All About the Low FODMAP Diet. Written by: Stephanie Clairmont, MHSc, RD

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1 All About the Low FODMAP Diet Written by: Stephanie Clairmont, MHSc, RD

2 Congratulations! You have successfully downloaded and received the Clairmont Digestive Clinic E-book All About the Low FODMAP Diet. This E-book is full of useful information about the evidence-based Low FODMAP Diet approach that in research and at the Clairmont Digestive Clinic, has improved digestive symptoms in over 75% of people that have implemented it into their lives. The team and I at the Clairmont Digestive Clinic are excited to share information about this revolutionary diet approach to help you improve your symptoms of Irritable Bowel Syndrome (IBS) and other digestive symptoms to start to feel better. The Low FODMAP Diet is a relatively new dietary approach in treating Irritable Bowel Syndrome (IBS) being recommended by health practitioners, but there is over 10 years of research demonstrating the effectiveness of this diet intervention in helping people decrease digestive distress. Many physicians and gastroenterologists are not yet aware of this diet, and may not be teaching their clients about the benefits of making these dietary changes; while other medical doctors are just recently starting to recommend the diet to clients with IBS. At the Clairmont Digestive Clinic, the team and I have been using this approach along with several other strategies and coaching with our one-on-one clients for three and a half years and have been thrilled with the results that we see in helping people to improve their lives. So many of our clients have tried various approaches to heal their gut and reduce digestive symptoms with no results and no improvement. Suffering with gas, bloating, abdominal discomfort, diarrhea, and/or constipation can be life-altering. It affects food choices, travel, dining out with friends, family get-togethers, the drive to and from work, comfort at work and school, exercise, and more! The list is long. IBS and digestive issues can be traumatic and cause significant upset in your life.

3 They can influence your body and mind. These symptoms are uncomfortable, annoying, and embarrassing. I know this, because I too was diagnosed with Irritable Bowel Syndrome in I wasn t given much advice and just sent on my way to live a life of discomfort and uncertainty in when my system would react. After a few years of studying nutrition and becoming a dietitian, I realized that there was an evidence-based way to improve my health. When I say evidence-based, I mean actual research to support changes to my diet that I could make. Not just another theory or recommendation from someone that didn t know what it was like to deal with IBS and digestive distress. Many of my clients tell me that they have heard a million and one ways to cope with IBS and digestive upset. They have tried probiotics, digestive enzymes, fibre supplements, eating healthy or drinking more water. Some of my clients have tried cutting out foods like gluten or dairy with no results. And for some people, one small change might work... but for most of us, it s just not enough to heal the gut and reset our digestive system to allow it to work well again. That s why I do what I do at the Clairmont Digestive Clinic and on my website With weekly articles, recipes, product and restaurant reviews and videos, the team and I will provide you with advice and expertise on how to live a healthy, happy life with IBS. If you want to learn more about our classes, courses, support groups, and one-to-one services, or just check out all the free resources we have, please visit Now let s learn more about the diet that has helped me and changed so many people s lives.

4 Think you Might Have IBS? Some people have been told that Irritable Bowel Syndrome (IBS) is diagnosed once all other disorders or diseases are ruled out; a diagnosis of exclusion. This is actually not the case. Although it is very important to see your medical doctor to discuss your symptoms and screen for various disorders and diseases, there are specific digestive symptoms that are associated with IBS. Many physicians use the Rome II criteria to diagnose IBS, which says that one must experience at least 12 weeks in the previous 12 months of continuous or recurrent abdominal discomfort or pain along with a change in stool (bowel movements). Many can also experience symptoms that include abdominal bloating, distension, excessive gas (flatulence), and/or other symptoms. IBS presents differently in different people and only some or all of the symptoms may be present. If you are experiencing any of these above mentioned symptoms, seek out the advice of your medical doctor before making any changes to your diet, taking any supplements or doing anything further. It s important that you be properly screened for various digestive disorders and diseases. At the Clairmont Digestive Clinic we specialize in Irritable Bowel Syndrome (IBS) and other digestive issues. We have helped hundreds of clients improve their digestive health and reduce uncomfortable and life-altering symptoms such as gas, bloating, distension, abdominal discomfort or pain, heartburn, reflux, headaches, rumbling/load belly sounds, diarrhea, constipation or both. To learn more about our classes, courses, support groups, and one-to-one services, visit

5 What is FODMAPs? FODMAPs is an abbreviation that stands for: Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols These are complex names for groups of poorly digested carbohydrates that are not absorbed well in the digestive tract. Many individuals cannot digest or absorb these molecules, but for those with Irritable Bowel Syndrome (IBS), they can experience a vast amount of symptoms including gas, bloating, distension, abdominal discomfort or pain, diarrhea and/or constipation when these carbohydrates are consumed.

