Stuck in FODMAP Elimination? 4 Tips for Re-Challenging FODMAPs
WHY IT’S SO EASY TO GET STUCK IN THE ELIMINATION PHASE
So, you started on the Low FODMAP Diet, and, amazingly, your symptoms improved. You were so over the moon that you finally had an answer. You finally had some sort of control over your gut and felt remotely ‘normal’ again. So, you stayed on it. After years of horrible digestive problems, why would you want to risk going back when you’ve finally found relief? It can be so tempting to stay in elimination mode and just live a low FODMAP life. When something actually works and some of those symptoms go away, the thought of re-challenging FODMAPs is the last thing you want to do. However, it’s so important for your health in the long run. Not only that, but re-challenging FODMAPs is the key to being able to live your life.
When you research the diet, you hear about the 3 phases, but you don’t hear much about why they’re important. Also, you might have got some bad information and be thinking that the Low FODMAP Diet is a ‘forever’ diet. You might think that you need to stay eating ‘Low FODMAP’ for life to keep your symptoms in check. The truth is, you should only really be in the elimination phase (where you eliminate all high FODMAP foods - find out more here) for 2-6 weeks. If you see your symptoms improve during that time, you should then start to re-challenge FODMAPs.
WHAT IS THE RE-CHALLENGE PHASE?
The re-challenge phase is the second phase in the Low FODMAP Diet. The idea behind it is to identify the specific foods & FODMAPs that trigger YOUR IBS symptoms. Everyone is different and not all FODMAPs will trigger symptoms in you. Also, the ones that do will be different than the ones that trigger symptoms in someone else. The Low FODMAP Diet is quite a restrictive diet and therefore, you don’t want to be on it long term. Re-challenging FODMAPs allows you to reduce the restrictiveness of the diet. It lets you find a balance between controlling those IBS symptoms and expanding your diet so you’re not so limited. This will make it a whole lot easier to cook, eat out and travel, as well as get the nutrients your body needs.
You shouldn’t be following a complete Low FODMAP Diet in the long term, but rather an ‘adapted,’ or personalised, FODMAP Diet. This should only exclude the FODMAPs that triggered YOUR symptoms when you were re-challenging FODMAPs.
Re-challenging FODMAPs can be a pretty difficult and tedious phase of the diet, because you’ve got to test each group individually. I’m not going to lie, it takes time and it isn’t fun. However, it is so important to do and so worth it in the long run.
WHY SHOULD YOU DO IT?
1. TO LEARN YOUR SPECIFIC TRIGGERS
Before I heard about the Low FODMAP Diet, I used to be so confused about what was causing my stomach to bloat up like it did. I used to dream of just knowing what was triggering it, so I could do something about it (read more on my story here). Understanding what was triggering my stomach was my motivation to start the diet, and it is for so many people.
Re-challenging FODMAPs is what lets you work out what those triggers are. By testing each group of FODMAPs individually, you’ll find out which ones you can tolerate and which ones you can’t. You could find out that actually, you’re absolutely fine with wheat, or avocado, or milk. Think of how great that would be? One of the hardest things about the Low FODMAP Diet is having to give up your favourite foods. Re-challenging FODMAPs could help you find out that, actually, you can tolerate some of those foods. It could mean you can add back some of your favourite things into your diet. How great would that be?
2. TO MAKE MAKE SURE YOU’RE GETTING ENOUGH PREBIOTICS
When you remove FODMAPs during the elimination phase, it can cause changes to your gut micro-biome. There’s been a lot of buzz about the gut micro-biome lately. It basically refers to all the microbes that live in your gut. These are bacteria that are really important for digestion, among other things, like controlling your weight and allowing you to get vitamins from your food.
The reason this happens is because a lot of FODMAPs (especially fructans and GOS) contain prebiotics. The term prebiotic is defined as ‘a substrate that is selectively utilised by host microorganisms conferring a health benefit' by the ISAPP. Some of the good bacteria in your gut can be affected by your prebiotic intake. As lots of high FODMAP foods contain these, a strict Low FODMAP Diet may reduce the amount of prebiotics you eat. Therefore, this reduces the numbers of ‘good’ bacteria in your gut. Several studies have been done in the UK, Canada, New Zealand and Australia which have all shown that a Low FODMAP Diet affects the amount of good bacteria in your colon.
