Please note the information in this post is from 2013 but has been left here for reference. Back then it was common practice for restriction phase of the low FODMAP diet to be followed for 8 weeks. From 2016 this changed to 4 weeks, with an additional 4-8 weeks maximum only if symptoms had not reduced during the first 4 weeks. At the end of the original article I have added a new section ‘Practical Tips for a low FODMAP diet’.(Updated 2019 by Lee Martin MSc RD
The Low FODMAP diet starts today!
For the next 8 weeks we (2 Registered Dietitians) are going to follow the low FODMAP diet to help us better understand the difficulties, and benefits, from completing the diet so we can help advise our patients with lots of practical ideas and experience.
If you are new to the low FODMAP dietary treatment then to get started have a look at The best introductory videos & podcasts for FODMAPs & IBS on our Best Low FODMAP Resources Page.
A Brief Overview of the FODMAP dietary treatment
The low FODMAP diet is a 3 phase dietary treatment. Phase one is the low FODMAP restriction diet which you should follow for 4 weeks. Phase two is the reintroduction phase which takes about 10 weeks to complete and the third phase is the long term self management of IBS symptoms using a modified low FODMAP diet. You can read more about a modified FODMAP diet here.
It is important to complete phases one and two under the guidance of a dietitian. If you are unable to do this then ensure you have the best available resources to help with these two phases:
- For the low FODMAP restriction diet: Purchase The Monash University low FODMAP App or the FoodMeastro ‘FODMAP by FM’ app
- For the reintroduction phase purchase the book ‘Re-challenging and Reintroducing FODMAPs A self-help guide to the entire reintroduction phase of the low FODMAP diet‘
You can follow more links from our Best Low FODMAP Resources Page for information on: Lists of Foods & Ingredients high and low in FODMAPs, Probiotics, Prebiotics, Vegan & Vegetarian, trustworthy websites and more….
End of Week 1 on a low FODMAP diet
Well now that we are at the end of the first week of following the low FODMAP diet I can see why some people find it very difficult to follow strictly. If you’re the sort of person who eats everything outside of the home the diet is really hard, there just isn’t enough non-wheat options always available (especially for a short lunch break!); let alone also then trying to find suitable low FODMAP foods from the small selection presented to you. We have had a busy week, meaning we have had plenty of opportunities to test out the difficulties of the diet – including a sunny bank holiday weekend involving lots of eating with friends. Here are some of the things we found out this week:
I had to grab some lunch in Pret a Manger last week and was limited to two choices of Salad, which when you are really hungry sometimes isn’t what you always fancy – and especially hard if you want to eat on the move (luckily I did have time to sit down). I fancied a soup but all the soups had onion or some other high fodmap veggie so I opted for the chicken salad, and only had to remove the pistachio nuts. It was actually really tasty and not having any carbs wasn’t a problem (if you did want some carbs you were probably limited to a packet of crisps or popcorn). We relied on taking lunches into work, usually leftovers from the night before – which is probably the way forward when following this diet. I also ate out on 2 more occasions, one at restaurant with a very small selection of food and so opted for…yet again…a chicken salad – this one a little dry and boring so left feeling quite unsatisfied. Our usual Saturday morning trip for brunch was again a little difficult with limited wheat free options, however Fego’s did give us some amazing tasty steak and chicken salads which really hit the spot. Sharing a portion of chips also meant we could still be a bit more indulgent on the weekend.
Nuts and suitable dried fruit have become my mainstay for snacking at the moment. I also tried the original NINE bar which was great but at 222kcals per 40g it might put people off if they are trying to watch their weight. Having said that most of the calories are from seeds so definitely not wasted calories and it did seem to fill me up for a while. Eat natural bars are also wheat free and so long as you avoid the problem fruits…are a good snack on the go and available everywhere. Otherwise I have been snacking on fruit through the day such as grapes and strawberries.
This week we have been making our own cereal using oats, oatmeal, seeds, nuts, dried fruit, banana chips etc. We have also been soaking oats overnight and having it cold in the morning mixed with fruit and soya yogurt and/or two tablespoons of Greek / natural yoghurt . We have been trying a variety of gluten free breads, some of which are really great and perfect for weekend eggs on toast.
Yes even a dietitian screws up sometimes! We bought a grape juice fizzy drink in Pret which had a large percentage of apple juice…showing us reading labels for ALL new foods is so important. As far as trying new products go… It was probably a mistake trying Waitrose Love Life free from gluten bread which was really sweet and not particularly nice especially with eggs. We have been trying lots of gluten free breads and products. Some are really great and make following the low FODMAP diet so much easier.
