OH! Magazine - Australian Version January 2018 | Page 9

DR
JOANNA
However, many people don’t and
this means that lactose becomes
fuel for the microbiota. Most
people with lactose malabsorption
can tolerate small amounts, but
exceed this threshold and
symptoms result. Foods high in
lactose include milk, soft cheese
such as ricotta and cottage,
custard, and ice cream. Yoghurt
has already been fermented to
some degree and tends therefore
to have lower lactose levels;
however, this does depend on the
type and/or brand.
3. Foods that contain sugar polyols
including sorbitol, zylitol and
mannitol. These occur naturally in
foods such as apples, apricots,
nashi pears and stone fruits.
However, they are also often used
in sugar free products such as
chewing gum, sugar-free mints and
sugar-free bakery products.
4. Foods that contain fructans and
galactooligosaccharides (GOS).
These are short-chain
carbohydrates found in barley,
wheat and rye; veggies including
garlic, onions, legumes and
artichokes; fruits including
nectarines, custard apple,
watermelon and persimmon;
chicory-based drinks; and products
where inulin has been added as a
fibre/prebiotic (e.g., many yoghurts
and muesli bars). There are also a
list of veggies and fruits with a
more moderate content of fructans
or GOS. These may only be
problematic if consumed in
excess.
Oils, including extra virgin olive oil, do
not contain FODMAPs. Cobram Estate
also make a range of infused oils and
these have all been certified as being
FODMAP-friendly. These include a
roast onion infused oil and a garlic
infused oil – brilliant for using on a low
FODMAP diet, to deliver flavour but
without the FODMAP problems that
may come with the whole foods.
What is a low FODMAP diet?
Researchers at Monash University are
at the forefront of treating IBS with a
diet they designed to be low in these
FODMAPs. They have found roughly 7
out of 10 patients with IBS achieve
good symptomatic relief with a low
FODMAP diet.
An important point to make is that
many IBS sufferers have tried a
gluten-free diet and reported an
improvement, but some ongoing
problems. The Monash team have
shown that it is not gluten that is the
problem at all. Rather, by cutting out
gluten-containing foods, such as wheat,
they inadvertently also reduced their
load of fructans and other FODMAPs.
The ongoing problems are as a result of
other FODMAPs still present in fruits,
veggies and other plant foods that are
gluten-free.
If you have a diagnosis of IBS it is well
worth trying a low FODMAP diet.
However, this is best done with the
help of a dietitian experienced with this
approach. It is not intended as a diet
for life and in fact may be detrimental
if followed for too long.
Most of the foods containing FODMAPs
are healthy foods and, importantly,
FODMAPs are prebiotics, supporting
the growth of a diverse and balanced
microbiota. Cut them our forever and
there may be damaging consequences
for the microbiome and, in turn, your
overall health.
A dietitian will help you to make the
appropriate food swaps to ensure you
have a healthy balanced diet while you
aim to get symptoms under control. He
or she will then devise a strategy for
reintroducing FODMAP-containing
foods into your diet. You may find you
build a tolerance to many of these, as
your gut and your gut bugs adapt,
although others may continue to be
triggers. The goal is to end up with a
much smaller list of foods you need to
avoid, and in some cases, there may be
none at all.
Where to seek help
Monash University have an excellent
low FODMAPs app to help; you can
even send your symptom reports and
food diary directly from the app to your
consulting dietitian.
TO FIND OUT MORE CONNECT
WITH DR JOANNA VIA:
Web: drjoanna.com.au
Facebook: drjoannamcmillan
Twitter: @joannanutrition
Instagram: @drjoannamcmillan
OH! MAGAZINE ( JANUARY 2018 )
9