After creating a highly successful form of fructose malabsorption diet in 1999 in her private dietetic practice, Sue Shepherd went on to become a member of the research team which developed the Low FODMAP Diet. Her PhD research and other studies she was involved in proved that FODMAPs could trigger symptoms of IBS, and in turn, limiting dietary FODMAPs is an effective treatment for people with symptoms of IBS in susceptible people. The low FODMAP diet has been published in international medical journals and is now accepted and recommended as one of the most effective dietary therapies for IBS. Abstracts of these articles are available in the links section of this website.

FODMAPs are found in the foods we eat. FODMAPs is an acronym (abbreviation) referring to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are complex names for a collection of molecules found in food, that can be poorly absorbed by some people. When the molecules are poorly absorbed in the small intestine of the digestive tract, these molecules then continue along their journey along the digestive tract, arriving at the large intestine, where they act as a food source to the bacteria that live there normally. The bacteria then digest/ferment these FODMAPs and can cause symptoms of Irritable Bowel Syndrome (IBS). Symptoms of Irritable Bowel Syndrome include abdominal bloating and distension, excess wind (flatulence), abdominal pain, nausea, changes in bowel habits (diarrhoea, constipation, or a combination of both), and other gastro-intestinal symptoms.

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What are FODMAPs?

FODMAPs are found in the foods we eat. FODMAPs is an acronym for

  • Fermentable
  • Oligosaccharides (eg. Fructans and Galacto-oligosaccharides (GOS))
  • Disaccharides (eg. Lactose)
  • Monosaccharides (eg. excess Fructose)
  • And
  • Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

Where are FODMAPs found?

A few examples of food sources high in each of the FODMAPs are listed below. The list is not complete, and is subject to change as new data becomes available regarding the FODMAP content of foods. The dietitians at Shepherd Works can provide you with a more complete and up to date list of foods during a consultation.

  • Excess Fructose: Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup

  • Fructans: Artichokes (Globe), Artichokes(Jerusalem), Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder), Spring Onion (white part), Shallots, Wheat (in large amounts), Rye (in large amounts), Barley (in large amounts), Inulin, Fructo-oligosaccharides.

  • Lactose: Milk, icecream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).

  • Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils, Chickpeas

  • Polyols: Apples, Apricots, Nectarines, Pears, Plums, Prunes, Mushrooms, sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and isomalt (953).

What does the low FODMAP diet involve?

The Low FODMAP Diet has two phases. It is recommended that you consult with an experienced dietitian who specialises in teaching the low FODMAP diet for both phases, as FODMAP intolerances are unlike other conditions that have a unique cause and a simple fix – they can affect everyone differently and therefore require an individualised treatment approach.

As a general outline, the two phases are described below, however remember there is no “one-size fits all” approach – the Low FODMAP Diet is most effective and nutritionally adequate when it is tailored to you with a dietitian. It is important you don’t rely on reading information on the internet, books and other literature to self-diagnose and follow the diet on your own. We strongly recommend consulting with your medical practitioner first for diagnosis, then working through your symptoms and diet with a specialist dietitian from Shepherd Works to ensure you follow the diet that is just what YOU need.

Phase 1
The first phase of the Low FODMAP Diet generally involves the strict restriction of all high FODMAP foods for 4-6 weeks. The dietitian will help identify these foods and will suggest alternatives to ensure the diet is nutritionally adequate. The symptom response over this period should be noted, and a review appointment with the dietitian will then provide guidance on the second phase.

Phase 2
The second phase is where foods that were restricted in the first phase are reintroduced gradually and the diet is liberalised to suit each individual. This is where the type and amount of FODMAPs that can be tolerated by the individual are identified so that their longer term diet can be established. It is very important to determine the level of FODMAPs that can be comfortably tolerated, so that the prebiotic effects of FODMAPs can be enjoyed and the diet is not overly restricted. The dietitian will provide guidance on the reintroduction process to help minimise symptoms and to ensure maximum variety is achieved in the diet. The end result should be a long term diet that is lower in the problematic FODMAPs for the individual than were originally consumed, but is not as FODMAP-restricted as the first phase of the diet.

Note: This is a LOW FODMAP Diet, not a NO FODMAP Diet. Eliminating all FODMAP foods from the diet over the long term is not desirable or recommended. We strongly recommend you consult with an experienced dietitian from Shepherd Works to guide you through all aspects of the Low FODMAP Diet.

Where can I get advice?

For expert dietitian advice, please book an appointment with one of the Shepherd Works dietitians on +613 9890 4911, or click here to submit an appointment enquiry online.

Day time and early evening appointments are available. For people who live interstate, overseas or are unable to make it to one of our practice locations, Shepherd Works offers popular phone & Skype consultation services – please phone +613 9890 4911 or complete the online booking details to arrange.

Where to next?

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