The low-FODMAP diet moderates or restricts the consumption of certain carbohydrates, benefiting individuals with gastrointestinal problems.
The low-FODMAP diet is not one of the thousand miracle diets that have already saturated the summer market. In fact, it is a form of diet whose benefits can be enjoyed throughout the year, although it should only be recommended in certain cases, and it is not without its disadvantages. A diet low in FODMAPs, as its name suggests, involves the application of certain dietary restrictions, which is why a health professional trained in nutrition should always guide it.
In this case, the low FODMAP diet has been shown to improve symptoms of diseases such as dyspepsia or "upset stomach", irritable bowel syndrome, and even non-celiac gluten sensitivity or inflammatory bowel diseases (ulcerative colitis and disease Crohn). However, and although there are many who mistakenly think that it can improve constipation, at the moment there is no evidence in this regard.
What is the low-FODMAP diet?
The acronym FODMAPs refers to a group of carbohydrates; In its English acronyms they are Fermentable-Oli-Di-Monosacharides And Polyols (fermentable oligosaccharides, disaccharides, monosaccharides and polyalcohols). It is a type of hydrates or "sugars" that are poorly absorbed in the small intestine, and that are rapidly fermented by intestinal bacteria.
It should be noted, however, that not all short chain carbohydrates or HCCC are FODMAPs, but only those that are fermentable as they are poorly absorbed by the small intestine.
Foods rich in this type of carbohydrate, being more complicated to process due to their poor intestinal absorption, can cause symptoms such as abdominal bloating or bloating, gas, or altered bowel movements (constipation, diarrhea or alternate episodes of both). This type of dietary approach is not new, but was already mentioned in the late 1990s at Monash University in Melbourne, Australia.
Many of these FODMAPs are found in a multitude of foods that are known to be healthy and rich in nutrients, such as various fruits and vegetables, dairy products, whole grains, legumes, seeds, nuts ... although not in all, and not to the same extent. Therefore, it should be noted that the fact that a food is rich in FODMAPs does not imply that it is less healthy, but that there will be individuals who will process it better, and others worse, so that its moderate consumption can improve these gastrointestinal symptoms.
Benefits of a low-FODMAP diet
The dyspepsia intestinal discomfort or, in many occasions associated abdominal swelling, pain, heartburn and even gastroesophageal reflux usually treated by modern medicine with Omeprazole or derived drugs. Although it is true that these drugs are very useful in certain cases, it should also be noted that there has been an overuse of them, and it is known that prolonged use can lead to side effects, sometimes very serious.
In mild cases, some dietary modifications, such as a low-FODMAP diet, can improve this dyspepsia. In more serious cases, it is necessary to carry out different diagnostic tests by our family doctor.
On the other hand, there is irritable bowel syndrome or IBS, a disease whose origin is still unknown, and which is usually characterized by abdominal pain and changes in bowel habits. Specifically, pain usually occurs at least three days a month together with an alteration in the frequency of bowel movements (diarrhea or constipation). Depending on the type, there is IBS with constipation (hard stools one in four times), IBS with diarrhea (diarrhea one out of four times), and mixed patterns where there is an alternation of both symptoms.
In this case, the low-FODMAP diet has been shown to improve symptoms in 50-90% of irritable bowel syndrome cases. Although, yes, this diet should always be prescribed after ruling out other causes that may give rise to these symptoms. A diet low in FODMAPs should never be started to "try to see what it is," and it always requires follow-up by health personnel trained in nutrition.
For its part, during outbreaks of inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease, a diet low in FODMAPs has been shown to help improve these exacerbations, always accompanying drug treatment. According to studies, this diet would improve symptoms such as diarrhea, abdominal pain and bloating, and nausea, but not constipation.
Finally, in some cases of suspected gluten sensitivity (not celiac disease as such), the low-FODMAP diet has shown benefits. In these cases, the hypothesis is that gluten would not be the most important problem in these cases, but rather the difficulty to process the FODMAPs as such.
Possible harms of a low-FODMAP diet
Like any type of diet that involves restrictions, the diet low in FODMAPs is not without criticism and nuances to highlight, as already stated in a work published in Gastroenterology & Hepatology last year 2017.
As its name suggests, carrying out this type of diet will involve moderating or even totally restricting the consumption of certain foods (there are very detailed tables on which ones are processed better and worse), and it is complex to carry it out correctly. In fact, many professionals mistakenly use this dietary approach as a way to diagnose irritable bowel syndrome. However, today, such a diagnosis is always one of exclusion after ruling out other possible diseases, and based on a series of clinical criteria called the Rome Criteria. Therefore, "testing and seeing" is not a form of diagnosis.
On the other hand, limiting FODMAPs will also imply limiting other types of carbohydrates with prebiotic action, something that in the long term can imply health problems.
Finally, carrying out this type of restrictive diets has been shown to trigger or increase the risk of eating disorders in individuals who are very concerned about their way of eating. Therefore, I insist, it should always be recommended by a professional trained in nutrition, and proper monitoring of the diet should always be carried out.