Monday, March 7, 2016

FODMAP Overview

So I thought I'd do a little overview of this whole FODMAP thing that my doctor has me doing just for transparency's sake, because I love sciency stuff and also just to hang my head and laugh that I am a walking, talking South Park episode now.  I know, part of me realizes that this is God smiting me for laughing at the GF craze.  I promise I won't speak ad nauseam of the diet because there is nothing worse than someone who blathers on about that nonsense, though I will be giving updates here and there on how things are going.

What is a FODMAP?

FODMAP is short for Fermentable Oligo-Di-Monosaccharides and Polyols, and essentially it's a type of carbohydrate that is found in certain foods:

  • Fructose (fruits, honey, high fructose corn syrup (HFCS), etc)
  • Lactose (dairy)
  • Fructans (wheat, garlic, onion, inulin etc)
  • Galactans (legumes such as beans, lentils, soybeans, etc)
  • Polyols (sweeteners containing isomalt, mannitol, sorbitol, xylitol, stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums, etc)

When eaten in excess, high FODMAP foods can cause issues in the gut, and specifically they cannot be digested and cause fermentation.  It can cause lovely symptoms like diarrhea, gas, bloating and severe constipation.  Mind you, a majority of people can tolerate these foods just fine, this compound seems to mostly affect those with IBS, celiac or colitis.

So what's the deal with the diet?

Essentially you eat a low FODMAP diet for 6-8 weeks to clear your system, give it a chance to heal and start out with a clean slate.  Once you do that, you slowly reintroduce the higher FODMAP food items (one at a time) to monitor symptoms and pinpoint what foods are causing an issue for you.

I hate calling this a diet because the purpose isn't to lose weight, it is purely a diagnosing tool for these chronic digestive issues and helps clear your system to do proper symptom monitoring.  You own't eat this way forever, it is temporary.  Ideally you would be able to add most of the foods on the "no" list back in and only eliminate whatever is causing you issues.  That can be different for everyone, so if you find that your doctor wants you to try this out, don't despair that you will have to eat like this the rest of your life.  Giving up things should be temporary, depending on what your triggers are.  And honestly if a food is triggering you to the point of causing disease, would you really be that bummed to give it up?

So how is it going for YOU?

My emotions are mixed, but physically I do feel really great.  I haven't seen improvement in the potty department, BUT my stomach is feeling so much better and I'm in awe of how much the bloating in my stomach has gone down.  After 3 days on this diet, I was down a half inch in my waist.  All of my pants fit normally now, and I was also able to buy a couple of items in a medium (!!!) yesterday, which I would not have been able to do last week.  

The most difficult part of the diet is getting organized and informed, and figuring out what you can and can't have.  And people, the list is weird.  There are certain things I totally get, like high fructose corn syrup which I generally try to stay away from anyway, and of course evil gluten.  But we are raised with basic principles of what foods are healthy for you, so it is VERY difficult at first to be in the mindset that some of these very healthy things are high FODMAP and off limits.  Apples, mushrooms, honey, celery, beans, peaches....the list goes on.  And white table sugar, which we're told is the absolute devil is okay to have.  It is all very strange indeed, so the figuring out stage has been interesting.  The diet definitely isn't vegetarian or vegan, and if anything I feel horrible for any vegan that has to be on this diet since you cannot have things like beans or honey.  

Eating whole foods is not the issue on this diet, it's quite easy to eat a piece of grilled chicken with steamed vegetables and rice, or roasted salmon with a salad and quinoa.  That's stuff I generally eat anyway, and I love all vegetables/fruits (other than Satan in a can water chestnuts), so no matter what I eat of those I'm happy.  And I love all meats, so having that is not a problem.  The issue comes with buying convenience foods, and let me tell you THAT part is a total bitch.

