How does a ‘top down’ approach to finding your FODMAP threshold compare with the usual low FODMAP approach?
We know that cutting out FODMAPS when trying to keep the windy consequences of nasty gut bacteria under control can actually be risky in terms of wiping out helpful gut bacteria.
So is there a way to cut FODMAPs down progressively?
This ‘top down’ approach means you cut down FODMAPs one at a time and until you find your ‘FODMAP threshold’ – which is the most FODMAP containing food you can eat whilst remaining symptom free.
The evidence based approach to dietary management of Irritable Bowel Syndrome (IBS) is the low FODMAP diet, originally ‘invented’ and investigated at Monash University in Melbourne Australia, but now recognised and embraced around the world.
While known to be extremely effective for overcoming IBS symptoms in 80 – 85% of IBS sufferers who trial the diet, a low FODMAP diet is challenging to follow, and should not be followed for any longer than necessary as it does decrease the viability of healthy gut bacteria.
While there is little published evidence to support the use of a more progressive approach to reducing FODMAPs, there are many practical advantages and some anecdotal evidence that a progressive approach could be useful.
Who should try it?
A progressive approach to managing FODMAPs could be worth considering if any of the following points resonate with you:
- If you have tried a low FODMAP diet and found it too difficult to follow
- If you have other dietary issues that would prevent you from complying with a low FODMAP diet for 2 – 6 weeks
- If your symptoms are not severe enough to be classified as IBS but impact on your quality of life – perhaps wind, bloating, abdominal pain, diarrhoea or flatulence?
- If you don’t feel the need to understand exactly which FODMAP might be most problematic, and are just happy if the symptoms go away
- If you are considering a low FODMAP diet trial but you need to ‘test the water’ first.
What is involved?
If you do trial a progressive approach to lowering FODMAPs some of the barriers you might need to overcome include:
- Deciding which FODMAPs to decrease and by how much
- Understanding which FODMAPs are most problematic for you
- Knowing which dietary changes helped the most in symptom reduction
- Learning how much FODMAP load you can manage before symptoms are triggered.
These pointers are intended to show that if a low FODMAP diet trial is not for you, there are other ways you can go about finding your own ‘FODMAP threshold’.
Of course, having a Dietitian on hand to step you through the process might not be a bad idea.
Make a booking for a video consultation with one of our gut health dietitians.