An estimated one in six Americans—the majority of them women—suffer from irritable bowel syndrome, an often poorly managed condition that can combine abdominal pain, gas, bloating, constipation and diarrhea. Now an Australian dietitian, Sue Shepherd, PhD, has developed a healing diet sparked by the observation that people with IBS seem to have trouble digesting certain sugars in their small intestine; foods containing them can bring on uncomfortable gastrointestinal symptoms. Along with Australian colleagues, Shepherd, of LaTrobe University in Melbourne, developed a process-of-elimination plan that allows IBS sufferers to find exactly what causes them problems.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, the chemical structures of potentially problematic sugars. The IBS diet starts by eliminating all of these sugars for about two weeks, then reintroduces foods from one group every seven days to see if they make the IBS sufferer ill. The sugar groups include foods high in lactose (most dairy), fructose (fruits like apples, along with high fructose corn syrup), fructans (wheat, vegetables like onions, and the fiber inulin, which is added to processed foods), galactans (cabbage, beans and tofu) and polyols (plums, nectarines and apricots). When the groups are added back, many people find they can safely eat some of them, especially in small amounts, says Sandy Livingston, a registered dietitian in Palm Beach Gardens, Florida.
In a recent small British study, 76 percent of IBS sufferers reported significant improvement on the diet, compared with 54 percent of those following standard IBS-diet advice. One concern about following this diet in the U.S. is that none of the FODMAP studies have been done here, so the foods tested are somewhat different from those found in this country. Nonetheless, gastroenterologist William D. Chey, director of the Gastrointestinal Physiology Laboratory at the University of Michigan Health System, has found that some of his patients on the diet could stop their medication.
For more information and menu plans click here. You may also want to consult the book IBS—Free at Last! by Patsy Catsos, which contains advice about the process-of-elimination diet.
A day on the diet (here we’re just eliminating, not adding back)
1 cup unsweetened toasted-oat cerealwith ½ cup blueberries and 1 cup lactose-free low-fat milk
4 ounces turkey burgeron a gluten-free hamburger buntopped with ketchup sweetened with cane sugar (such as Simply Heinz Ketchup)
Baked sweet potato fries made from 1 small potato and olive oil spray
1 cup carrotand celery sticks
2 rice cakesspread with a thin layer of peanut butter
Salad of 1 cup mixed greens,tomatoes and olives with dressingof 1 tablespoon each olive oiland vinegar, plus 4 ounces baked white fish like snapper or tilapia with 2⁄3 cup brown riceand ½ cup sautéed baby spinach
½ ounce mixed nuts
Sandy Livingston developed our one-day sample plan.
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