What is the low-FODMAP diet, and should you try it? | Dr Will Bulsiewicz

[Music] hello and welcome to Zoe shorts the bite-sized podcast where we discuss one topic around science and nutrition I'm Jonathan wolf and today I'm joined by Dr will bwitch and today's subject is FODMAP [Music] diets Jonathan we're advised to follow all sorts of diets going dairy free gluten-free avoiding fruit to from fruit or cutting out whole grains or legumes what most people don't realize is these are all variations of low FODMAP diets so will what I want to know is what does FODMAP even mean it sounds super geeky well fod map Jonathan is an acronym and I'll tell you what it stands for in a second and we'll learn why fod maps are incredibly important for Digestive Health okay let's dig into all of this then and try to map out our way to fod maps for our listeners now before that I'd love to say that I love that you're listening to this you know it means a lot to me and to Will and to the whole team behind the scenes here at Zoe who put a huge amount of effort into this podcast each week uh and we release this show for free without any ads because our mission is to trying to help millions of people to improve their health with the latest cutting age science and in return I have one favor to ask you which can really make a difference to that mission and how many other people will see the show and that is to hit the Subscribe button right now I believe you've done it so thank you and on with the show so will you mentioned that FODMAP is an acronym and that tells me that there are probably a few members of this FODMAP gang so can tell me who's in the gang when did they first get together is the gang still together and can I join you make it sound so cool Jonathan I don't want to disappoint you but unfortunately I don't think you can join because it's a rather exclusive club and also you're not a carbohydrate okay I was say I get told often that I can't join because it's an exclusive Club not so often that it's because I'm not a carbohydrate I have quite a lot of carbohydrate in me that's that's not that's not enough you know sadly Jonathan uh you and I neither of us would be able to join this club and I don't think any of our listeners would either because none of us are actually exclusively carbohydrates but you know nonetheless the members of this exclusive gang are I just want to prepare everyone because I'm about to use some insanely large words here fermentable oligosaccharides disaccharides monosaccharides and polyols which is basically an extremely nerdy way of describing food that contains fermentable carbohydrates and whether they be simple sugars or sugar alcohols or short chains of sugars that actually kind of resemble fiber the FODMAP gang essentially got together in the early 2000s when a group of scientists in Australia at manash University first identified them and realized that there's a huge group of people that are struggling to digest these nutrients okay so now you've explained that fob maps have just become more of a mouthful will and it still sounds very scientific can you try and make it even simpler like what does this actually mean for my day-to-day eating absolutely Jonathan so um let's put it this way in terms that anyone will understand there's five categories of fod maps so I'm going to run through these and you're going to be hearing food that you probably are consuming on a daily basis so the first is fructose which is a sugar classically found in fruit so like watermelon peaches nectarines apples pears the second is lactose many people have heard of lactose that's because you'll find it in dairy products third are the galactans these are found in legumes so things like beans and lentils and peas and this is the first one I was like it sounds more like it's science fiction than something in the food so I know we're moving outside of the normal range to keep going well yeah well you know you hear it Go Bean free right but like maybe this is what we're talking about right and the same could be oh well go glutenfree and that brings us to this next category which are the Frans um which you and I have discussed on a prior episode about lectin now these fructans they're found in onions garlic but also the grains that contain gluten so wheat barley and rye and then the fifth group are the polyols and these are sugar alcohols that you may find in some plant-based foods but you can also find them in artificial sweeteners all right well so you're starting to explain that there are like these five categories of um of fod maps that's starting to get a little clearer but it still seems like a really wide mix of foods like I don't know like an apple and an onion like and a bean these things like very different things so can you explain like why they're lumped together and you mentioned they could be tough to digest why is that yeah I mean I think it's understandable that to the untrained eye these may feel like very functionally different foods but yet they are tied together by the presence of these fod maps and the reason why it's important is because fod Maps the way that they behave the way what I'm about to describe you can find as sort of being Universal to all of them which is that fod Maps require digestion they have to be processed and until they're processed until until we actually digest them they're just not well absorbed in the gut so they're able to slowly pass through the intestines and as they do that they're pulling water in now you can imagine if you pull a lot of water into the intestines this is how you ultimately generate diarrhea but the other thing is that fodmaps I mentioned earlier are fermentable so what this means is that if they're undigested they eventually will reach the large intestine and this is where our microbiome lives and these gut microbes will actually go to work and ferment the fodmaps which is gas producing and so normally we talk about food for our microbes being great so why can this be a bad thing the fact that they're tough to digest um you this can be an issue for people that have digestive problems or gastrointestinal problems so uh as they pass through and they're pulling in this water and they're producing more gas this is how we ultimately develop symptoms and they can cause the bowel wall to stretch and you know create the