How To Use FODMAPs In Your Dietetic Practice
The FODMAP diet has an increasing amount of evidence-based research to suggest it as being an effective diet to reduce symptoms of irritable bowel syndrome (IBS), fatigue, diarrhea, and other functional gut disorders. FODMAP, which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, are a group of short-chain carbohydrates which rapidly digest in the gut and are poorly absorbed causing excess fluid and gas in the bowels. This can result in uncomfortable symptoms such as bloating, abdominal pain, and gas. Following a low-FODMAP diet is recommended as a nutrition prescription for people with IBS to alleviate these symptoms. Dietitians should be knowledgable about the diet and how to use FODMAPs to expand your dietetic practice.
Kate Scarlata, RDN, Digestive Health and low FODMAP Diet Expert, suggests dietitians should first “do due diligence in understanding the research supporting the diet by getting acquainted with what foods are low and high FODMAPs. Use up-to-date resources such as the Monash University low FODMAP diet app or the high and low checklist located at, www.katescarlata.com. Know which patients might benefit from this diet approach. Before altering the diet, we recommend patients get screened for celiac. The low FODMAP diet is not gluten free but does reduce gluten; testing for celiac should be done with adequate gluten intake.” EA Stewart, MBA, RD, integrative dietitian and digestive health specialist at Spicy RD Nutrition, advises to “learn as much as possible about the low FODMAP diet. Most clients you work with will probably have read at least a little bit about FODMAPs from the internet and will have a lot of questions, and perhaps some confusion, about the diet.” Get informed and educated to provide the right coaching. Stewart also recommends Patsy Catsos website along with Scarlata’s and Monash’s.
Scarlata informs, “realize the low FODMAP diet provides symptom management for about 50-70% of those with IBS. Individuals with a FODMAP intolerance should know within 1-4 weeks if the diet is beneficial for them. The low FODMAP elimination diet is not designed to be followed indefinitely, it is a 3-phase diet. The 3 phases include 2-6 weeks of the low FODMAP elimination diet, followed by the reintroduction phase (FODMAPs are added back to the diet to identify which FODMAPs trigger symptoms. Most people only have a few FODMAP triggers), and the integration phase, where tolerable FODMAP containing foods are added back gently to help expand the diet while maintaining good symptom control.”
During the reintroduction phase, Stewart explains, “many people are anxious about reintroducing challenging, high-FODMAP foods back into their diets. It’s really important to have empathy with them. Gently and slowly guide them, not only through the challenge phase, but to help them develop a long-term plan that works best for them.”
Bottom line: Education is key towards effectively incorporating FODMAPs into your dietetic practice. Use the resources to get informed and provide your clients with the right tools needed for their health, wellness, and success.
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