What is a FODMAP Dietitian and How Can They Help You?

If you’ve been diagnosed with IBS or struggle with uncomfortable bowel symptoms like bloating, gas or constipation, chances are you’ve turned to google for advice. You may have come across the low FODMAP diet in your research. But what is it? And do you need a FODMAP dietitian to help you?

In this article we will explore:

• What is a low FODMAP diet, and why is it used?
• What are some foods that can be included in a low FODMAP meal plan?
• What is a FODMAP dietitian and do you need a dietitian for FODMAP?
• Can a FODMAP dietitian help with other digestive issues beyond IBS?

The Low FODMAP diet is a 3 stepped approach. It is used to help individuals living with Irritable Bowel Syndrome (IBS) manage their symptoms and improve their quality of life. IBS is a common gut condition that affects ~30% of Australians characterised by symptoms such as of bloating, gas,abdominal cramping and constipation or diarrhoea. (, )

FODMAP is an acronym which stands for:
F – Fermentable
O – Oligosaccharides
D – Disaccharides
M – Monosaccharides
A – and
P – Polyols ⁽¹⁾

Put simply, FODMAPs are a group of short-chain carbohydrates (aka sugars) found in a variety of foods such as fruits, vegetables, legumes, nuts, dairy products, wheat products and more. In some people, the sugars from these foods are poorly absorbed which results in IBS symptoms. ⁽¹⁾.

The low FODMAP diet is mainly used to:

a) Determine what foods and FODMAP’s trigger IBS like symptoms, in an effort to manage them
b) Identify what foods are well tolerated, to help add more variety and less restriction in the longer term; and
c) Determine if food is not in fact the trigger to IBS like symptoms, and what other therapies may be required ⁽²⁾

A FODMAP diet consists of three steps:

1. Low FODMAP diet elimination phase – where some or all FODMAPs are eliminated from the diet for 2-6 weeks to determine whether symptoms improve. ⁽³⁾ A FODMAP dietitian can provide a low FODMAP meal plan to assist you during this phase
2. FODMAP reintroduction phase – FODMAPs are reintroduced into the diet in specific amounts, as guided by a FODMAP dietitian to determine if and how much a person can tolerate certain FODMAPs with minimal symptoms; ⁽³⁾ and
3. FODMAP personalisation – Determining what foods can be enjoyed with minimal symptoms, while promoting a varied, balanced diet to promote good gut health ⁽³⁾

While the initial low FODMAP elimination phase can be quite restrictive, it still allows you to eat foods from all food groups including fruit, vegetables and meat/meat alternatives.

Some options a Low FODMAP dietitian will discuss with you include:

• Fruit; oranges, kiwi fruit, pineapples
• Vegetables; carrots, cucumbers, potato, lettuce and zucchini
• Nuts; macadamias, peanuts, walnuts, almonds
• Breads and cereal; rice, quinoa, sourdough bread, and gluten free alternatives e.g. gluten free pasta
• Seeds; most seeds are low in FODMAPs
• Lean proteins; steak, chicken, lamb, egg, firm tofu
• Dairy/dairy alternatives; Lactose free dairy, hard cheeses and fortified almond products

*Please note it is not limited solely to the options above*

When working with a FODMAP dietitian, they’ll be able to provide a full list of foods you can enjoy during each phase.

Put simply, a FODMAP dietitian is someone who has been adequately trained to provide education, guidance and support around the FODMAP diet. Managing IBS symptoms and navigating this diet without professional support can be extremely challenging, which is why seeking support from a FODMAP dietitian is crucial.

So what are the benefits of seeing a FODMAP dietitian?
Here are 6 main reasons why seeking support from a FODMAP dietitian can be so beneficial to managing IBS:

1. To help improve your IBS symptoms
The main reason for completing a low FODMAP diet is to decrease the frequency and severity of symptoms. According to Monash University (the founders of this diet), the low FODMAP diet can improve IBS symptoms in 3 out of 4 people, but most importantly the quality of life for individuals living with IBS (2, 3).

