- Does cooking breakdown certain FODMAPs in a way that would make them less problematic?
- I usually cook meals containing onion and garlic and am finding it difficult to add enough flavour to my meals without them. Do you have any suggestions?
- I am sure some low FODMAP fruits still cause me gut symptoms. Is there anything else I should be considering?
- Why are some dried fruits listed as high FODMAP when the fresh fruit is low FODMAP?
- Further clarification regarding the sourdough breads would be helpful. What about the process of making sourdough improves the digestion of the grains?
- Could you please tell us if it's important to have smaller, more frequent meals or if meals need to be spaced further apart to allow for better digestion? Can I eat large meals if I am more hungry?
- Are fats and oils high in FODMAPS? Is there a difference between oils like olive oil and coconut oil?
- Is meat/chicken/fish/shellfish low in FODMAPs?
- I'm not sure what "Low Glycemic Index" or Low GI means for the wine listed in the app.
- Which cheeses contain FODMAPs?
- Specialist Dietitians
1. Does cooking breakdown certain FODMAPs in a way that would make them less problematic?
The types of food processing that we have found have the most dramatic effect on FODMAP content of food are -'canning' and preserving under acid conditions ie. 'pickling'. For example, for canned legumes (lentils and chickpeas) the water-soluble FODMAPs (GOS) 'leach out' of the legume into the brine mixture. Ensure that you discard the brine and wash the legumes before use. For pickled artichokes, the combination of acid (from the vinegar) and the 'leaching' greatly lower the FODMAP (fructan) content of the artichokes. While it is also possible that very high temperatures may also break down FODMAPs, we have found that the extent of this reaction can vary greatly depending on the food being cooked, the temperatures used as well as other cooking conditions. In other words, it is harder to predict how effective the cooking has been in lowering the FODMAP content. We currently can't recommend the use of cooking to lower the FODMAP content of a meal and clearly more research is required in this area. At present the most reliable approach is to use low FODMAP ingredients in your cooking.
2. I usually cook meals containing onion and garlic and am finding it difficult to add enough flavour to my meals without them. Do you have any suggestions?
Garlic and onions are very high in the FODMAP- fructan and so are not suitable on the Low FODMAP diet. However, it is possible to get some of the flavour from onion and garlic in your cooking. We know that FODMAPs are not soluble in oil, therefore sautéing whole peeled garlic in oil for 1-2 minutes to develop the flavour in the oil (followed by removing and discarding the garlic) should be well tolerated by most people. Chapter 14 in the 'About' section of our phone app ('Adding Flavour without Symptoms') also contains a number of suggestions for low FODMAP alternatives to add onion and garlic flavour to foods.
3. I am sure some low FODMAP fruits still cause me gut symptoms. Is there anything else I should be considering?
All fruits we have tested as low FODMAP should be tolerated by most people with IBS at the serving sizes we have specified in the app. Avoid large serves of any fruit and be particularly careful to limit fruit juice and dried fruit to safe quantities (as outlined in our app). There are, however, other dietary components that can induce various reactions (including gut symptoms) in a small number of people. We recommend you consult a Dietitian with experience in food intolerances for further advice in this area.
4. Why are some dried fruits listed as high FODMAP when the fresh fruit is low FODMAP?
Preparation of dried fruit requires 'drying' the fresh fruit to remove the water. This process 'concentrates' all sugars (and therefore FODMAPs) that were present in the fresh fruit. We also detect fructans in dried fruit that are not present in the same fresh fruit. For dried fruit in general, serving size is very important. We advise checking the app for appropriate servings for each type of dried fruit rather than relying only on the overall traffic light rating. Some dried fruits (e.g. cranberries) are only high in FODMAPs if consumed in larger serve sizes (e.g. 2 tablespoons) but a smaller serve (1 tablespoon or less) are low in FODMAPs and should be tolerated by most people with IBS.
5. Further clarification regarding the sourdough breads would be helpful. What about the process of making sourdough improves the digestion of the grains? Brands and recipes would also be great.
We know that the levels of FODMAPs (specifically fructans) are reduced during the sourdough fermentation process. It appears that fructans are used by the yeasts and lactobacilli during fermentation. Therefore certain traditionally-fermented sourdough breads (made from lower FODMAP flours such as spelt and oat) are classed as low or moderate in FODMAP content. However, sourdough breads made from high FODMAP flours (such as wheat and rye) still tend to be high in FODMAPs. The best approach is to ask your baker, which flours are used, how the bread is prepared and if traditional sour-dough techniques have been used (ie. an overnight proving).
