By: Rachel Neifeld, RD, CDN
Gastrointestinal issues such as nausea and constipation are experienced by many pregnant women, but when a woman has irritable bowel syndrome (IBS), typical pregnancy tummy aches can be even more uncomfortable. Fortunately, there is a new diet that has proven successful in treating the symptoms of IBS.
This diet is called the Low-FODMAP Diet, an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These compounds are a group of short-chain carbohydrates which researchers believe play a role in causing the bloating, gas, cramping and diarrhea that accompanies IBS- a role big enough to warrant cutting them out of one’s diet altogether. These fermentable molecules are believed to be poorly absorbed in the small intestine of a sensitive person. The intact molecules continue onto the large intestine where they become food for normal gut bacteria. The digestion or fermentation of these molecules by bacteria in the large intestine causes the symptoms associated with IBS. This process can be avoided if sensitive individuals avoid foods containing these poorly absorbed molecules.
The diet entails avoiding many commonly consumed foods and can lead to inadequate nutrient intake if not well-planned. For starters, it requires exclusion of milk and ice cream which contains lactose. Some hard cheeses which are lower in lactose are allowed, such as parmesan, cheddar, and Swiss. Women following the diet can consume alternatives such as almond milk, rice milk, or lactose-free milk to ensure adequate calcium intake. It is important to have daily three servings of calcium-rich foods to ensure adequate intake of this important mineral.
Fructose, found in high amounts in apples, pears, honey, and watermelon, must also be avoided. Fortunately, there are many other nutritious vitamin-packed fruits that are allowed on the diet due to their lower fructose content. These include strawberries, bananas, blueberries, pineapple, and kiwifruit. Pregnant women following the diet should be sure to include at least two servings of these low-FODMAP fruits in their diets every day.
To avoid fructans, one must avoid wheat, onion, large amounts of garlic, or inulin (sometimes listed as chicory root). Galacto-oligosaccharides (GOS) include legumes such as beans, lentils, and chickpeas, while polyols include prunes, avocado, apricots, mushrooms, sugar-free gum, and mints. As a replacement for wheat, women should eat other 6-8 ounces of other whole grains rich in B-vitamins and fiber such as quinoa, brown rice, and oats. Gluten and soy-free flours can substitute wheat flours.
Though some vegetables must be avoided, low-FODMAP-followers should strive to consume at least three servings of colorful veggies allowed on the diet such as spinach, carrots, red bell pepper, eggplant, bok choy, and potatoes. Luckily, with the exception of pistachios, many heart-healthy nuts such as walnuts, almonds, peanuts, and pecans are all allowed on the FODMAP diet. Women should be sure to include these to benefit from their healthy fats and protein.
It is recommended that a woman consults with a registered dietitian if considering attempting this novel diet approach. To find a registered dietitian near you, go to eatright.org and search for a dietitian located in your zip code. It takes savvy label reading and careful menu planning to undertake this diet from the land down under, but for women who have been suffering from IBS symptoms and are looking for relief; it might just be enough to stomach.
By: Rachel Neifeld, RD, CDN