The low FODMAP diet: Why do I need to see a dietitian?

The low FODMAP diet is now a well-recognised treatment for Irritable Bowel Syndrome (IBS), and many doctors and other health professionals are prescribing it to their clients.

Do a quick Google search, and you’ll find a dizzying amount of information at your fingertips – FODMAP tables, meal plans, product lists, FODMAP apps and do-it-yourself manuals.  The low FODMAP diet certainly is big business these days!  But what we often hear from our clients is that the information out there is confusing, and that many of the Low FODMAP food lists online frequently contradict each other.

Using the internet for dietary information can be helpful, but it can also be quite confusing.

Why is that?!

Well, partly because of the nature of the internet (anyone can start a blog or website about FODMAPs – regardless of their nutrition qualifications or experience with the diet).   And also, because research and testing of foods is constantly underway, meaning that our understanding of FODMAPs continues to evolve.  Foods once thought to be high are sometimes tested again and found to be low.  And different labs have produced quite varying FODMAP results when testing the same foods.

There’s no doubt that having apps, websites and books can be a great tool for those following the diet, and in this day and age, we expect to have such information at our fingertips.  Shepherd Works founder Dr Sue Shepherd, who was an integral part of the team who developed the low FODMAP diet, has authored a number of books on the subject.  But, in Sue’s own words ‘my books were never intended as stand-alone manuals to replace individualised dietary advice from experienced dietitians!’

So what are you missing if you’re trying to do it all yourself with apps, books and online research?  Here’s a few of our thoughts:

An app or book doesn’t know how sensitive you are to different FODMAP sugars.  And neither do you, unless you have trialed the diet, then conducted some systematic challenges to test your individual tolerance.

Which foods should you use to challenge the various FODMAPs?  How much should you test with?  How often?  If honey upsets you, does that mean that asparagus is also out?  And if you seem to react to a challenge, should you then avoid that FODMAP completely, or do you try again with another food, at another time?

These are all good questions, which we spend much of our consultation time exploring with clients.  The bottom line is that it’s a complex business.  Enlisting the help of an experienced dietitian usually results in less restriction and second guessing, and can help you gain a much more complete picture of your individual needs and tolerance.

An app or book will usually only display the current data available regarding the FODMAP content in a specified serve of each food. Essentially, it is a simple and accessible, but rather one-dimensional source of information.  It doesn’t factor in the fat, fibre, caffeine or other natural or added compounds that can cause food intolerance symptoms.  In fact, one of our most common questions is:

‘The list says ‘X’ is suitable, but I’m sure it upsets me – how can that be?’

The answer is that foods and food intolerance symptoms are complex, and not as black and white as many would imagine.  The FODMAP content of food is only ONE factor that can cause symptoms.  An experienced dietitian can help you understand the many different aspects of IBS and food intolerance, why your tolerance may differ from meal to meal and day to day, and help you make sense of your reactions to various foods, and what these mean in the bigger picture.

With over twenty years’ experience at Shepherd Works, we’ve worked with the low FODMAP diet since it’s conception, and we know how helpful it can be for those with IBS and food intolerance. But we also know that overly restricting FODMAPs, stressing over minute details, and checking and double-checking every food eaten in order to achieve the ‘perfect’ formula is NOT the answer for most of our clients.

In fact, narrow, repetitive eating patterns can appear to worsen food sensitivities in some cases.  And it can often mean a less healthy diet and relationship with food.  A phrase that echoes through our consulting rooms every day is that one serve of a high FODMAP food does not make a high FODMAP load.  Nor does it mean that you have mucked it all up, or cheated!

We encourage our clients to lessen their grip on having to ‘get things right’ with their food, or treating FODMAP lists as the holy grail to live by.  We help them understand the complex, and often murky picture of food intolerance, in order to find the best balance for each individual.

Has this post resonated with you?  Click on through to our website, and set the wheels in motion for your own individualised consultation with an experienced dietitian.  What have you got to lose?!