a novel gut health diet paradox, Op. 75

The low FODMAPs diet

FODMAPS  – Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.  Basically, FODMAPs are a bunch of sugars that are poorly digested in some people and cause a fantastic variety of health problems ranging from bloating and abdominal pain all the way to chronic fatigue and anxiety.  AND a low FODMAPs diet seems to provide some relief (Ong et al., 2010; Staudacher et al., 2011).

Just like it’s weird name, it’s difficult to simplify the rules of the low FODMAPs diet, so here it is graphically:

FODMAPs vs. GFCF

Grains are excluded from GFCF due to gluten and from FODMAPs due to oligosaccharides.  Dairy is excluded from GFCF due to casein and from FODMAPs due to lactose (not sure where FODMAPs stands on fermented dairy like kefir or FAGE).  Thus, both GFCF and FODMAPs exclude grains and dairy.  However, GFCF doesn’t restrict fructose, which is excluded in FODMAPs (monosaccharide).  And last but not least, GFCF but not FODMAPs allows polyols, but as I’ll explain later, I don’t think polyols belong on this list (perhaps “FODMAPs” was just more pleasant-sounding than “FODMAs”).

"polyols"

FODMAPs vs. low carb

A low carb diet is low in both FODMAPs and gluten.  But perhaps similar to polyols, some leniency should also be applied to casein, as standard low carb diets don’t restrict casein but still improve a variety gastrointestinal symptoms (and quality of life in IBS patients; Austin et al., 2009).  Alternatively, a dairy-free low carb diet would cover all your bases.

or you could bring a gun to a knife fight, part I.

Alterations in gut bacteria are frequently associated with gastrointestinal problems, and two classes of nutritional supplements aimed at modifying the gut flora seem to help.  “Probiotics” contain the buggers themselves, while “prebiotics” contain their fuel.

divide and conquer

Bifidobacteria

With regard to the former, “bifidobacteria” seem to be the major player.  Bifidobacteria are the highest in the gut of breast fed babies and lowest in elderly folk.  They are lacking in IBS sufferers (Kerckhoffs et al., 2009; Parkes et al., 2012), and supplementation with bifidobacteria-containing probiotics improve a variety gastrointestinal symptoms (B. infantis 35624 [Whorwell et al., 2006]; B. animalis DN-173 010 [Guyonnet et al., 2007]; B. bifidum MIMBb75 [Guglielmetti et al., 2011])

B. infantis 35624 is found in Align.

B. animalis DN-173 010 is found in Dannon’s Activia yogurt.  But as with most yogurt products, it comes unnecessary added sugars.

Personally, I’d recommend a blend like that found in Jarrow Bifidus Balance (which comes preloaded with its own stock of prebiotics, to be discussed later).

Back to the paradox (or a shameless teaser for next week’s episode): the low FODMAPs, GFCF, and low carb diets all have beneficial effects on gut health but reduce bifidobacteria.  Bifidobacteria supplements and bifidogenic prebiotics are also good for the gut.

a far more enigmatic paradox than the French one, IMO, to be continued…

 

calories proper

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  • greenie

    “but as I’ll explain later, I don’t think polyols belong on this list
    (perhaps “FODMAPs” was just more pleasant-sounding than “FODMAs”).”

    Did you happen to explain this elsewhere… searched for polyols on your blog but couldn’t find it. Basically, I’m trying to decide if quest bars are a bad addition to my diet.

    Brief history:
    I’ve been on numerous rounds of long-term broad-spectrum antibiotics for acne along with many other short-term antibiotics for every cold/sore throat until my mid-20’s. I went Paleo, then low carb, then ketogenic, took Prescript Assist probiotics for months, and still can’t poo regularly without the aid of 500mg of magnesium at night. I’m long-winded. Sorry.
    It sounds like you could offer info on this matter.
    Thanks!

    • http://www.caloriesproper.com/ William Lagakos

      Ha! no, I didn’t explain it. Basically, the word is way too broad. Erythritol is completely absorbed and doesn’t cause any GI effects; maltitol & sorbitol cause gas, bloating, and diarrhea in most people. All are polyols; very different effects.

      The other major FODMAP in Quest bars, “isomalto-oligosaccharides,” might upset your stomach; I’d experiment with it because it could also have the opposite effect – improved regularity.

      • greenie

        thanks for the quick feedback!

        • http://www.caloriesproper.com/ William Lagakos

          You’re welcome 😉

          If you decide to try Quest, let me know how it goes.

          • greenie

            I had a couple (they’re mighty tasty) yesterday. No stomach pains. So far, so good. I ordered some bifido balance today from my readings here. Thanks for the great info. Also started following you on twitter. :)

    • Natalie

      Is Prescript a good probiotic or no? Is it a FODMAP? Do we even need a probiotic if we are trying to avoid FODMAPs? Confused…..

      • http://www.caloriesproper.com/ William Lagakos

        Hi Natalie,
        From the best I can tell, there are no FODMAPs in Prescript Assist.

        As to whether it’s good or not, ymmv. It doesn’t have any bifidobacteria or GOS (two of the ‘good guys’), and I’m not familiar with the prebiotic “leonardite” …

        Technically, no one “needs” to take a pre or probiotic. If you have any GI issues, they might help, but there’s no requirement for them.

        hope this helps!