Vegan Diets and Irritable Bowel Syndrome: The FODMAP Approach

appleOne of the most frequent questions I get through this website is about the low-FODMAP diet. This popular approach to easing symptoms of irritable bowel syndrome (IBS) eliminates (at least initially) many plant foods. It’s definitely a bit of a challenge for vegans, but may be worth it if you suffer from IBS.

 

The FODMAP Diet

IBS affects as much as 15% of the population in North America, so it is no small problem. And while it’s not life-threatening, it can have a significant effect on quality of life.

The idea behind the low-FODMAP diet is that certain fermentable short-chain carbohydrates contribute to symptoms in people with IBS. Some of these carbs are poorly digested and some are not digested at all. Others, like lactose in milk or the sugar fructose, are digested by some but not all people.

Since they aren’t digested, these carbs aren’t absorbed. Instead, they travel to the colon where they are fermented by bacteria, resulting in gas production. They can also pull water into the lower intestines, creating an uncomfortable feeling of distension. For most people, these effects are not a problem or at least, they are felt to only a minor degree. But people with IBS may be hypersensitive to the effects of water and gas in their lower intestines.

The FODMAP approach limits these fermentable carbs for several weeks to see if IBS symptoms improve. If you feel better after avoiding these foods, the next step is to determine which type of fermentable carbs are responsible for your symptoms. This is achieved by gradually adding foods back one at a time.

Some research suggests that about 75 percent of people with IBS may be helped with the FODMAP approach.

 

The FODMAP Family of Foods

The term FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are all short-chain carbs that are not bad for you in general. In fact, they have prebiotic effects that may lower risk for colon cancer. You don’t need to eliminate them completely (and you couldn’t unless you ate an all-meat diet) but, if you suffer from IBS, a low-FODMAP diet can help you determine which of these carbs you can comfortably eat.

Here are the groups of foods that are avoided during the elimination phases:

Galactans: These are oligosaccharides (short chains of sugars) that are abundant in beans. No one can digest these carbs, since humans lack the appropriate enzymes. That’s why beans can cause gas even in people who don’t suffer from IBS.

Fructans: Another type of oligosaccharide, these are chains of fructose that occur naturally in artichokes, garlic, onions, leeks, wheat, rye, and barley. Certain types of fructans called inulin and FOS are also added to foods for their prebiotic effects.

Lactose: A disaccharide—two simple sugars linked together—found in milk and other dairy foods. It’s an issue for vegans only in that it shows up as an additive in some foods and supplements that vegans might sometimes unwittingly eat.

Fructose: A simple sugar (also called a monosaccharide) found in sugars and fruits. The ratio of fructose to the sugar glucose is more important than the total amount of fructose in the diet since this ratio affects absorption. As a result, some fruits that are high in fructose, like apples, pears, watermelon, and mango, can be worse for IBS symptoms than plain old table sugar which has both fructose and glucose. Agave nectar, on the other hand, should be avoided due to its high fructose content. During a low-FODMAP diet, fruit should be limited to one serving of a low-FODMAP fruit per meal. Choose well-ripened fruit since it’s lower in fructose.

Polyols: Also called sugar alcohols, these include sorbitol, xylitol and mannitol. They’re used in sugarless gums and candies because they are poorly absorbed. They also occur naturally in some fruits like apples, apricots, avocado, cherries, nectarines, pears, plums, prunes, and mushrooms.

 

Eating a Low-FODMAP Diet

I’ve created a pdf of vegan foods you can eat as part of a low-FODMAP diet (and also lists of foods to avoid). Keep in mind, that you are limited to these foods for just 6 to 8 weeks. After that, you’ll start to add back other carb-rich foods to see which you can tolerate. It’s important to add foods back in small amounts and to test one type of fermentable carb at a time. For example, apples provide both polyols and fructose. If eating them causes you discomfort, you won’t know which of those types of carbs you are sensitive to. Instead, choose a food like apricots to test your sensitivity to polyols and then try some mango to test your tolerance for fructose.

Make sure you start with small quantities. You may be able to tolerate ¼ cup of high-FODMAP beans but not ½ cup. If you start with ½ cup, you’ll never know whether you can eat those beans at all. You’ll need to keep a food diary, and it can be very helpful (highly advised, in fact) to work with a professional who has expertise in the low-FODMAP diet.

Sample Low-FODMAP Menu

Even if you could never eat any high-FODMAP foods—if you ended up being sensitive to all of them—you could eat a vegan diet. Low-FODMAP foods include tofu, tempeh, peanut butter, many nuts and seeds, many fruits and vegetables, added fats, plenty of condiments, and gluten-free grains. You can also have small amounts of certain beans.

Here is one example of a low-FODMAP menu.

Breakfast

Oatmeal with almond milk, blueberries, and chopped walnuts
Coffee or tea
Gluten-free toast with peanut butter

Lunch

Vegetable soup with potatoes, tomatoes, green beans, ¼ cup well-cooked lentils
Salad with oil and vinegar dressing
Banana

Dinner

Tofu or tempeh sautéed with zucchini, bok choy, and spinach seasoned with ginger, miso and sesame oil
Quinoa or brown rice

 

Snacks

Rice cakes with sunflower seed butter
Popcorn
Gluten-free pretzels

 

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23 Responses to Vegan Diets and Irritable Bowel Syndrome: The FODMAP Approach

  1. Robyn March 9, 2016 at 12:30 pm #

    Thank you for this information. I think it may be the source of my intestinal issues and I plan to give it a go.

    • Ginny Messina March 10, 2016 at 7:57 am #

      Great–let me know how it goes!

