IS REAL FOOD GOOD FOR EVERYONE?

What would you think if I told you that avoiding foods as healthy as raspberries, apples,

broccoli, legumes, nuts or dairy could really benefit your health?

In recent years there has been an increase in interest towards low diets in FODMAPS, mainly

with the aim of alleviating or improving the symptoms associated with irritable bowel syndrome

and other gastrointestinal complaints.

BUT, WHAT ARE FODMAPS?

The term FODMAPS refers to a series of short chain carbohydrates (sugars) that are not absorbed

properly in the intestine, which can trigger certain gastrointestinal symptoms. It is an abbreviation

of the words Fermentable Oligosaccharides Monosaccharides and Polyols. Let's clarify these

concepts:

● Oligosaccharide: A carbohydrate formed by a molecule. Ex: fructans (fructose polymers).

● Disaccharides: Carbon hydrate formed by two molecules. Ex: lactose.

● Polysaccharide: Hydrate of carbon formed by more than 3 molecules. Ex: fructose.

● Polyols: We find some fruits in a natural way and, artificially, in sweeteners. Ex: sorbitol and mannitol.

We would understand the term Fermentable. Fermentation is a process that can benefit our body.

It occurs when these FODMAPS are not digested in the intestine and reach our gut microbiota

(bacteria) where depending on the compound breakdown occurs through this fermentation

producing short chain fatty acids (SCFA), vitamins or gases, which can serve as food to other

bacteria, besides fulfilling protection functions in our organism, as is the case of SCFA, as shown

in some studies (Canani, RB et al. (2011))

Among the intestinal benefits of some SCFA such as butyrate we find:

However, the fermentation of certain proteins can also cause adverse effects in our body and

generate toxic substances, also associating the place where said fermentation occurs with the

place of appearance of certain diseases such as colorectal cancer (Windey, K. et al. 2012))

Given that the issue of gut microbiota and its great importance in the body gives to talk long and

hard talk about it in future posts if it is a topic that interests you.

WHY CERTAIN PEOPLE SHOULD AVOID THESE FODMAPS?

Within this population group we find people with chronic gastrointestinal problems dragged

during a considerable period of time.

These FODMAPS can aggravate the symptoms causing even more distention in the walls of the

intestine due to the release of liquid and gas through its fermentation.

In addition, numerous recent studies have observed an improvement in symptoms associated with

irritable bowel syndrome following a diet low in FODMAPS (Vincenzi, M. et al. (2017) &

Halmos, E. P. et al. (2014))

In contrast, more popular diets regarding dietary restriction of lactose or gluten for the treatment

of these symptoms shines by the absence of high quality scientific evidence (Cozma-Petrut, A. et

al. (2017)).

BUT, IF I HAVE GASTROINTESTINAL PROBLEMS, SHOULD I PERMANENTLY

MAINTAIN A LOW DIET IN FODMAPS?

No. 

Low diets in FODMAPS usually produce positive effects between 3 and 8 weeks in most studies

and could be considered as a temporary treatment of symptoms to cause improvement, having to

reincorporate later and progressively high healthy foods in FODMAPS .

SHOULD I RESTRICT ALL FODMAPS TO THE SAME MEASURE?

No. 

It is evident that within the FODMAPS category we find foods with a very different nutritional

contribution, placing fruits and vegetables in the highest category, and in the lowest category

ultraprocessed, soft drinks and artificial sweeteners. We should not eliminate them to the same

extent for several reasons:

● Release rate and appearance of symptoms: Processed and industrial foods artificially present

the FODMAPS and its passage to the intestine is much faster and isolated, being able to cause

the symptoms associated with irritable bowel syndrome in a much more concentrated and

sudden . Otherwise, FODMAPS naturally present will be absorbed in a slower way and may

cause minor symptoms and, in some cases, nonexistent.

● Amount of fodmaps: In addition to the fact that artificial FODMAPS arrive much more quickly,

normally in rations of habitual consumption, ultra-processed and industrial foods contain much

more of them when compared with fruits and vegetables. For example: A 150-gram serving of

watermelon contains approximately 1.5-2 grams of fructose, plus vitamins, fiber, water, and a

higher satiety sensation, while a can of cola contains about 20 grams of fructose, plus of another

15-20 grams of sugar and some gift chemicals. Therefore, we will not make a similar restriction

in both categories.

● Nutritional density: The nutritional density in ultra-processed foods is usually quite low, so its

elimination and substitution by other foods is not only recommended if you have gastrointestinal

problems, but in all cases.

Finally I leave a link where you can see high and low foods in FODMAPS 

http://www.dolorabdominal.com/nutrisiia/tablas/tabla-dieta-baja-fodmaps.pdf

CONCLUSION AND PERSONAL RECOMMENDATION.

● If you suffer from gastrointestinal problems a low diet in FODMAPS can be a good strategy

being supervised by a dietitian-nutritionist.

● It has more scientific support than other more popular diets such as low gluten or lactose.

● The low diet in FODMAPS is only temporary (3-8 weeks)

● Not all FODMAPS are the same.

● If your diet is very based on ultra-processed products, eliminating or replacing them with low

FODMAPS foods may be enough to alleviate the symptoms, given their large amount of

FODMAPS per portion of habitual consumption if we carry out their comparison with food rich

in more nutritious FODMAPS such as fruits, vegetables or nuts.

REFERENCES:

1.    Windey, K., De Preter, V., & Verbeke, K. (2012). Relevance of protein fermentation to gut health. Molecular nutrition & food research, 56(1), 184-196.

2.    Canani, R. B., Di Costanzo, M., Leone, L., Pedata, M., Meli, R., & Calignano, A. (2011). Potential beneficial effects of butyrate in intestinal and extraintestinal diseases. World journal of gastroenterology: WJG, 17(12), 1519.

3.    Vincenzi, M., Del Ciondolo, I., Pasquini, E., Gennai, K., & Paolini, B. (2017). Effects of a low FODMAP diet and specific carbohydrate diet on symptoms and nutritional adequacy of patients with irritable bowel syndrome: Preliminary results of a single-blinded randomized trial. Journal of translational internal medicine, 5(2), 120-126.)

4.    Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771.

5.    "About FODMAPs and IBS | Monash FODMAP - Monash Fodmap." Recuperado de: https://www.monashfodmap.com/about-fodmap-and-ibs/.

6.    So, D. (2018) "Diet, fermentation and the gut microbiota" Recuperado de: https://www.monashfodmap.com/diet-fermentation-and-gut-microbiota/