things that we think about with the iral bowel syndrome so abdominal pain gas and bloating distension diarrhea and in some cases even constipation so well this is all making the fmac G sound rather like the bad guys I'm not quite as excited to join them as I was at the beginning however our team here at Zoe have looked into the science and there is research that shows that people following a low FODMAP diet actually had a significant reduction in healthy gut microbes which we would normally say is a bad things so in other words being on a low fob map diet doesn't seem to be great but I guess there must be some benefits if some people have been told they should be doing this I think this is a really important point and I'm glad that you brought this up a low FODMAP diet is only necessary for people who suffer with gastrointestinal issues so for example my diet could be described as high in fod maps I actually like seek them out I want them I want all the fod maps if you're offering fod Maps I will take them I am more than happy to have them and there's a couple reasons for this so first of all fod maps themselves they aren't inherently bad when we sort of mentioned the gang in the beginning I support support this gang and we'll get into the reasons why but you know the other thing that I want everyone to know is that these fod Maps they they actually have proven to be Prebiotic which means that they're beneficial to your gut microbiome and you know the other thing is that fod Maps aren't the only thing that you will find in high fod map Foods I knew you wanted to be part of this uh gang well just like me I was I was confident about it so um you're saying as well as fod Maps as other things in these Foods what what are they we tend to fixate on what is the one nutrient that we're talking about but hold up let's see the big picture here High fod map Foods include whole grains and legumes and fruit and these are incredibly healthy foods because they contain fiber and polyphenols and phytochemicals and vitamins and minerals and things that nourish our body and also nourish our gut microb these uh foods are great for our gut I mean I would call them gut superfoods to be completely honest with you now you mentioned a moment ago and I said this is an important point a low FODMAP diet reduces healthy gut microbes let's come at this from the opposite perspective for a moment Jonathan what happens when people consume a high FODMAP diet here's what happens you develop a gut microbiome that has a greater diversity this is not the perfect measure of gut health but it is a measure of better gut health it also has been shown to increase a family of bacteria called bifido bacteria now these bifido bacteria they are beneficial to us they have a myriad Myriad of health benefits that include suppressing unhealthy microbes and optimizing our immune system we want more so this is why Jonathan I'm all about the fod maps give me all the fod maps I'll take all of them so given this will why might some people want to restrict or rol void fod Maps well Jonathan the the researchers from manes University who coined the acronym fod map they found that by restricting the amount of fod maps in the diet they could actually make people feel better if they had iral bowel syndrome or if they had inflammatory bowel diseases like Crohn's disease so basically what you're saying is FODMAP diet is really for people who have these sort of digestive problems can you tell us a bit about what a low fod map do you know really entails definitely and it's important to understand a low FODMAP diet is not a person perhaps even your medical doctor handing you a sheet of paper with a list of foods that are high in fod maps and then you eliminating those foods that is not what a lowfodmap diet is so let's break this down so we know that these high FODMAP foods are actually quite nutritious for us there's no need to change your intake of fod maps if you haven't been diagnosed with a digestive problem as I mentions they can be full of nutrients and many of us can eat loads of fod maps and be just fine however for those of us with digestive problems the WOD map diet could be part of the solution it's just that it can be quite tricky at first and why is it tricky well so the first stage is very restrictive and in essence it involves cutting back on the high fod map foods like in other words eliminating them and you're going to do this for a period of 2 to 6 weeks where by eliminating these high five map Foods s the intention is to see an improvement in your symptoms I've actually done this will and um it's incredibly hard if I remember rightly I was basically eating sort of white rice and chicken for like three meals a day which becomes pretty you know it's not much fun even by meal too it's pretty miserable so what happens in the next stage after you've you've gone into that period where hopefully you um you see your symptoms go away I'm really glad that you brought that up Jonathan um and shared your experience so once your gastrointestinal issues stabilize then the next step is to start to reintroduce these FODMAP foods that you have already cut out of your diet and this is done in a systematic faction so you go one by one where by doing this one at a time you are able to identify which specific fod Maps among those five categories which specific ones trigger your symptoms so most people don't struggle with all of the fod maps this is not an All or Nothing thing this is a personalized thing like so much else in nutrition and there are specific fod maps that a person will struggle with so by going through this process you can actually understand yourself your own body your own microbiome and how it responds to these individualized fod maps and once you build this understanding you can narrow down the list of which ones are the problem and so the fob map diet is a sort of trial and error process so you see what foods like are having this negative impact and which ones don't have any you know they're just fine and then you're good to go you could say it that way um once you've worked out which foods are causing these negative side effects these digestive symptoms then you can start to move towards personalizing your own diet so what that means is that the well tolerated fod maps are back on the menu you bring them back in