  2. Paula March 9, 2016 at 6:59 pm #

    This was super helpful! Than you so much!!

    • Ginny Messina March 10, 2016 at 7:58 am #

      Thanks, Paula–I’m glad it was helpful!

  3. Anna March 10, 2016 at 6:05 am #

    Would green onions be included as onions and leeks are?

    • Ginny Messina March 10, 2016 at 7:58 am #

      Yes, you should avoid all types of onions during the elimination phase.

      • Anna March 12, 2016 at 4:50 pm #

        Thanks, and another question.

        I really like herbs like cilantro and basil, and I will eat more than 1/2 a cup of them at a meal; do you happen to know if they are low or high fodmap foods?

        • Ginny Messina March 15, 2016 at 6:07 am #

          They’re low in FODMAPs so yes, you can include them if you’re experimenting with the FODMAP approach.

      • Josh March 17, 2016 at 11:23 am #

        I have the worst with irritability to all 4 types. Green onion are not fodmaps only eat the green part, they are different from white onion in that white onion is a modified stalk and these are quite a bit less starchy.

  4. Martine March 14, 2016 at 2:43 am #

    Thanks Ginny, I think this will help a lot of people! I’ve read that seitan is also okay low-FODMAP, since almost all the wheat starch has been washed out.

    • Ginny Messina March 15, 2016 at 6:05 am #

      Yes, you’re right! I meant to include it and may re-do the pdf to add this in.

  5. Eloise March 17, 2016 at 12:26 am #

    Hello,
    Thanks for this. I use a fair amount of spices normally in cooking. Are spices like Tumeric and Cumin low or high FODMAP?
    Also what about thoe flavours used in Thai cooking like lemon grass and kaffir lime leaves?
    Cheers.

  6. Linda March 18, 2016 at 5:27 am #

    Thanks! When my doctor suggested trying FODMAP, I just could not imagine making it vegetarian, much less vegan.

    My doctor already recommends that I take a multi-vitamin. Do they tend to be okay while trying out a vegan FODMAP diet?

  7. Brian Booth March 22, 2016 at 9:36 am #

    I have suffered from irritable syndrome for about 10 years and I have found as long as I avoid wheat rye and barley. I get no problems.

    Beans do not bother me and neither are they gas producing for me. One other thing that can set it off is drinking tea where the water has been boiling for a long time as well as too much coffee especially standing coffee. I think what started my IBS was drinking coffee from a company coffee pot that had been boiling for too long

  8. Isabelle March 23, 2016 at 7:16 am #

    I believe that I have food sensitivities to some of the foods listed as low FODMAP. Should they be eliminated during the 6-8 week elimination diet. Perhaps it isn’t the foods that I am intolerant to but the high FODMAPS I have bee ingesting

  9. Lara May 16, 2016 at 6:05 am #

    Hi thanks for this! But i still have some questions…
    Why can you not eat avocados but still can eat avocado oil?
    Also… what about soysauce, ketchup, vegan mayo and sugar replacements like cocopalmsugar?
    Can i still use black pepper or chiliflakes?

    Thanks for replying

    Lara

    • Lara May 16, 2016 at 6:14 am #

      Oh and also… what about spelt and spelt Bread?
      Sorry for all the questions haha but this is gonna help me alot

  10. Márcia Gonçalves June 1, 2016 at 2:05 pm #

    Loved this article! The list of foods to avoid is so helpful… :)

  11. Laura June 25, 2016 at 4:15 pm #

    Thank you so much for this! My significant other has IBS and I’m always looking for things that might help him (he’s also giving a plant based diet a go, so this is perfect). Great info!

  12. theresa July 7, 2016 at 7:20 am #

    I’ve been researching IBS symptoms and how to remedy for my husband. We’ve been vegan for 8 years so I’m so surprised this is happening to him. We hardly eat any processed foods or fake meats besides tofu and tempeh so its a really clean diet. We do pretty much have salads for lunch and dinner every night so I’m thinking maybe its just too much raw vegetables for his stomach to handle.

    We don’t ever plan on eating meat or dairy ever again so that is not an option. So I’ve been looking for something like this. It is so confusing and frustrating though with all the mixed information out there. On the OK list of foods to eat here, there are so many foods listed, that other sites say to absolutely not eat with possible IBS, for ex. curciferous veggies like Brussel sprouts and kale. Also, you’re list doesn’t mention broccoli or cauliflower on either list. Where would you place those, as that was a regular staple for us?

    Also, re: your fruit list. I’ve read that it’s better to eat the lower sugar fruits that are higher in soluble fiber would be best, for ex. blueberries and especially blackberries being one the most highly recommend, but that’s on your do not eat list. why? most of the fruits you listed to eat seem to be the higher sugar fruits that are higher in insoluble fiber.

    Thanks in advance for this post and for any advice.

  13. Kris VeganFODMAPRocketScience July 20, 2016 at 7:29 am #

    Hi Ginny, I love your blog, and thank you for talking about this issue! I’ve recently started this diet myself and have started a blog about it which I hope it’s okay to share the link to- http://veganfodmaprocketscience.tumblr.com/

  14. Ella July 23, 2016 at 2:57 pm #

    One thing I can’t find anywhere online is a comprehensive list of all foods and their FODMAP status. It’s so frustrating. Just a printable list I can stick on my kitchen wall would very helpful indeed.

    I don’t know if anyone else is in the same boat as myself, but I think I may also be sensitive to the nightshade family of foods as well, just to complicated things even further.

    I personally don’t have it in me to go on a pure FODMAP elimination diet, it’s just too difficult and lengthy. Thanks for this blog though.

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