CHAPTER THREE

Eating Without FODMAPs

If your doctor has suggested a low-FODMAP diet for you, you will discover that the diet takes a fresh and careful look at all of the foods you eat. Your dietary needs are not the same as someone else’s. Your doctor may suggest that you work with a dietitian or nutritionist to help map out your plan, especially if you have other conditions that may further limit your food options, such as allergies or celiac disease.

During the first phase of a low-FODMAP diet, your food options will change dramatically. Some foods have a lot of substances like fructans, galactans, polyols, or lactose—high FODMAPs, in other words—while others have little or none of an offending substance—low FODMAPs. Many foods you may consider not only delicious but healthful are high-FODMAP foods. An apple a day may keep the doctor away if you have a healthy digestive system, but if you have a digestive disorder like IBS, it might send you into a serious gastrointestinal tailspin. Apples, onions, and garlic, among other foods, are considered healthful, but because of their fructans, for the time being they are foods you should avoid.

You should try eating small meals, spaced fairly regularly throughout the day. Eating large amounts of anything all at once can be disruptive while your system is still under siege. This tactic may take some advance planning, so you will find the menu plan in Chapter 4 a helpful guide.

A gluten-free diet is not the same thing as a low FODMAP diet, but when it comes to certain foods, seeing a “gluten-free” statement on a package in the grocery store can be of assistance. You’ll still need to read the nutrition label, since there can be high FODMAPs in gluten-free foods, but you can often find appropriate alternatives for flours, grains, cereals, breads, and baked goods by focusing on those gluten-free foods when you shop.

Foods to Avoid, Foods to Enjoy

Researchers are learning more about FODMAPs, and foods are shifting from the excluded group to the included group. This can lead to confusion. Some FODMAP dietary guides include beets and broccoli, for example, while others exclude coconut and avocado. In the following lists, you will find foods that are currently considered foods to enjoy, foods to enjoy in moderation, and foods to avoid. Here are a few general guidelines to keep in mind:

• Limit alcohol intake and opt for clear spirits with sparkling water.
• Drink plenty of water.
• Eat in moderation.
• Chew your food well.
• Limit processed foods to cut down on hidden FODMAPs and irritants.
• Remember that fresh fruits, vegetables, meats, and fish are best.

Fruits

Use the following guidelines for fruits:

• Limit intake of suitable fruits to 1 serving per meal e.g., one banana or orange).
• Drink one-third to one-half a glass of suitable juice.
• An appropriate portion for berries or grapes is a small handful.
• An appropriate portion for suitable dried fruits is about 2 tablespoons (about 10 raisins).
• Choose unsweetened dried fruits (because many are coated in sugar).

Suitable Fruits

Bananas

Blueberries

Boysenberries

Cantaloupe

Cranberries

Grapefruit

Kiwis

Lemons

Limes

Mandarins

Oranges

Passion

Fruit

Pineapple

Rhubarb

Tangelos

Suitable Dried Fruits

Banana

Chips

Cranberries

Currants

Pineapple

Sultanas

Raisins

Fruits to Limit

Avocado

Grapes

Honeydew melon

Raspberries

Strawberries

Fruits to Avoid

Apple

Apricot

Blackberries

Cherries

Lychee

Mangoes

Nectarines

Peaches

Pears

Persimmons

Plums

Prunes

Watermelon

Vegetables

In the early stages of your low-FODMAP diet, stick to the suitable vegetables listed below. As you progress through the diet, you can begin to reintroduce others to your diet if you tolerate them easily. You’ll find a few vegetables that are somewhat controversial, like avocados, in the recipes in this book. You should skip them entirely if they cause you trouble, but for most people, they are tolerated if you stay at or below the suggested serving size.