and um reintroduce them into your diet because you know that you can tolerate them now what do we do with the ones that are the problem well the surprise is this is not about elimination this is certainly not about permanent elimination this is about moderation so these foods are good for us and remember they include a lot of important nutrients for us we don't want to permanently eliminate them so what we do is we restrict them to a level that we can actually tolerate and this is something that each of us is capable of you can tolerate these Foods it's just that we have to moderate this is why we're using the word moderate portion size and so well what sort of foods am I likely to be eating if I am ending up on this low FODMAP diet you start by acknowledging that fod maps are carbohydrates so they are classically in carbohydrate containing foods although not in all cases like you know for example Dairy this is the only carbohydrate that you will find in dairy products so by uh following a low fap diet in a way you are aiming to consume more foods that are low in carbs so this could be like more Meats fish eggs um or like there's some that are dairy products that you're able to actually consume because they don't have a lot of this lactose so certain cheeses right the fermentation process actually digests and pre-processes the lactose so Brie and cheddar and feta and then like non-dairy milks so like almond milk and then like there's certain grains so I mentioned wheat barley and Rye are high in fod maps but then there's grains that are low in fod maps rice quinoa oats there's vegetables that are fair game on a low fod map diet so like eggplant or as you would say auen potatoes Tomatoes tomatoes cucumbers zucchini or as once again you would say in the UK Jonathan corette so fruits as well that you know may contain fructose so grapes and oranges strawberries blueberries pineapple you can consume quite a wide range of foods there are still a lot of choices on a low fod map diet we just have to be conscious of it and so what are the warnings around this doet will it's very important to understand that this is not designed for weight loss there are studies that suggest that weight loss can be an unintended consequence of low FODMAP diets and this is something that we see anytime a person enters into a hyper restrictive dietary pattern when you enter into that pattern because of the Restriction you will lose weight in the beginning but this can have consequences this can compromise the intake of specific nutrients such as fiber iron calcium you know we mentioned earlier that people who remain on a lowfodmap diet permanently it affects their microbiome in a negative way so for people who uh have the goal of losing weight there certainly are better ways to accomplish this without having to subject yourself to a very restrictive dietary pattern like the low FODMAP diet so will I think we got a really great picture of the FODMAP gang and how you might approach this um before we get to your verdict I'd actually love to share my own experiences and and get your thoughts because it's very rare that I actually get a chance to do that will instead of just asking you um as an interested party but I as I said I have actually done this and you know I think as regular listeners on the show know um I got a lot of food intolerances in my early 20s after I was sick that got better um at that point that was before anybody had even heard of fob Maps but then I sort of investigated this again about a decade ago a little bit before Zoe started and someone suggested the fob map diet and I had a gastroenterologist who was also involved and so I I did this and I think you know I had a couple of experiences the first is it was really really hard to do partly just living on the Restriction because as you said it's not just the couple of weeks is then you're putting these things in one after another it's slow you got this very restricted Di um I actually met my wife Justine at about this point and I was really low energy and she was basically convinced I was starving myself and I think that I it's interesting you talk about people on weight loss I suspect in retrospect it's hard to get enough calories potentially just to give you all the energy because you sort of can't eat anything and what you can eat is so boring you know so sort of not very excited I think the other thing is it's very hard to do this experiment on yourself trying to understand really for these individual Foods cuz it's not not like just with one thing like people you know you sometimes talk about gluten there's all these foods and trying to understand what's going on um can be very hard um particularly if you know you have some symptoms but they may be driven by the amount of things and combination so it's actually very difficult to do but I did definitely come out of this saying oh I think there's some things that really triggering this and so I sort of cut back on that but then introduce lots of these fodm mats back because just as you said you know the gastroenterologist and nutritional experience you lose a lot of like all the nutrients you get in food if you don't put this in but the other thing I've taken away because this was now probably you know this is before the start of Zoe is at that time there were lots of foods that I couldn't eat and today I can eat all of those Foods uh which is amazing and I know you went through a bit of you know having read um your book you went through a bit of this experience also over the last you know 15 years where in a sense your gut was really not in good shape so you would would eat these Foods you know I don't know cauliflowers and raw onions or whatever and you like really struggle with them but the truth is you know that's a sign of I think the state of your gut and your microbiome and all the rest of it and although you can't just instantly switch this on you know I've definitely experienced that step by step and a lot of this has been through the Zoe experience and the guidance that I am now able sort of like you to eat a very high FODMAP diet and sort of seek it out and feel great about how it makes me feel and I know if I just tried to eat that diet a decade ago I would be feeling really sick I mean you brought up so many great points and you know part of it is that the journey