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”).
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
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…
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