Going gluten free isn't an issue either.  I can kind of sort of bake GF and there are a lot of GF products on the market to choose from.  BUT, you can't have soy on this diet.  I challenge you to start picking up packages and reading labels of any random thing in the store and see what you can find without soy.  It's nearly impossible, and the first time shopping I got so pissed I just about had to walk out of the store.  And if it doesn't contain soy, it contains HFCS or other artificial sweeteners.  A majority of the GF cereals contain honey, so that's out.  It was incredibly difficult to find any convenience foods that met all of the low FODMAP criteria.  Obviously we all should be eating mostly whole, fresh foods, but sometimes a convenience food is needed and appreciated.  I finally gave up and started experimenting with some GF baking this weekend that I modified to be FODMAP friendly, and thankfully I have some delicious cornmeal waffles to take to work next week.  Eating out is also a challenge, and I've really had to do my homework before we go to Arizona this week.  Anyway, this diet has me reading labels like I'm translating Greek prose, and that's something I really hate having to do.



The other painful part of this diet is that onions and garlic are completely off limits.  Onions I can live without, especially since I suspect they may be a trigger for me, but not having garlic blows.  I absolutely love garlic.  I put outrageous amounts of it in everything, I love roasting it and spreading it on toast, I can't get enough of it.  I made soup the other night and it was just totally lame without garlic in it.  Thankfully you can have garlic infused oil, since the fructans in garlic are water soluble but not oil soluble.  I picked up some garlic oil yesterday and it's been a lifesaver!

But...I've survived

A lot of it is knowing that I won't be doing this forever, and I've also discovered that approaching something from a medical standpoint makes it a LOT easier to stick with.  At the end of the day, my doctor and I are doing this to try to diagnose me and rule out IBS.  Any annoyances or giving up of things is acceptable since this may make me feel better, provide answers and ultimately maybe end this hell I've been in for the last year.

And I've already discovered some little tricks and tasty food due to having to think outside of the box.  My polenta with eggs baked right in the polenta is delicious.  I made the most stellar "quesadilla" yesterday with turkey, cheese and FODMAP friendly rhubarb jam.  Last night we had delicious stuffed peppers with rice and ground turkey.  I'm still eating good and am getting in a rhythm of enjoying my meals, which is ultimately all that matters to me.  I am still strictly counting calories since eating gluten free doesn't give you a pass to eat with abandon.  My eyes just about bugged out of my head with the calorie counts on a couple of the GF recipes I made, so trust me, GF or vegan doesn't immediately mean healthy!

It will be interesting once all is said and done.  If I find this diet works and get to the adding things back in phase, I am curious and anxious what will trigger me and what won't.  I mentioned this earlier, but I do think onions may be something that triggers me.  I've had bad reactions (horrible stomach pains and heartburn that lasts for hours) the last few months when eating them.  Anyway, it's all very interesting.  I hope you guys didn't get too bored with me blathering on about this stuff, but also hope if someone out there is experiencing horrible stomach issues, perhaps they can reach out to their doctor and discuss doing a low FODMAP trial as well!  

5 comments:

  1. Didn't you say you once went to a doctor who told you that eating apples might be your issue? Ironic that apples are actually on the FODMAP restriction list. Maybe that doctor wasn't as quacky as we all assumed he was lol.
    I really hope that you find the culprit or culprits so you can go back to enjoying food again and that your body will stop rebelling in other departments.

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    1. YES! I was discussing that very thing with Eric the other day. That particular doctor just made the blanket statement of "apples are constipating to everyone", which is obviously insane and makes no sense because for the average Joe that's not the case. Maybe she was thinking of this diet, and had she explained about FODMAPs it would have not only made more sense, but could have saved me MANY months of misery because that was literally over a year ago. I definitely am very encouraged even after a few days, so I can't wait to see what things look like 6 weeks from now!

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  2. Elimination/detox diets can be very interesting. It takes patience when adding things back in. I learned that a headache can be caused from something you ate 24 hours earlier. So adding things back in can be slow going. I'm interested in following that part of your journey. And I've been in the same boat as you in the grocery store. You can just get so pissed at food labels and think there is nothing you can eat. It's rather eye opening.

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  3. Thank you for taking us on this adventure with you. It is fascinating to consider the different effects of various foods. I would have never thought garlic infused oil would be okay and garlic so not okay. Fingers crossed that the beloved mushroom is not banned for life. And everything crossed that this process resolves your GI issues once and for all.

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  4. I'm avoiding garlic for the lupus too and it sucks. At least I'm just supposed to minimize it. I don't know how you'd avoid it entirely and ever eat at a restaurant since it is pretty much everything but breakfast and dessert!

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