The FODMAP diet eliminates certain types of sugar or carbohydrates that cause digestive distress in people with IBS and some other types of digestive disorders. Stanford Health Care has become a leading expert in treating IBS through dietary adaptations. The Stanford low FODMAP diet is easy to follow and can bring much-wanted relief.
Stanford Low FODMAP Diet
The low FODMAP diet was developed at Monash University by a team of researchers in 2004. Since then, respected universities and medical centers have adopted and continued to research the low FODMAP diet as a way of treating people with irritable bowel syndrome (IBS). Stanford University Medical Center has become a trusted resource on the effectiveness of the low FODMAP diet and publishes resources for both doctors and patients.
When we talk about FODMAPs, we’re referring to a group of carbohydrates that are found in many of the common, everyday foods you eat. While FODMAPs are carbohydrates, not all carbohydrates are FODMAPs. FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
To put this another way, FODMAPs are fructose, fructans (inulin), lactose, galactose, and polyols. The idea is that by avoiding these types of carbohydrates, you can reduce or eliminate the symptoms of IBS.
One of the main guidances issued by Stanford University Medical Center is a PDF that lays out the basics of the low FODMAP diet and provides a thorough list of low FODMAP foods and those that should be limited while following the low FODMAP diet. The food list provided by Stanford details which foods can be included, both liberally and in strict moderation (if at all) on the FODMAP diet.
Who Needs a Low FODMAP Diet?
According to Stanford Health, the low FODMAP diet is frequently suggested to patients living with irritable bowel syndrome. There are occasions when it might be suggested to someone with other digestive disorders, such as chronic bacterial overgrowth. The low FODMAP diet relieves symptoms of gas, bloating, cramping, diarrhea, and constipation.
If you are living with IBS, following the low FODMAP diet through each of the three phases can help heal your gut and also provide you with knowledge about which foods are triggers for your IBS.
In some instances, a physician may recommend the low FODMAP diet to someone who is suffering from inflammatory bowel disease. Some people with IBD do find relief when following a low FODMAP diet. However, it isn’t suitable for everyone with IBD. Some people with IBD are unable to tolerate foods on the low FODMAP list. If you have active IBD, it’s best to discuss the low FODMAP diet and other dietary approaches with your health care provider.
How Does a Low FODMAP Diet Work?
FODMAPs are known to cause digestive distress. When you consume FODMAPs, which include many different types of foods, they draw more water into the intestines. This is because FODMAPs are osmotic and can pull water through the semi-permeable lining of the intestines. This causes bloating, cramping, loose stools, and general discomfort.
Many over-the-counter laxatives work using osmotic agents. Now imagine this effect, when you don’t need or want it, coming from foods you eat. People with IBS are more susceptible to the osmotic effect of FODMAPs, and experience mild to severe symptoms as a result.
The low FODMAP diet works by first eliminating high FODMAP foods. This is accomplished by learning which foods are highest in FODMAPs, along with foods that are low and moderate in FODMAPs. Low FODMAP foods can be consumed liberally, while moderate FODMAPs should be limited, and high FODMAP foods should be avoided completely.
The elimination phase of the FODMAP diet can last anywhere from 2-6 weeks. After that comes the reintroduction phase that lasts between 6-8 weeks. During this phase, high FODMAP foods are slowly reintroduced. This allows you to recognize which foods cause IBS symptoms so that you can permanently eliminate them from your diet while reintroducing foods that don’t act as triggers.
The FODMAP diet’s goal isn’t to be on it forever but to recognize which foods are the cause of your IBS symptoms and eliminate them from your diet.
Stanford FODMAPS List
Stanford’s FODMAP list looks at each food group individually and assesses the FODMAP level of foods within that group. Of course, considering the variety of foods available and cultural differences in food preferences, it’s near impossible to list every food.
The Stanford list does do a good job of listing many popular foods, including ingredients that you may have dig a little on food labels to find. When looking at the FODMAP list, you’ll also begin to notice some patterns, for example, how many stonefruits are on the foods to limit list due to their FODMAP content, while most citrus fruits are allowed.
Monash University has tested many foods for FODMAPs. What they’ve found is that portion size is often key to the tolerability of FODMAP foods. A food, such as certain types of cheeses, might be low FODMAP at 1.5 oz but high FODMAP at 2 oz or more. When reintroducing foods to avoid, stick to smaller portions at first.
