marshmallows (not made from corn syrup)
3 cups rice cereal (or any gluten-free cereal you choose)
½ cup creamy natural peanut butter
¼ cup raw almonds, chopped
1 cup unsweetened craisins (dried cranberries), divided in half
Nonstick cooking spray
Add the cereal, almonds and half of the craisins to a large mixing bowl. Using a microwave-safe dish, heat peanut butter in the microwave for 35 seconds, stirring about halfway through heating. Pour melted peanut butter over the mixture, then add 2 cups of melted marshmallow to the bowl. Spray hands with cooking spray and use them to mix ingredients together well. Use nonstick spray to coat an 8-inch by 8-inch glass dish and press the cereal mixture into the glass dish. Sprinkle the other half of craisins on top and press into the mixture. Refrigerate overnight to set. After refrigerating, cut into bars or squares.
Mediterranean Garbanzo Bean Salad
Serves 4
Dressing:
2/3 cup quinoa
1/4 cup olive oil
1 1/3 cups water
2 tablespoons balsamic vinegar
1 (15-ounce) can garbanzo beans/chickpeas (drained, rinsed)
6 basil leaves, chopped
1/2 medium cucumber, diced (about 3/4 cup)
1 cup halved cherry tomatoes
2 scallions, sliced, (green tops only)
Optional: 1/2 cup mozzarella cheese, cut into small cubes
Cook the quinoa with water according to package directions (about 15 minutes). Transfer to fridge to cool. In a small bowl whisk together the olive oil, balsamic vinegar, and chopped basil. Set aside. In a medium bowl, stir together cooked quinoa, chickpeas, cucumber, tomatoes, green onions, and mozzarella cheese. Drizzle with dressing and toss to combine.
Note: Quinoa is used in cooking like a whole grain, but it is actually a gluten-free seed. It is a great substitute for rice in any recipe, and is a good source of iron, protein and magnesium.
Chickpeas are the only bean included in the low-FODMAP diet.
Recipe adapted from http://www.swbeans.com/recipe/mediterranean-garbanzo-bean-salad/ and provided by Rhianna Cenci, retail dietitian at Kinsley's ShopRite of Brodheadsville.
