FODMAP : What Does This Map Really Show?

Introduction

Well to start off, FODMAP is not really a map. Real shocker eh? FODMAP stands for —Fermentable Oligo-, Di- and Monosaccharides and Polyols and is a dietary therapy which has gained increased popularity to treat functional gastrointestinal disorders (FGID), which refers to the disorders of the functioning of the gut. It has, over the years, become more reliable for dietitians with its well-defined mechanism of action and established effectiveness to prescribe for patients suffering from FGID.

Anatomically, the cause of many functional gut symptoms is known to be abdominal distension (the accumulation of gas/liquid in the abdomen leading to bloating). Luminal (inner open space or cavity of an intestine) distension induces symptoms of pain, discomfort, the sensation of bloating and can lead to motility disorders (refers to disorders in intestinal contractions which aids in the process of digestion and excretion).

Intestinal distension is an effect of the solids, liquids, and the gases present in the regions of the intestine and its interaction with the gut environment (gut bacteria and components of the gut). The concept of FODMAP relies on the theory that by regulating the consumption of dietary elements which can cause intestinal distension, we can improve the condition and treat the symptoms of functional gut disorders. Well, seems just about right, doesn’t it? Now that you are introduced to the basic concept of FODMAP, let us briefly dwell into the world of FODMAP and learn more about it.

FODMAPs

FODMAP is an acronym used to describe a group of previously unrelated group of short-chain carbohydrates and sugar alcohols (polyols). The short chain carbohydrates include lactose, fructose, fructo- and galacto-oligosaccharides (fructans, and galactans), and the polyols include sorbitol, mannitol, xylitol, and maltitol. All the above mentioned dietary components fall under the three following functional properties:

  • Poor absorption by the small intestine: Poor absorption as a result of slow, less efficient transport mechanisms across the intestinal membrane, reduced activity of essential enzymes, lack of enzymes, or molecules that are too large for simple diffusion.
  • Small and therefore easy to absorb molecules: Dietary components which produce a laxative effect when consumed in sufficient dose by increasing the liquidity of intestinal contents and thus affecting gut motility.
  • Rapidly fermented by gut bacteria: The effectiveness of fermentation by gut bacteria mainly depends on the chain length of the carbohydrate; oligosaccharides and sugars are more rapidly fermented compared to polysaccharides such as soluble dietary fiber.

So, FODMAPs basically allows us to manage our health utilizing the knowledge of the effects that different components of the food we consume have over our gut health.

What is the role of FODMAP in managing gut health?

Low-FODMAP diet has been used to manage the symptoms of many functional gut disorders such as Irritable Bowel Syndrome (IBS) and has shown significant success in improving the quality of life of those patients.

This doesn’t mean that FODMAP vigilance is restricted to people suffering from functional gut disorders. If you want to understand how FODMAPs affect your individual health and make conscious diet decisions using this understanding, you too can make use of FODMAPs. If everybody around you isn’t talking about it already, they soon will be.

But, before we jump into this seemingly complicated world of FODMAPs let us understand the two main underlying principles of it.

FODMAPs are not the cause of functional gut disorders: FODMAP is a concept which looks at gut disorders where there is malabsorption of certain dietary components (FODMAPs) due to hypersensitivity( lactose and fructose intolerance), excessive gas production by the gut microbes leading to the symptoms presented by the disorders.  This essentially provides an opportunity to manage symptoms and improve the quality of life.

FODMAP as a dietary therapy works on the concept of global restriction of FODMAPs and not individually: Whereas many dietary therapies involve restricting specific FODMAPs, the dietary therapy of FODMAP involves the reduction of the consumption of all poorly absorbed short-chain carbohydrates for a better management of gut disorders and proper functioning of the gut.  So, to get a better picture of where these FODMAPs really come from, let us look at the following illustration :

Diets differing in their FODMAP content have been shown to alter the diversity of the gut microbes. And low FODMAP diet has been associated with a greater diversity of the gut microbes than seen in patients with functional gut disorders. Especially, in IBS patients where the diversity of the gut is inversely related to the degree of the intestinal inflammation.

Now that you are formally introduced to FODMAP, let us briefly address certain key points:

What has been established so far? 

  • A low FODMAP diet has been shown to reduce the symptoms of the gut problems in almost 75% of patients with IBS (Irritable Bowel Syndrome).
  • Studies have shown that low FODMAP diet aids in the stimulation of growth of beneficial bacteria in our gut.

What are the considerations?

  • There must be caution exercised when suggesting a low-FODMAP diet for a long-term.
  • FODMAP can be used as a way to manage symptoms of any functional gut disorders and should be looked at as an individual concept where we can access its potential health benefits.

So, if you want to better understand the effect of what you eat and keep that gut happy, the best way to start is by observing how different foods affect your digestion. So, say hello to FODMAP and do not forget to carry this ‘map’ along in your mind when you venture out on your upcoming food journeys.

Disclaimer: The above article is sponsored by Thyrve, the world’s first Gut Health Program that incorporates microbiome testing and personalized probiotics to ensure a healthier gut, happier life, and a brighter future.