Are FODMAPs causing your child’s abdominal pain?

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One new diet trend that is becoming increasingly popular is the low-FODMAP diet. FODMAPs (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are foods that are poorly absorbed by the human intestine and are very easily digested by bacteria that normally line our gut. The bacteria feed on these sugars and sugar substitutes allowing them to grow out of control and produce and excessive amount of gas. The high-FODMAP foods can cause inflammation along your intestine, excessive gas, bloating and discomfort. A well-balanced, low-FODMAP diet is recommended for some children with chronic unexplained abdominal pain. Consult your pediatrician or pediatric gastroenterologist before instituting any restrictive diet such as low-FODMAP.

FODMAP DIET

A FODMAP diet restricts those sugars that can be poorly digested in the small intestine but easily digested by bacteria which can cause stomach pain, gas, and diarrhea in some people. FODMAP is composed of poorly absorbed, short-chain carbohydrate: Fermentable Oligo-, Di- and Mono-saccharides and Polyols. These sugars (FODMAPS) are found in a wide range of foods and include fructose (found in fruit, honey, juices), lactose (found in milk and milk products), sugar polyols such as sorbitol and mannitol (found in some fruits, vegetables, and added artificial sweeteners), and fructan and galactans (found in wheat, rye, some vegetables and legumes and added to some foods as prebiotics and fiber).

The low FODMAPs diet goal is to reduce stomach pain, diarrhea, and gas. It is important to avoid all of these foods in your diet at the start of implementing the FODMAP diet. Testing may be done to determine whether fructose and lactose need to be avoided in diet. If test is negative, you may not need to eliminate those foods. The FODMAP diet should be strictly followed for first 6-8 weeks. After that time you may test the tolerance of foods (one at a time) to ensure maximum variety in the diet. A registered dietitian will be able to assist if you have any questions. The next few pages will show you which foods to stop eating and which ones are allowed (FODMAP friendly).

It is very important to read food labels and become aware of everything you consume.

Common food ingredients you would want to avoid:

High fructose corn syrup

Fiber supplements (Sorbital and Inulin, FOS)

Wheat (as main ingredient)

Fructose

Aspartame, Sorbitol, Mannitol, Xylitol, Isomalt, Polydextrose

Honey

Lactose

Onion

Food additives that are safe:

Maple syrup, rice syrup, wheat starch, wheat thickeners, wheat matodextrin, wheat dextrin, wheat dextrose, wheat glucose, wheat color caramel.

***Note small amounts of rye and wheat are ok as long as they are not the main ingredient.

FODMAPS DIET ALLOWED FOODS FOODS TO AVOID
FRUITS (for allowed foods consume only one serving per sitting)

 

Limit large servings of allowed fruits, fruit juice and tomato juice.

Banana (moderate amounts), Blueberry, Boysenberry, Cantaloupe,

Grapefruit, Grapes,

Honeydew melon, Kiwi,

Kumquat, Lemon, Lime,

Mandarin orange, Orange,

Passion fruit, Pineapple,

Raspberry, Rhubarb,

Strawberry, Tamarillo,

Tangelo; 3 ounces orange juice is ok

Fresh fruit: Apples, Blackberries,

Cherries, Coconut, Guava, Lychee, Mango,

Papaya, Pears, Persimmon,

Quince, Star fruit,

Watermelon, Peaches, Nectarines, Plums, Apricots

Dried fruits:

Apple, apricot, currants, raisins, pears, figs, prune; Dried fruit bars and rolls

VEGETABLES Bok Choy, Carrots, Celery,

Corn, Cucumber, Eggplant,

Green beans, Green and red pepper, Lettuce (moderate amounts), Parsnip,

Potatoes, Pumpkin, Spinach, Squash, Sweet potatoes, Tomato, Turnip,

Zucchini

Leeks, Asparagus,

Artichokes, Beans and legumes (pinto, black, kidney, baked, chickpeas, lentils, split peas, etc), Beets, Broccoli, Brussels sprouts, Cabbage, Cauliflower, Fennel, Garlic, Green peas, Mushrooms, Okra, Onion (white, yellow, green, red, shallots), Snow peas, Sugar snap peas.

BREAD, GRAINS, CEREALS

 

Please note that small amounts of rye and wheat are ok in a food as long as they are not the main ingredient.

 

 

 

 

BREADS, GRAINS AND CEREALS (continued)

Bread, grain and cereal products:

Rice-brown and white,

Wheat free bread, Rice noodles, Corn crackers,

100% Rice crackers,

100% Buckwheat soba noodles, Cornflake crumbs,

Oat bran, Rice bran, rice flour, buckwheat flour, Corn meal, Corn tortillas, Polenta, Quinoa,

Puffed rice cereals, Rice Krispies, Corn flakes,

Muesli (without fruit or wheat),

Oatmeal (unflavored plain),

Gluten free cereals low in dried fruit and honey,

Gluten free pasta, bread,

crackers and cookies, gluten free cereals without dried fruits and/or honey,

Gluten free cakes, pastry

All wheat and gluten containing products:

White and Wheat flour,

White and Wheat bread,

Rye products, Pasta,

Cereals, Crackers, Cakes, Cookies, Muffins, Biscuits made with wheat.

MEAT, POULTRY, FISH, EGGS,

MEAT SUBSTITUTES

All without breading unless using allowed ingredients; Tofu; Peanut butter with out HFCS. Any meat, fish or poultry breaded with ingredients not allowed
MILK, CHEESES, YOGURT

These foods contain lactose and should be restricted if you have lactose intolerance

Lactose free dairy products and/or use lactase enzyme. Some hard cheeses like parmesan may be ok. Rice milk, almond milk, soy milk. One ounce of cheddar cheese, 2 tablespoons ricotta, cottage cheese and sour cream and 1 tablespoon cream cheese are ok as lactose content is minimal. Regular milk, goat milk, yogurt, ice cream, sherbet, half and half, heavy cream. Any other products with milk as a main ingredient.
SWEETENERS Sugar in moderation is fine. Glucose sweetened sweets (even if wheat-derived glucose)

Nutrasweet, Sweet and Low and Splenda

Fructose, High Fructose Corn Syrup (HFCS), Honey, Fruit juice concentrate. Polyol sugar substitutes: Sorbitol, Mannitol, Xylitol, Isomalt, Polydextrose
SAUCES, SPREADS, ETC Mustard, dill pickles Ketchup, Barbecue sauce, Relish, Plum sauce, Sweet and sour sauce
FATS

Too many fats can increase symptoms of irritable bowel in some people

Oil, butter, margarine, nuts, mayonnaise (without HFCS), olives, sour cream (1-2 tablespoons only), salad dressings made with allowed ingredients. Salad dressings with high fructose corn syrup, polyols, onion, garlic; mayonnaise with high fructose corn syrup.
MISCELLANEOUS Unsweetened chocolate; Popcorn. Glucose supplements such as tablets, powder, syrup. Glucose sweetened energy/sports drinks. NO more than @ 12 ounces sugar sweetened drinks (no HFCS). Regular sodas with high fructose corn syrup

 

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