The Stanford guidance on the low FODMAP diet was used as a reference in creating this FODMAP food list.
Low FODMAP Fruits
- Mandarin oranges
- Papaya – on the Stanford list of high FODMAP fruits but is listed as low FODMAP from other sources
- Cantaloupe melon
- Grapes – green, red, black
- Honeydue melon
- Kiwi fruit
Fruits to Limit
- All canned fruit
- Dried fruit, including figs and raisins, in larger quantities.
- Avocado (rated high for sorbitol but may be tolerated by some in small amounts)
Low FODMAP Vegetables
- Bell peppers
- Bok choy
- Leafy greens
- Squash – butternut, winter (note that summer squash is on the list of vegetables to limit)
Vegetables to Limit
- Brussel sprouts
- Green beans
- Snow peas
- Summer squash
Low FODMAP Meats, Fish, Poultry, Eggs
- Canned tuna
Meats, Fish, Poultry, and Eggs to Limit
- Meats that are marinated or served with gravy/sauces that contain high FODMAP ingredients
- Most processed meats, like salami and sausage
Low FODMAP Dairy
- Hard cheeses
- Aged cheeses
- Mozzarella cheese
- Lactose-free dairy products
- Butter – usually tolerated
Dairy to Limit
- Milk, all varieties from animals, except those that are lactose-free
- Sweetened condensed milk
- Evaporated milk
- Whipped cream
- Sour cream
- Ice cream
- Cottage cheese
- Most soft cheeses
Low FODMAP Grains
- Wheat-free grains
- Gluten-free grains
- Wheat-free flour
- Unsweetened cereals, such as oatmeal, cheerios, corn flakes, etc.)
- Bread made with low FODMAP ingredients
- Pasta made with low FODMAP ingredients
*Grains to Limit
- Wheat grains – einkorn, kamut, spelt, emmer
- Wheat flours and food made from wheat flour – durum, enriched flour, bromated flour, graham flour, semolina, white flours
- Grain products with high fructose corn syrup added
Low FODMAP Nuts, Legumes, and Meat/Dairy Alternatives
- Most nuts
- Most nut butter
- Most seeds
- Most plain, unsweetened plant milk – almond milk, rice milk, coconut milk, etc.
- Frozen desserts/ice cream made with plant milk
Nuts, Legumes, and Meat/Dairy Alternatives to Limit
- Coconut cream
- Most beans
- Black-eyed peas
- Soy products
Low FODMAP Condiments
- Most herbs
- Most spices, but pay attention to spice blends that might have sweetener of some type added
- Olive oil
- Pure maple syrup
- Marinara sauce – small amounts
- Soy sauce
Condiments to Limit
- Any condiment with high fructose corn syrup (HFCS)
- Sweetened coconut
- Pickles/pickle relish
- Sauces made with high FODMAP ingredients
- Salad dressings made with high FODMAP ingredients
- Artificial sweeteners – sorbitol, mannitol, isomalt
What conditions does the low FODMAP diet help?
The low FODMAP diet is designed to eliminate foods that cause digestive distress, specifically for people who suffer from irritable bowel syndrome (IBS). It’s important to note that IBS is different from irritable bowel disease (IBD) and that the low FODMAP diet often isn’t suitable for people with IBD.
When was the low FODMAP Diet developed?
The Low FODMAP diet as we know it now was developed by a research team at the Monash University, the public research university in Melbourne, Australia, in 2004, with research on the diet being published in 2006. The low FODMAP diet’s roots go back a bit further to the 1990s, where positive results were being seen in IBS patients who followed a similar fructose malabsorption diet.
Do you stay on the low FODMAP diet forever?
No, you do not have to stay on the low FODMAP diet forever; in fact, it’s highly recommended that you don’t. There are three stages to the low FODMAP diet, one of which is the reintroduction, where you can assess which FODMAP foods are your IBS triggers, and another phase called integration, where you work toward lifelong inclusion of FODMAPs that don’t cause digestive distress.
The guidance offered for the Stanford low FODMAP diet has helped many people improve their health and gain control over their IBS symptoms. Eating low FODMAP doesn’t have to be a challenge. With advice from Stanford and the growing number of meal kit services offering low FODMAP options, treating IBS symptoms through diet has become easier and more accessible.