We are not able to name brands of bread in the app. The foods listed in the app are an average of a number of products that have been tested. Some bakeries, however, are now part of the Monash University Low FODMAP Certification program – which means we have tested these particular products directly and the companies have agreed to not change their recipe. These certified products are named in the app under ‘Low FODMAP Certified Foods’ in the Food Guide section.
6. Could you please tell us if it's important to have smaller, more frequent meals or if meals need to be spaced further apart to allow for better digestion? Can I eat large meals if I am more hungry?
In line with general dietary guidelines, we suggest eating 3 main meals per day plus 1-2 between meal snacks if required. See “A dietary guide to healthy eating when restricting FODMAPs” in our booklet or app for information about serving sizes and recommended serves per day from each food group to achieve an adequate nutrient intake. If you have additional dietary considerations we advise you seek the advice of a specialist dietitian for more individual recommendations (click here for help on how to find a dietitian trained in this area).
If you are hungry – try including another type of low FODMAP food or perhaps consume a larger serve of a low FODMAP food (if appropriate). Serving size does significantly affect the FODMAP rating of some foods. Consult our booklet or app for more information on whether larger serves of foods you regularly eat contain moderate or high levels of FODMAPs.
7. Are fats and oils high in FODMAPS? Is there a difference between oils like olive oil and coconut oil?
Fats and oils are generally low in FODMAPs as they contain very little or no carbohydrate. However, it is important to note that fats and oils do affect gut motility and, when consumed in excess, can also trigger gut symptoms in some people. Also be aware of oil-based sauces and condiments (such as salad dressings and aioli) as these may contain high FODMAP ingredients such as garlic. Check the ingredients list of these products.
For general good health and to reduce the risk of chronic disease, the current Australian Dietary Guidelines also recommend to limit intake of fats and oils that are high in saturated fat (such as butter, palm oil and coconut oil) and to moderate total fat intake.
8. Is meat/chicken/fish/shellfish low in FODMAPs?Sources of animal protein such as meat, chicken, fish and eggs are generally low in FODMAPs as they contain very little or no carbohydrate. However, beware of potential high FODMAP ingredients added in the preparation of these foods such as breadcrumbs, onions, garlic, marinades and sauces/gravies.
9. I'm not sure what "Low Glycemic Index" or Low GI means for the wine listed in the app.
GI or 'Glycemic Index' is a rating applied to carbohydrate-containing foods according to how much they raise blood glucose levels after eating. Low GI foods are slowly digested and absorbed and therefore result in a more gradual rise in blood glucose levels compared to high GI foods. The low GI wine tested here is high in excess fructose and so intake should be avoided if you malabsorb fructose.
For more information on GI see www.glycemicindex.com
10. Which cheeses contain FODMAPs?
The FODMAP contained in dairy foods (including some cheeses) is lactose. If you do not malabsorb lactose then you do not need to restrict these foods. Ask your dietitian about testing for lactose malabsorption. Generally speaking, hard cheeses and other matured or 'ripened' cheeses (such as brie, camembert and feta cheese) are low in lactose or lactose-free. Cheeses that contain moderate amounts of lactose are cream cheese, ricotta cheese and haloumi cheese. Low FODMAP serving sizes are provided for ricotta and haloumi cheese in our phone app.
11. Specialist Dietitians
Dietary restriction of poorly absorbed FODMAPs is a specialised area of nutrition. We highly recommend that individuals with IBS/Functional Gastrointestinal Disorders seek the guidance of dietitian with experience in this area. We recommend that the Low FODMAP diet is trialed for 2-6 weeks followed by review. The Dietitian will help guide the re-introduction of FODMAP-containing foods (which foods and how much) back into the diet. We recommend you search for Accredited or Registered specialist gastrointestinal dietitians through the official association in their country of practice.
- Australia: www.daa.asn.au 'Find an Accredited Practising Dietitian' Area of Practice 'Gastrointestinal (Bowel/stomach disorders)'
- Canada - http://www.dietitians.ca/Find-a-Dietitian.aspx
- US - http://www.eatright.org/programs/rdfinder/default.aspx 'Find a Registered Dietitian'
- UK – For FODMAP-trained Dietitians see http://www.kcl.ac.uk/medicine/research/divisions/dns/projects/fodmaps/faq.aspx or see www.nhs.uk 'How can I find a registered dietitian or nutritionist?'