6 How do FODMAPs Cause Digestive Symptoms? To understand how FODMAPs cause digestive upset, we need to understand the first steps of digestion. When you eat food, it moves from your mouth, through the esophagus, into the stomach and then to the small intestine. At this point, FODMAPs can start to cause trouble. FODMAPs cause symptoms of IBS in three ways: 1. These molecules are poorly absorbed. They arrive in the small intestine and pass right through to the large intestine (colon) because they cannot be broken down or are slow to absorb. We differ in our ability to break down FODMAPs, some people break them down better than others. 2. FODMAPs are small molecules that are consumed in a concentrated dose. When the body tries to dilute these poorly absorbed molecules, extra fluid in the gastrointestinal tract (small and large intestine) causes diarrhea and movement. 3. FODMAPs provide food for bacteria in the large intestine (colon). If these molecules are not absorbed in the small bowel, the billions of bacteria that live in the colon will quickly break down these molecules as food. This breakdown produces hydrogen, carbon dioxide, and methane, which can contribute to symptoms.

7 What is the low FODMAP diet? The low FODMAP diet was developed by a leading dietitian in digestive health, Dr. Sue Shepherd in She has shown, along with other researchers, that limiting foods that are high in FODMAPs is an effective treatment for people with symptoms of Irritable Bowel Syndrome (IBS). Over 75% of people with IBS suffering from gas, bloating, discomfort, distension, diarrhea and/or constipation see significant improvement in their symptoms. There is a small collection of published research that demonstrates the low FODMAP diet may be beneficial for other types of digestive conditions, but it is not evident yet how effective the treatment is. For links to the most recent research, scroll down to the end of this E-book. Where are FODMAPs Found? FODMAPs are found in many foods. From fruit to milk to vegetables to grains; FODMAPs are very common in most people s diets.

8 High FODMAP Foods Foods to Avoid Vegetables Artichoke (Jerusalem and Globe), Asparagus, Cauliflower Garlic, Leek, Leek bulb, Mushrooms, Button, Onion (including shallots, Spanish, spring (bulb), white), Sugar Snap Peas Fruit Apples, Apricots, Blackberry, Boysenberry, Cherries Figs, fresh, Grapefruit, Lychee, Mango, Nectarine Peach, Pears (except Prickly variety), Persimmon Plum, Tamarillo, Watermelon Processed Fruit Apple, Dried, Apricot, Dried, Dates, Dried Figs, Dried, Mango, Dried, Paw paw, Dried Pear, Dried, Pineapple, Dried, Prunes, Raisins Grains & Cereals Bread, Naan or Roti, Bread, Pumpernickel, Bread, Rye (including Dark and Sourdough), Bread, Wheat (including multi-grain, whole-grain), Cous Cous, Wheat Noodles, Wheat Bran, pellets, Pearl barley, Muesli Meat, Fish, Eggs & Meat Alternatives *Be cautious of prepared dishes that may have added high FODMAP foods, such as onion and/or garlic Confectionary, Sugars and Sweetners Dried fruit bar

9 High FODMAP Foods Foods to Avoid Legumes & Pulses Baked Beans, Borlotti Beans, Broad Beans, Four Bean Mix, Haricot Beans, Boiled, Red Kidney Beans, Soya Beans, Boiled, Split Peas, Boiled Nuts & Seeds Cashews, Pistachio Milk Products & Substitutes Buttermilk, Cream Cheese, Cream, Pure, Regular Fat, Cream, Sour, Cream, Thickened, Custard, Ice Cream, Milk (including homogenized, reduced fat, goats, evaporated, skim, soy beans*, condensed), Yogurt (regular, low fat, flavoured) Condiments, Sauces & Spreads Caviar dip, Hummus, Tahini, Tzatziki, Pasta Sauce, Cream-based, Pasta Sauce, Tomato Based, Honey, Mixed Berry Jam Beverages Rum, Wine, Sticky, Apple and Raspberry Cordial (50-100% Real Juice), Orange Cordial (25-50% Real Juice), Juice: Apple, orange blend, tropical blend, Tea (oolong, fennel, chamomile), Herbal Tea (strong), Dandelion Tea (strong), Chai Tea (strong)