Main tips for the week
One of the best foods discovered this week was garlic infused oil which really does give a good flavour of garlic which we made a pesto with for our gluten free pasta. See here for recipe Low FODMAP Pesto Gluten Free Pasta with Griddled Aubergine and Tomatoes
Adding Flavour to Low FODMAP Meals
One of the most common comments that I’ve had when telling others we are doing the low FODMAP diet, isn’t that they would miss bread, cereals and certain fruits…but ‘I definitely couldn’t do without onion and garlic!’ I think this is certainly true when eating out, as most cuisines such as Italian, Indian, Thai and Middle Eastern food rely on onion and garlic as a base flavour for many of their dishes. This is the same for many salad dressings, sandwich fillings and soups which makes many wheat free choices when out and about again unsuitable for restriction phase of the low FODMAP diet.
Garlic Infused Oil
The solution for replacing garlic is as simple as garlic infused oil. We cannot stress how important this ingredient has been in cooking over the past 5 weeks on a low FODMAP diet. We definitely use it in meals most evenings, and it means that meals that you usually enjoy stay true to their original flavour. Actually the flavour from garlic infused oil is stronger than we would have predicted, meaning it is perfect for using in all cuisines. Some of our favourites have been pad Thai, bolognese, stir fried or griddled veg and in sauces and dressings all of which require garlic for that traditional flavour. IT IS ESSENTIAL, and available in most supermarkets now (we stocked up when we found a good offer).
You can actually find ways to use fresh garlic and onion in cooking on the diet too and a blog post by Monash gives a good overview (although if I was you I would still get the garlic infused oil) Cooking with onion and garlic- myths and facts
To replace the flavour of onion some people use asafoetida powder although personally I do not like this and prefer to use the green part of the spring onion and chives which was one of the herbs we used a lot during the low FODMAP diet (see below).
Low FODMAP Herbs
One of our favourites so far is having a wide range of fresh herbs in the house. A plant can be picked up in the supermarket for not much more than a standard bag of herbs, they look and smell great and they definitely pack a punch with the flavour. So take the opportunity to get those green thumbs flexing! Currently we have basil, coriander, parsley, thyme and mint which we are using daily in meals like omelettes, salads, stews and many more. You will see lots of these used in the recipes we will be adding to the blog. For more information on Growing Your Own Herbs and plants check out The Royal Horticultural Society which is a great website. It’s been a pretty good summer in London this year so growing our herbs and even some tomatoes has been good fun.
What we have found however, whilst cooking at home and preparing meals for ourselves, is that adding flavour to food whilst adhering to low FODMAP is actually really simple with a bit of preparation. In fact it has really given us the opportunity to do a bit more experimenting and seek out some new products which we wouldn’t usually have as part of our weekly shopping.
We’ve used lots more fresh herbs since starting the diet and this is something which is definitely going to continue post FODMAP diet. Making a pesto is another good way to use up herbs; in fact I think nearly all of the main meal recipes on the blog contain some sort of fresh herbs….so make sure you stock up!
We have both noticed a general reduction of symptoms, with more settled stomach in general after just one week. With having a break for one day, the return of these symptoms was noticeable that day and the next – shows sticking to it is worth it.
We are definitely getting used to the restrictions already and have found great products to replace with and so for the moment it is not feeling difficult. It feels that preparation is the key, and the difficulties are buying lunch or dinner on the go and eating at other peoples houses! We have got some really good low FODMAP recipes already which we will be sharing. Here goes week 2!
End of Week 2 on the Low FODMAP Diet
The eating out issue…
Second week in and the hardest thing we are finding is (as we thought) eating out! In the last two weeks we have been out to eat a few times and wanted to share our thoughts. Last week we went to Prezzo where you basically have three choices. For starter you can have the Chicken Wings and well erm that’s it 😦 For main you can have Siciliana (more chicken with parma ham, tomatoes and cheese) and some potatoes / chips or a Salad. Or you can have a gluten free pizza, and choose your topping wisely! The gluten free pizza chosen was pretty disappointing and felt like we probably could have done a better job at home with a gluten free base – however I would be willing to try again in a different restaurant. Overall the choices again were very limited, but at least there were options that didn’t need adapting to remove high FODMAP ingredients.
Another restaurant we visited was a small family run restaurant in North West London called Ortenzi (a family favourite) and the menu Mr Ortenzi and the crew have unbelievably gives you loads of FODMAP friendly options. I had the Veal in Marsala wine sauce with fried potatoes and courgettes, while Mel had the Duck a l’orange with the same vegetable selection. We also had the prawn cocktail starter each and a coffee at the end of the meal all for £40 which is amazing value. The main changes eating out here compared to pre-FODMAP diet, is having to say no thanks to the complementary bread basket, and to the dessert trolley! This was a really positive experience and showed that you don’t always need to feel restricted on social occasions.