King’s College ran a study that showed a probiotic supplement could help to bolster the good bacteria. However, this will only help some of the way. It's also obviously a much more expensive way of boosting the good bacteria than through food.
The good news is that you only need to have a little bit of these prebiotic foods to get the benefits. So, if you re-challenge FODMAPs and work out that you can tolerate a little bit of wheat or a tablespoon of kidney beans without symptoms, great. That’s all you need to get enough prebiotics to boost those good bacteria and maintain long term gut health.
3. TO MAKE SURE YOU’RE GETTING ENOUGH NUTRIENTS
As you know, the Low FODMAP Diet is pretty restrictive. If you find it overwhelming, or you’re not working with a coach/nutritionist, you can get stuck with eating a very limited amount of foods, that you’re confident are ‘safe.’ This means you might not be getting all the nutrients you need to keep you healthy in the long run. Calcium, iron and fibre are the nutrients that are most commonly reduced in the elimination phase. These nutrients are really important for you body for a number of reasons, including energy and bone strength. Also, a lack of fibre can actually make constipation worse if you suffer from IBS-C and increase the risk of inflammatory bowel diseases in the future.
The good news is that, by re-challenging FODMAPs, and finding your own ‘adapted’ diet, you won’t suffer any long term effects. A recent study in New Zealand showed that the initial Low FODMAP Elimination Diet did reduce nutrient intake. However, these nutrients were restored after 6 months of re-challenging FODMAPs and finding the right ‘adapted’ diet. Therefore, re-challenging FODMAPs will let you work out what you can tolerate and help you get any missing nutrients back into your diet.
Aside from all the health benefits, re-challenging FODMAPs will help improve the quality of your life. The Low FODMAP Diet can obviously dramatically improve your quality of life as it helps you reduce and control your symptoms. On the other hand, it can reduce it by limiting what you can eat and therefore making eating in social situations difficult. Re-challenging FODMAPs is the key to finding the balance between the two. It lets you expand your diet, meaning you may have more choice of foods and be much more flexible. You won’t have to live on the same old meals that you know are safe. You will be able to socialise with friends more easily and have more choice when you eat out.
The end goal of the Low FODMAP Diet is to get the right balance between controlling your IBS symptoms and having a good quality of life. Gaining control over your symptoms shouldn’t leave you on a restricted diet, eating unhealthily, with no life. You shouldn’t have to compromise between the three. Re-challenging FODMAPs is your key to finding this balance and to reducing the restrictions of the Low FODMAP Diet so you can eat as healthily as possible and live your life.
If you’re still not convinced, let me share the results of a recent study on IBS patients 16 months after starting the diet. These patients had re-challenged FODMAPs and were on an ‘adapted’ FODMAP diet. A huge 86% of them had reduced their symptoms through this ‘adapted’ diet. (Interestingly, the foods most commonly restricted long term are wheat, dairy and onion). Therefore, I’ve got every faith that re-challenging FODMAPs will allow you to expand your diet and live your life, whilst still keeping your symptoms in check.
I know the thought of re-challenging FODMAPs is scary and complicated. It’s so easy to just want to stick with a Low FODMAP Diet. However, there are so many benefits of re-challenging FODMAPs. I hope this has shown you why it’s so important and given you some motivation to start re-challenging.
If you’ve decided you’re going to do it, but you’re stuck on how to re-challenge FODMAPs, I can help you out. My next post will be dedicated to helping you through the re-challenge phase. Pop in your details below, and you’ll get an email as soon as it’s ready.
SUMMARY - WHY RE-CHALLENGING FODMAPS IS SO IMPORTANT
It's the way to learn your specific triggers
To make sure you're getting enough prebiotics
To get enough nutrients in your body
It allows you to live your life more freely
It's SO EASY to get stuck in the FODMAP elimination phase and not to want to risk adding any back in. However, re-challenging FODMAPs is the key to finding the balance between symptom control, eating well and living your life. That is possible for you!
Thanks so much for taking the time to read this. Are you struggling to re-challenge FODMAPs? Let me know in the comments.