is a multi-year journey so sometimes we are looking for short-term results and um seeing that big picture understanding that it does take time but also this this there should be optimism um that your gut is adaptable that your gut can learn to consume and enjoy these Foods you are not rigidly stuck in a position where the food that you struggle with you are completely incapable of consuming it can be trained and the foods that you know you feel like you have to moderate in the future they could be enjoyed without restriction and you're absolutely right when I say that I want the high FODMAP diet when I want all those High FODMAP Foods I didn't feel that way 15 years ago I felt the opposite and this is part of the Paradox that exists is that these foods are in fact good for the gut there is no doubt that these foods are good for the gut microbiome but it is completely understandable that the person who suffers with digestive symptoms like irritable bowel syndrome that they struggle with these foods and they think that these foods are the problem and therefore should be permanently eliminated and what we're here to say is that you don't need to permanently eliminate these foods but there is a process that you can follow to work these Foods back into your diet so that you can enjoy them without restriction and actually get the nutritional benefits in addition to the flavor profiles that they bring which is is you know an add an added thing that I like so I think that there's a lot that's good there I love that will and as you was saying that I was just thinking my little girl has just learned how to ride her bicycle which is like a big milestone and um you know the the analogy I'm thinking about is you don't just put your child on a bicycle like the first time ever and then just push them off and expect them to be able to ride right like you know that that's going to end up with them crying on the ground and there's a process and you know these days you can even ride you know start with a bicycle with like a Balan bike with no pedals which didn't exist when I was little uh and that's what happened um with my daughter which was like this amazing way but she was on that for a long time um and then you know she switches to to the pedals and that still takes a little while to get and I feel like there's something like that as as we're thinking about um your gut which is for most of us who probably grew up eating this Western diet you know know super processed very little fiber you know very limited amounts of vegetables a lot of things in it that you know we now think of as Ultra processed food and probably caus us a lot of issues you know very cut off from nature all these sorts of things you can't expect to suddenly jump and it's like saying like oh I'm just here's a bicycle you're just going to ride it instantly like you know that's not going to work and so there's something about this being a being a process uh which I've definitely experienced myself and I guess I I'm just sort of feel like perhaps that's a useful metaphor yeah I love that um it is a process in a way our gut almost needs to learn for the first time or relearn to consume these Foods because um they largely have been stripped from the diet that we were all raised on um but much like your daughter learning to ride a bike when you reach the point where your your gut has matured in its ability to handle these Foods you get to ride off into the sunset and enjoy a bike ride and you know the hope would be there's no turning back so well having said all of this you know as a g gastroenterologist like what's your verdict on the on the fbap diet well I think that the verdict is um once again we have emphasized that this is about people who have digestive symptoms so if you don't have digestive symptoms then I really don't see why you would ever be entertaining the loud map diet if you do have digestive symptoms it's possible that you may find benefit and Improvement of those symptoms by following a low FODMAP diet but as we've emphasized this is not just a restriction of fod maps is certainly not a permanent restriction it's really important to understand that this is ultimately about building up your gut like a muscle making it stronger and having enhanced abilities to process and digest these foods which can be done and that process may take time and it also may require the expertise of people who are fat file in these concepts of the low map diet and this is why I'm a big believer and supporter much like you did Jonathan and people seeking out help such as with a dietitian I think if you are doing this then obviously firstly you should probably be starting off talking to to a doctor if you've got really bad symptoms and secondly I agree that I did this with a dietitian with a nutritionist and I think that it'd be almost impossible to sort of do the fmat diet sort of safely and well unless you're guided CU I think you could easily end up being really malnourished right where you're just basically eating like rice and chicken and wiped bread and you're going to get really sick so I think this is an example where of course like the food we eat is so important for us so if you suddenly start to cut it all out you know in the you can have profoundly negative impact in the same way that if you add all the good stuff I I believe obviously you can have great impact completely agree well I think that is much clearer for me I never really understood what I did and now I think I do understand what it was I hope it's much clearer for our listeners thank you for navigating us so well through this rather complex story of fod baps oh it's my pleasure Jonathan and thank you for our listeners for being with us today if you want to understand how to support your body with the best foods for you then you may want to try Zoe's personalized nutrition program you can learn more and get 10% off by going to zoe.com podcast I'm Jonathan wolf and I'm will B swords join us next week for another Zoe [Music] podcast [Music] oh

Channel: ZOE

Views: 194,888

Keywords: zoe, zoe podcast, gut health, ultra processed foods, tim spector, jessie inchauspe, gut health diet, ultra processed foods documentary, ultra processed food, fopmap, fodmap, ibs, will bulsiewicz

Id: kZSwVifQg7g

Length: 25min 37sec (1537 seconds)

Published: Thu Dec 07 2023