Studies have determined that individuals who receive the support of a dietitian are more likely to finish the low FODMAP diet, complete it effectively and experience the benefits compared to those who complete the diet without dietetic support ⁽⁴⁾. Individuals who follow the Low FODMAP diet with a dietitian experience;

2. To maintain nutritional adequacy through all stages of the diet
The initial stage of the FODMAP diet is quite restrictive, which can lead to deficiencies in calcium, iron and fibre if not well managed. A FODMAP dietitian will help you find suitable alternatives you can enjoy, and ensure you are meeting your nutritional requirements to avoid worsening symptoms, or potential health risks in future. Also, a FODMAP dietitian is vital in the reintroduction and personalisation stages too, to ensure non-triggering FODMAPs are added back in to support growth of good bacteria in your gut in the long term.

3. To tailor the diet based on the severity of your symptoms
There’s no such thing as one-size fits all plan when it comes to IBS. That’s why a FODMAP dietitian will work with you to understand how severe your symptoms are, and recommend the most suitable approach for you. Some individuals may benefit from a less restrictive low FODMAP meal plan if they’re experiencing milder symptoms, while others may require a more restrictive approach. FODMAP Dietitians provide the game plan and can determine what will provide you with the best outcome.

4. To make the low FODMAP diet easier for your lifestyle
We all live busy lives, so trying to adhere to a low FODMAP meal plan while balancing our other responsibilities can be daunting. Having support from a FODMAP dietitian can make the process much easier, as they can provide education and support on how to adhere to the diet, without compromising too much of your lifestyle.

For example, a FODMAP dietitian can:

• Provide meal and snack ideas and meal plans personalised to you
• Offer guidance around eating out, and how to communicate dietary requirements to waitstaff
• Tips to communicate with family members around the changes.
• How to adjust cooking techniques and shopping purchases to low FODMAP.

5. To help minimise your symptoms in the long term
Suffering with IBS symptoms can have a number of impacts, especially to your mental health, social life, and overall happiness. Seeking support from a FODMAP dietitian can help you get the tailored support you need, so you can not only manage your symptoms now, but also in the long term. They’ll provide you with the tools and knowledge so you can confidently identify your triggers, and understand how much you can tolerate to minimise symptoms, and improve your health and wellbeing.

6. To identify if/when the FODMAP diet may not suitable for you
While the low FODMAP diet is effective for many IBS sufferers, it doesn’t work for everyone. That’s because many other factors can trigger symptoms that aren’t FODMAPs, such as stress, alcohol, fatty or spicy foods and caffeine. Working with a FODMAP dietitian means they’ll be able to do a thorough assessment of your current diet and lifestyle, to determine the best approach for you. Also, not all gut symptoms are caused by IBS, and may indicate other health conditions are at play such as Coeliac disease, Inflammatory Bowel Disease (IBD), or even Bowel cancer. As FODMAP dietitians are trained to understand ‘red flag’ symptoms, they can also advise you when it’s appropriate to seek further treatment and advice from a specialist.

Yes. More often than not, FODMAP dietitians are not only trained in IBS management, but in improving overall gut health and managing a variety of gut conditions such as:

• Inflammatory Bowel Disease (IBD) – Crohns and Ulcerative Colitis
• Coeliac Disease
• Diverticular disease
• Reflux and Gastroesophageal Reflux Disease (GERD)
• Food intolerances
• Small Intestinal Bacterial Overgrowth (SIBO)
• Gut dysbiosis due to previous parasitic infections

Also, dietitians can closely work with people who are suffering from symptoms, but are not sure of the root cause.

Looking for support on any of the conditions above? Our team at Healthy Gut Australia can help! Simply click here to book a call to learn more about our program, and how we can help you today.

The Low FODMAP diet is an evidenced-based treatment to reduce the symptoms of IBS in individuals, however can be complex to do on your own. Seeking support from a trained FODMAP dietitian can not only help manage your symptoms, but help you manage your lifestyle, improve nutritional adequacy and achieve success in the long term.

If you suffer from IBS, or any gut related condition and are seeking professional support, book your free assessment to learn more about our program at Healthy Gut Australia, and how our expert dietitians can help you.

Written by Bayley Molenaar
Accredited Practising Dietitian
BNutSc and MDiet