10 Low FODMAP Foods Foods to Include Vegetables Canned Artichoke Hearts < 1/8 cup, Arugula, Alfalfa, Aubergine, Bean Sprouts, Green Beans, Beetroot <2 slices (20 g), Bok Choy, Broccoli Brussel Sprouts, Butternut Squash <1/4 cup diced (30 g), Common Cabbage, Savoy Cabbage < ½ cup (35 g), Carrot, Celeriac, Celery (1/4 medium stalk), Chicory Leaves, Red Chili Pepper, Chives, Choy Sum Sweet Corn < ½ cobb, Courgette, Cucumber, Eggplant, Endive Leaves Fennel Bulb, Fennel Leaves, Ginger root, Kale, Leek Leaves, Butter Lettuce Radicchio Lettuce, Red Coral Lettuce, Rocket Lettuce, Mange tout (<5 pods) Olives, Okra, Spring Onion (Green tops only), Parsnip, Green Peas < ¼ cup (36 g), Snow Peas < 5 pods (17 g), Thawed Peas <1/4 cup, Green Pepper, Red Pepper, Sweet Potato < ½ cup (70 g), Potatoes, Japanese (Kabocha) Pumpkin, Radish, Silverbeet, Spinach, baby, Squash, Butter nut squash <1/4 cup diced, Swiss chard, Tomatoes, Turnip, Water chestnuts Witlof, Zucchini Processed Vegetables Black & Green Olives, pitted, Seaweed/Nori Sun-Dried Tomatoes < 1 tbsp Fruit Avocado <1/8 of a whole, Banana, Blueberries, Carambola Clementine, Dragon Fruit, Durian, Grapes, Kiwi, Lemon Longon <5 (15 g), Mandarin Oranges, Cantaloupe Melon Honeydew Melon, Navel Orange, Passionfruit, Paw Paw Prickly Pear, Pineapple, Pomegranate <1/4 cup seeds (38 g) Rambutans <2, Raspberries, Rhubarb, Starfruit, Strawberry Processed Fruit Dried Banana, Coconut Milk, Dried, Shredded Coconut < ¼ cup (18 g), Dried Cranberries <1 tbsp, Currants <1 tbsp

11 Low FODMAP Foods Foods to Include Meat & Alternatives Beef, Chicken, Eggs, Fish, Kangaroo, Lamb, Pork, Prawns, Salmon, Tuna, Tempeh, Tofu Nuts & Seeds Almonds <10 nuts (12 g), Chia seeds, Hazelnuts <10 nuts (15 g), Lsa, Macadamia, Peanuts, Pecans, Pine Nuts Pumpkin seeds, Sesame seeds, Sunflower seeds, Walnuts Pulses Canned Butter Beans < ¼ cup, Chickpeas < ¼ cup, Canned Lentils, Boiled Lentils < ¼ cup, Lima Beans < ¼ cup Milk Alternatives Cheese, hard (all types such as cheddar, feta, brie, goat, camembert mozzarella, swiss, colby, Havarti, pecorino), Cheese, soft (such as cottage <4 tbsp, ricotta <2 tbsp), Cheese, haloumi <2 slices, Almond Milk, Coconut Milk, Lactose-free Cow s Milk, Soy Milk (made with soy protein) Lactose-free Yogurt, Whipped Cream <1/2 cup Grains & Cereals Gluten-Free Bread, Gluten-Free Multigrain <1 slice, Oat Sourdough Bread <1 slice, Spelt Sourdough Bread, Chia rice, gluten-free bread <1 slice, White or Wholemeal Wheat bread <1 slice, Buckwheat, Buckwheat Kernels <1/8 cup, Cornflakes cereal <1/2 cup, Corn flour, Gluten-free Flour (for baking), Muesli (yeast, fruit, and wheat-free), Oats < ¼ cup dry, Gluten-free Oats, Oat Bran, Gluten-free Pasta, Quinoa Pasta, Wheat Pasta <1/2 cup cooked, Polenta (cornmeal), Quinoa, Quinoa flakes cereal, Rice (all varieties), Rice bran, Rice noodles, Rice puffed cereal < ½ cup, Wheat Bran < ½ tbsp, Amaranth, puffed grain <1/4 cup, Spelt Pasta <1/2 cup, cooked