Suitable Vegetables

Alfalfa sprouts

Baby corn

Bamboo shoots

Bean shoots

Bok choy

Carrots

Celery

Chilis (hot)

Chinese cabbage (choy sum)

Corn

Cucumber

Eggplant

Endive

Ginger

Green beans

Green onions (green part only)

Lettuce

Olives

Parsnip

Peppers

Potatoes

Pumpkin

Rutabaga

Spinach

Squash

Taro

Tomato

Turnip

Yam

Zucchini

Vegetables to Limit

Beet

Broccoli

Vegetables to Avoid

Artichokes (globe and Jerusalem)

Asparagus

Broccoli

Brussels sprouts

Cabbage

Cauliflower

Chicory

Dandelion greens

Fennel

Garlic

Green onions (white part)

Leek

Mushrooms

Okra

Onions

Peas

Radicchio

Shallots

Snow peas

Sugar snap peas

Sweet potatoes

Dairy and Dairy Alternatives, and Cooking Fats

This food category includes milks, cheeses, cultured dairy products like yogurt and kefir, as well as cooking fats like butter and oil.

Suitable Dairy/Fats

Almond milk

Butter

Camembert and Brie cheese

Coconut milk

Custards and puddings made with lactose-free milk

Edam cheese

Eggs

Hard cheeses (like Parmesan)

Dairy-free ice cream substitutes (gelato, sorbet)

Lactose-free ice creams or desserts

Lactose-free milk

Lactose-free yogurt

Limburger cheese

Mozzarella

Parmesan

Provolone cheese

Rice milk

Romano cheese

Swiss cheese

Vegetable oils

Dairy/Fats to Limit or Avoid

Buttermilk

Cream (light cream, half-and-half, whipping cream)

Cream cheese

Creamed soups

Evaporated milk

Fresh cheeses (e.g. ricotta, cottage cheese)

Ice cream

Milk, regular and low-fat milk (cow, goat, sheep)

Milk powder

Milk products (creamer, instant cocoa, etc.)

Processed cheese, cheese spreads

Puddings, custards

Regular and low-fat yogurt

Soft cheeses

Sour cream

Soy milk

Sweetened condensed milk

Yogurt, sweetened/flavored

What to Stock in Your Pantry

A low-FODMAP diet doesn’t have to be bland or boring. There are plenty of ways to add flavor and excitement to your meals, whether you love Mexican, French, Italian, or Asian foods. Be sure to read all labels on any canned, bottled, or packaged foods to identify foods that you are trying to avoid and look for alternatives that are safe for you to eat during the acute phase of the diet. Here are some spices, herbs, and other ingredients that you can use to add flavor to your food and also a few important go-to items to stock in your pantry:

Basic Items

Anchovies

Canned tomatoes (whole and peeled, crushed, or diced; avoid tomato paste or products with tomato paste)

Canned tuna, salmon, or crab

Capers

Coconut milk

Fish sauce

Mustard

Oils including olive oil, nut oils, coconut oil, seed oils

Olives

Spices, whole and ground

Spice blends (check the label to look for any FODMAP ingredients)

Sun-dried tomatoes

Tamarind paste

Vinegar

Herbs

Fresh and dried herbs are a perfect way to add flavor without FODMAPs. The recipes in this book rely on the following:

Basil

Chives

Mint

Oregano

Parsley

Tarragon

Suitable Nuts and Seeds

Nuts and seeds are used widely in FODMAP cooking, as long as portion sizes are monitored. The only nuts you need to avoid are cashews and pistachios (although some plans permit these nuts).

Chia seed

Flaxseed

Almonds

Brazil nuts

Hazelnuts

Macadamia nuts

Peanuts

Pecans

Pine nuts

Pumpkin seeds

Sunflower seeds

Walnuts

Nut butters and seed butters (but avoid cashew and pistachio)

Sweeteners

You might be surprised to find that some FODMAP recipes call for regular white or brown sugar, but they can be appropriate as long as they are kept to a minimal level. Here are some other alternatives to try as a sweetener and in baked goods.

Suitable Sweeteners (in Limited and Controlled Amounts)

Golden syrup

Molasses

Maple syrup

White, brown, and raw

Suitable non-nutritive sweeteners such as stevia

Sweeteners to Avoid

Artificial sweeteners (see exceptions above)

Corn syrups

Corn syrup solids

Chicory root extract

High-fructose corn syrup

Honey

Inulin

Sugar-free or low-carb sweets, mints, gums, and dairy desserts

Soy Products

One area of concern is soy and soy products. Most experts on the low-FODMAP diet conclude that soy sauce and tofu are acceptable. Your own level of tolerance may be different, however, so use these foods with caution and eat only the recommended amounts. Sometimes, a few mouthfuls can make the difference between feeling fine and feeling awful.

