A new study has uncovered that if you have Irritable Bowel Syndrome, you don’t need to cut out all FODMAPs to get relief from IBS! This is welcome news to everyone with IBS as as the FODMAP diet is overly restrictive, complex and often completely impractical. Currently there are Four Therapies to Treat IBS, but the FODMAP diet is often recommended as a first line of therapy. The FODMAP diet is backed by strong evidence that it improves symptoms in 75% of people living with IBS. The promising results of this new study shows you don’t need to cut out all FODMAPs to get relief from IBS!
Why is the original FODMAP diet overkill?
The FODMAP diet is arguably the most difficult diet to follow for patients. Even digestive dietitians who are experts in the FODMAP diet, often comment that the diet is very confusing, constantly changing and difficult to learn. Further, there is a growing concern in the medical community that the FODMAP diet may negatively impact gut health in those who follow it long term. Wait, what… so I don’t need to avoid avocados?
Why try a modified FODMAP?
The FODMAP diet identifies at least 100 common problematic foods that must be avoided during Phase 1 of the FODMAP diet. For more information about the FODMAP diet, read this complete guide to the 3 phases of the FODMAP diet. The list of FODMAP foods is at least 10 pages long and seems arbitrary; oranges are ok but apples are not, cornbread is ok but corn on the cob is not, almond milk is ok but almonds are not. The list goes on and on.
But what if not all FODMAP foods cause problems?
What if just a fraction of the high FODMAP foods cause the most problems? In fact, just two of the five FODMAP subgroups fructans and galacto-oligosaccharides (GOS), were found to be most likely to trigger IBS symptoms in a double-blind trial. On this hunch, researchers want to know if you avoid these two key clusters of foods, can you still get relief?
What are fructans and GOS?
Fructans include: garlic, onion, wheat, and a few fruits (watermelon, grapefruit, nectarine, persimmon, plums, pomegranate, ripe bananas, dates, prunes and raisins).
GOS include: legumes (such as chickpeas, lentils, and kidney beans), tofu, almonds and brussel sprouts.
Can a Simplified FODMAP Diet Work too?
Singh et al. asked this question when he studied people with IBS-D to compare the low FODMAP diet to a much simplified version. The study was a double blind, randomized controlled trial and was published in May 2024:
The simplified FODMAP diet only eliminated two of the five FODMAP subgroups: fructans and GOS. So one group of people had to cut out hundreds of foods and the other group only had to cut out wheat, garlic, onion, beans, almonds and brussel sprouts.
Simplified FODMAP Diet Study Results:
- The simplified FODMAP group had fewer dropouts.
- The simplified FODMAP group also significantly improved their symptoms.
While both diets were effective at reducing symptoms, the simplified FODMAP group improved symptoms to a somewhat lesser extent, compared to the FODMAP group. Importantly, the simplified FODMAP group was easier to stick to.
What does this mean for Patients with IBS?
This study suggests that the first-line therapy for IBS doesn’t need to be the FODMAP diet. Instead, practitioners can recommend a simplified FODMAP diet as a stepwise approach, in conjunction with the other treatment therapies to treat IBS. By eliminating, garlic, onion, beans and wheat, patients can improve their symptoms. Working with a digestive dietitian can also help identify effective supplements to help IBS symptoms. This approach can help minimize the negative risks of the FODMAP diet, such as nutritional deficiencies, social isolation and increased time and cost burden of meal preparation.
If you have IBS, work with a dietitian to try the simplified FODMAP diet that eliminates just fructans and GOS. Book with Cristina today.