12 Low FODMAP Foods Foods to Include Snack Food (Read food label for added high FODMAP ingredients) Gluten-free Biscuits, Corn-based crackers/biscuits Potato chips, Pretzels, Plain Rice Cakes, Flavoured Rice Cakes <1, Plain Rice-Based Crackers Herbs & Spices Basil, Chives, Cilantro/Coriander, Ginger root, Parsley, Rosemary, Tarragon, Thyme, All Spice, Cinnamon, Cumin, Five Spice, Tumeric, Paprika Condiments, Sauces & Spreads Barbeque sauce <2 tbsp, Chutney < 1 tbsp, Eggplant dip < 1 tbsp, Fish sauce < 1 tbsp, Marmalade, Mustard < 1 tbsp Oyster sauce < 1 tbsp, Relish < 1 tbsp, Peanut Butter, Pesto sauce < ½ tbsp, Soy sauce < 2 tbsp, Brown & Palm Sugar Sweet and Sour sauce < 2 tbsp, Maple Syrup, Balsamic Vinegar < 1 tbsp, Rice Wine Vinegar < 2 tbsp Worcestershire sauce < 2 tbsp, Vegemite Beverages Beer, Gin, Vodka, Whiskey, Wine (Red, White, Sweet, Sparkling), Cranberry juice, 100% Orange juice < ½ cup Hot Chocolate <2 tsp, Vegetable blend tomato juice Instant regular & decaffeinated black coffee Espresso, Tea (white, peppermint, green, dandelion) Herbal Tea (weak) <180 ml, Chai Tea (weak) <180 ml Black Tea (strong) < 180 ml

13 Low FODMAP Foods Foods to Include Fats & Oils Olive Oil, Peanut Oil, Rice Bran Oil, Sesame Oil Sunflower Oil,Vegetable Oil Confectionary, Sugars and Sweetners Dark chocolate <5 squares (30g), Milk chocolate <15 g White Chocolate <15 g, Stevia, Brown Sugar, Palm Sugar Raw Sugar, White Sugar, Maple Syrup, Rice Malt Syrup

14 How to Follow the low FODMAP Diet The low FODMAP diet is an exclusion diet developed to be followed along with the support and coaching of a registered dietitian (RD). In research, as well as in our practice at the Clairmont Digestive Clinic, the diet shows an improvement in over 75% of people with IBS when followed for 6 to 8 weeks. All foods that are high in FODMAPs are eliminated, while foods that are low in FODMAPs are included in the diet. At the Clairmont Digestive Clinic, a registered dietitian and social worker support clients one-to-one to follow the diet, as well as to look for other foods, situations, and patterns that can be contributing to symptoms. For many people with IBS and digestive issues, eating well for digestion and working with a dietitian can help to see great long-term results and reduce or eliminate uncomfortable and embarrassing symptoms. After following the low FODMAP diet for 6 to 8 weeks, many people see symptom improvement, while others may need to continue to follow the diet for several weeks or months longer before they see significant improvement. After the exclusion diet phase, foods may be reintroduced. However, with the complexity of the diet and ingredients in our foods, it is highly recommended to work through this diet, and especially the re-introduction phase with a registered dietitian that has advanced skills in digestive nutrition for best results. At the Clairmont Digestive Clinic, we specialize in Irritable Bowel Syndrome (IBS) and digestive issues. We have helped hundreds of clients to improve their digestive health and reduce uncomfortable and life-altering symptoms such as gas, bloating, distension, abdominal discomfort or pain, heartburn, reflux, headaches, rumbling/load belly sounds, diarrhea, constipation or both. To learn more about our classes, courses, support groups, and one-to-one services, visit

15 Next Steps Think you might like to adapt the Low FODMAP Diet to improve your symptoms of IBS and digestive distress? Reading this E-book and understanding the principles behind the Low FOD- MAP Diet is a great start. You now have the up-to-date list of low FODMAP foods to include daily in your diet and the high FODMAP foods to avoid. This exclusion diet should be followed for a period of time before foods are re-introduced. If you think you may have IBS or that this diet may work for you, the first step is to talk with your doctor. Make sure you don t make any changes to your diet until you ve first been assessed and screened by your medical doctor. Remember, the Low FODMAP Diet has been designed to follow along with the support of a registered dietitian (RD) who is an expert in nutrition. You ll want to work with an RD that specializes in the diet and digestive health, like those that are part of the team at the Clairmont Digestive Clinic. If you would like to follow this diet on your own, ensure you visit for articles, resources, recipes and advice while following this diet. This article on cooking Low FODMAP HERE will provide you with some tips on how to follow this diet and adapt the changes in your kitchen. For more support and tips, subscribe to and read the weekly newsletter The Relief Report provided by the team at the Clairmont Digestive Clinic.

16 Recent Research on FODMAPs Halmos, E. P., Power, V. A. Et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology Jan; 146(1):67-75.e5. doi: /j.gastro De Roest, R.H., Dobbs, B.R., et al. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Pract Sep;67(9): doi: /ijcp Staudacher, H. M., Irving, P. M., et al. Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nat Rev Gastroenterol Hepatol Jan 21. doi: /nrgastro Biesiekierski, J.R., Peters, S.L., et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology Aug; 145(2):320-8.e1-3. doi: /j.gastro Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals? Therap Adv Gastroenterol Jul;5(4): doi: / X