Baking

Baking is probably one of the trickiest areas for someone following a low-FODMAP diet. It is hard to forgo breads and pastries for weeks at a time. To make appropriate dishes while you are on the acute phase, you may want to stock up on a few specialty flours and thickeners. Most of the items in the following list are available in larger grocery stores as well as natural food stores. You can also find many of them online. If you are looking for more information about baking for a low-FODMAP diet, see Resources. Here are a few of the items used in the recipes in this book:

Alternative Grains, Flours, and Thickeners

Amaranth

Arrowroot powder

Buckwheat

Coconut flour

Cornmeal

Gluten-free breads

Gluten-free cereals

Grits

Millet

Oats

Polenta

Potato flour

Quinoa

Rice flour

Sago

Sorghum

Tapioca

Teff flour

Xanthan gum

Wheat and Rye Products to Avoid

Barley (pearl and whole-grain)

Bread

Bread crumbs

Breakfast cereals

Bulgur wheat

Cakes and pastries

Cookies

Couscous

Crackers

Pasta and noodles

Rye (unless it is wheat-free; however most rye breads have significant amounts of wheat flour)

Semolina (contains wheat)

Cooking Methods and Equipment

Foods can be cooked by almost any technique you like, but it is a good idea to limit or avoid fried foods. They can be difficult for anyone to digest and have the effect of either slowing foods down or speeding them up on their way through your gut.

Since many people on the low-FODMAP diet miss the flavor of garlic and onions, garlic- and onion-infused creams and oils make a good alternative. Add the garlic or onion to the oil or cream, heat them together, and then take them from the heat to cool. While the oil or cream cools, the flavors are steeped into them so you get the flavor without the FODMAPs.

Basic Cooking Equipment

Blender (electric)

Colander

Cutting board

Food mill

Food processor

Grater or microplane

Immersion blender

Mandoline or Japanese slicer

Measuring cups, for liquids and for dry items

Measuring spoons

Mixing bowls

Rolling pin

Rubber scrapers

Salad spinner

Sharp knives

Sieve

Skillets, sauté pans, crêpe or omelet pan, saucepans, heavy sauce pot, soup or stock pot, roasting pans, roasting rack, cooling racks, loaf pans, casserole baking dishes, muffins tins, and cake pans

Spatulas

Spice grinder

Stand or hand electric mixer

Wooden spoons, for stirring

Dining Out on the Low-FODMAP Diet

To get the most out of the first stage of a FODMAP diet, you may find it easier to eat at home. But no matter what stage of the diet you are on, you should know the basic guidelines for eating out at restaurants.

• Choose a friendly cuisine. Asian cuisines (e.g., Chinese, Thai, Japanese, Korean, Indian, and Vietnamese) are usually rice-based, while Mediterranean cuisines are usually wheat-based.
• Avoid soups and stews that are made in large batches. These dishes almost always include onions and garlic that have been simmered in the dish.
• Ask for sauces and dressings on the side. You can control how much you use or skip it altogether.
• Order bottled water, plain or flavored seltzer, or tea instead of juices and sodas.
• Order grilled or broiled meats, fish, and poultry, served with the sauce on the side.
• Look for side dishes like baked potatoes or rice that are low-FODMAP items.
• Remember that the effects of FODMAPs are cumulative; you can “save up” a serving of a food like butter or cream to have when you are dining out.
• Hot cereals like oatmeal or simple egg dishes are good bets at breakfast, and are available even at fast-food outlets.
• Ask the waiter which dishes contain garlic, onions, or other foods that are problems for you and find out if they can be left out or if they are cooked into the dish.
• Salads are one of the easiest dishes to modify to remove FODMAPs.
• Sushi and sashimi are usually good choices for a low-FODMAP diet.