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Irritable Bowel Syndrome & Fodmaps

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Irritable Bowel Syndrome & Fodmaps IRRITABLE BOWEL SYNDROME & FODMAPS What is Irritable Bowel Syndrome? IBS is a chronic condition of thE GI tract that can includE symptoms such as: diarrhea, abdominal pain, bloating, constipation, and cramping. It is not uncommon for IBS suffErErs to havE long pEriods without any issuEs and suddEn return of symptoms brought on by triggErs such as cErtain foods, illnEss, or stress. IBS can increasE an athlete’s stress and anxiety and intErfErE with training and performancE, so it is important to control and prEvEnt symptoms whErE possiblE. Almost two thirds of IBS patiEnts report that thEir symptoms arE rElatEd to food1. But the exact relationship betwEEn IBS and food rEmains poorly understood leaving treatment options limited. What are FODMAPs? As mEntioned abovE, many IBS suffErErs rElatE symptoms to Eating cErtain foods. RecEntly, intErEst has grown in a group of short-chain carbohydratEs, which have bEcomE known as FODMAP foods. FODMAPs stand for FErmEntablE, OligosaccharidEs, DisaccharidEs, MonosaccharidEs and Polyols. FODMAPs are a group of quickly fermented, short-chain carbohydratEs (sugar) molEculEs and sugar alcohols (a typE of caloriE-reducEd swEEtenEr) found in many everyday foods. Some individuals poorly absorb FODMAPs which results in gastrointestinal (GI) side effects including abdominal pain, cramping, bloating, excess gas, constipation and/or diarrhea. High FODMAP foods cause such symptoms because they are poorly absorbed in thE small intestinE and as a result, when they move into the largE intEstine they draw in watEr. ThEy are also quickly fErmEntEd by gut bactEria, yiElding by-products including gas. What is a FODMAP diet? A FODMAP diEt involvEs an elimination diet where high FODMAP foods are avoided and replacEd with low FODMAP foods. This list is devEloped in Monash UnivErsity in Australia and is continually updatEd as morE foods are analyZEd. Who should follow a low FODMAP diet? ThE first stEp whEn experiencing any common symptoms associated with IBS is to spEak with a doctor who will assess symptoms and refer to thE appropriate health practitioner. This may involvE sEEing a DiEtitian to explore a low FODMAP diet plan. In ordEr to sEE thE bEst rEsults from thE low FODMAP diet it is nEcEssary to follow thE plan strictly for 6-8 weEks. It is important to mEEt with a Dietitian to ensurE that low FODMAP alternatives are included in order to meet nutritional needs for health and training. IdEally, this intErvEntion should takE place in thE post season or prEparatory season, and not in thE compEtitivE season. ThE FODMAP diet is undertaken in two stages. The first stage consists of rEmoving all high FODMAP foods from thE diEt for 6-8 wEEks in ordEr to sEE if symptoms improvE. During the second stage, thE eliminatEd food itEms should bE rEintroducEd into thE diet, with supervision, in a spEcific order to sEE which foods can bE tolErated and which cause symptoms. ThE following tablE providEs a list of ExamplEs but should not bE followEd without the advicE of a qualified practitioner. A SPORTS NUTRITION PUBLICATION © THE UBC DEPARTMENT OF ATHLETICS AND RECREATION, JUNE 2017 Athletes and FODMAPs • During ExtEndEd ExErcisE, if you normally consumE carbohydratE-basEd Energy foods or drinks makE surE to avoid those madE with fructose, honey, high fructosE corn syrup, or high FODMAP fruits. Good options arE banana, Clif shots, Clif shot bloks or Gu chomps. • If chocolatE milk is a rEgular post-exercise snack for you, a good alternative is lactosE frEE chocolatE milk such as almond or soymilk. Group High FODMAP foods Low FODMAP foods Vegetables ArtichokEs, asparagus, bEEtroot, chicory Bok choy, bean sprouts, bell peppers, garlic, leek, onions, onion and garlic salt or cucumbEr, buttEr lEttuce, carrots, chives, powders, radicchio lEttucE, spring onions eggplant, green beans, tomatoes, potatoes, (white part), cauliflowEr, greEn pEppEr, spinach, bamboo shoots, Eggplant, grEEn mushrooms pumpkin, snow peas, broccoli beans, parsnips, pumpkin, spring onion (greEn), fennEl bulb and lEavEs, spaghetti squash, tomato juice Onion/garlic substitutEs: garlic-infusEd oil Grains Barley, rye or wheat (in large portions), GlutEn-freE breads/cEreals, spElt brEad/cErEal fructooligosaccharidEs, inulin products, ricE and corn pasta, ricE cakEs, corn tortillas Fruits ApplEs, avocado, boysEnberriEs, figs, Bananas, blueberries, grapes, honeydew mangoEs, pEars, watErmelon, apricots, melon, kiwifruit, lEmon, lime, mandarin blackberriEs, cherriEs, longan, lychEEs, orangEs, navEl orangEs, passion fruit, nectarines, peaches, pears, plums, prunes raspbErriEs, strawbErriEs, tangElos, most fruit juicEs, grapEfruit, pomegranatE, cantaloupE, frEsh pinEapplE, cranbErry juice driEd cranberriEs, raisins grapes Dairy Milk (cow, goat or shEEp), custard, LactosE-freE milk and milk products, ricE milk, condEnsed and EvaporatEd milk, dairy almond milk, coconut milk, gElato, sorbEt, dessErts, icE crEam, margarine, powderEd buttEr, hard cheeses (swiss, cheddar, feta, milk, yogurt, soft and unripEnEd chEEsE goat, Havarti, moZZarella), soft cheEsEs (briE (ricotta, cottagE, cream, mascarponE) and camembert) Legumes and Baked beans, borlotti bEans, kidnEy bEans, Legumes, firm tofu, walnuts, almonds, nuts chickpEas, lEntils, soybEans, cashEws, peanuts, pecans, pine nuts, macadamia nuts, pistachios and sesame seeds Sweeteners Agave, corn syrup solids, high-fructosE corn Sugar, glucosE, brown ricE syrup, dextrosE, syrup, honey, sorbitol, mannitol, xylitol, other artificial swEEtEners not Ending in ‘-ol’ maltitol, isomalt (ex/ aspartamE, SplEnda, Stevia) Alcohol Rum, sparkling wine, cider, dessErt wine Gin, vodka, scotch, whiskEy, dry white winEs, red winE, somE bEErs AdaptEd from: BarrEtt S. J., and Gibson R. P. (2012). FermEntablE oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallErgic food intolErancEs: FODMAPs or food chEmicals? ThErapEutic Advances in. Gastroenterology 5(4) 261-268. **PlEasE spEak with your Sports DiEtitian for furthEr information** 1. SimrEn M, Mansson A, LangkildE AM, et al. Food-related gastrointestinal symptoms in thE irritablE bowEl syndromE. DigEstion. 2001;63:108–115 A SPORTS NUTRITION PUBLICATION © THE UBC DEPARTMENT OF ATHLETICS AND RECREATION, JUNE 2017 .
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