Our changing routine…
Following the low FODMAP diet has started to change our routine, especially on the weekends – as we are tending not to eat in restaurants so much in the evening, and are unable to have the wheat based treats we may have with a coffee in the day (…cake mainly). We are eating at home more, as well as making treat foods ourselves. We are tending to eat out for lunch on the weekends as there are more options which we may not pick at an evening meal – and one of the foods which is fast becoming a FODMAP eating out classic is the humble jacket potato! There are loads of FODMAP free topping to choose from and its usually a pretty cheap option too. This is starting to prove to us further that another benefit to following the diet is the way it is forcing us into widening the variety in our diets and altering our routines. This includes dishes made at home, baking, picking new ingredients and choosing different dishes at regular restaurants and cafes.
A successful Sunday…
Having now followed this for over 2 weeks, it really is starting to become much easier. Avoiding foods and picking great choices is becoming second nature and the variety really is refreshing. Sunday has been a good one and it is surprising that FODMAP can be done where you think it may be difficult. We went to our local farmers market (www.duckpondmarket.co.uk) where we would usually pick up some artisan bread, local veg and a coffee.
We could pick up our usual veg, some more herb and chilli plants to prepare for meals over the next few weeks and some amazing olives. After lingering for a little too long at the bread stall, I noticed that the Crêpe stall was making hot buckwheat Crêpes with any fillings. After double checking this was the only flour used – we tucked into amazing low FODMAP pancakes in the sun. Perfecto.
Then onto a family BBQ (armed with gluten free rolls) where we quickly realised BBQ’s are a FODMAPers friendly eating place. We nibbled on olives and crisps, then could help ourselves to the selection of burgers, sausages, chicken, salad and potatoes. As long as you are careful to choose good quality meat products without added wheat, and no marinades/relishes with onion and garlic it really is easy.
We are certainly finding with some preparation, this really isn’t a limited diet! Keep checking back for more recipes and info………
End of the 8 week Low FODMAP Diet
Before starting the diet we discussed what we were going to miss most, and decided it would be the flavour from foods such as garlic and onion, fresh bread and our weekend baked treats such as pastries. In reality, these were relatively easy to deal with once discovering garlic oil and trying a wide range of wheat free breads. In the end the things that we really missed were having a variety of vegetables (especially some of our favourites like mushrooms & leek) & pulses. By taking pulses out of our diet, we started to realise how much we used them, for example when cooking a vegetarian meal as well as bulking out certain meals with meat; making them last longer so there were meals to take to work, reduce cost and help achieve a more sustainable diet. We would also use them as a quick lunch option, such as adding butter beans or lentils to a salad and hummus on bread. This meant that we relied on animal based protein such as meat and fish more than we had predicted.
The changing routine….
The past 8 weeks have flown by and to be honest following the FODMAP diet has now actually become part of our normal routine. The interesting part of following a structured diet, was discovering how difficult it was at first to change many ‘routine’ aspect of our day with the first week or two being the hardest. As the weeks went by we found finding suitable meals to grab for lunch easier and had discovered plenty of snacks to keep us going. Cooking lots of different meals and having to think a bit more creatively has been really enjoyable – and we do have a stack of recipes for all meals of the day which we feature on low FODMAP recipes found on the blog. A main message for those embarking on the diet *it really isn’t as hard as first thought, or felt in the first week – routines are very easily formed*
The new discoveries and essentials…
We have previously discussed how to get loads of flavour into meals and snacks, by using herbs and spices and garlic infused oil, and have described how to use these best in recipes. By not being able to use garlic and onion as a base flavour has made us use spices and herbs even more, which has been a revelation and made us prepare more dressings and sides such as pesto, pistou, Chimichurri and our own versions of these classics. Why we don’t use these sort of sauces & techniques more often in the UK is crazy, they are so simple and can be used with loads of different meals.
For us, using gluten/wheat free products was really useful and made the 8 weeks much more bearable. These products enable you to have the flexability you are used to, grabbing a slice of toast or crumpet before the gym or taking some rolls to a BBQ. Some of the companies also do cakes and muffins which are great for a treat, but ingredients need to be checked to ensure there are no FODMAPs added. Some of the breads available really are great but they are expensive. If possible request some product samples from companies and ‘try before you buy’, and we actually found the gluten free breads were often discounted in the supermarkets. If you shop smart the diet is no more expensive than your normal diet.
We don’t tend to eat that much pasta so having rice and potatoes more often was fine, and some of the gluten free pasta’s really were so good that we felt they weren’t any different from their wheat counterparts (providing you do not overcook!). Also discovering buckwheat flour in the form of pancakes (see week 2 above) has now meant we have a new favourite pancake – go see for yourself and try a buckwheat pancake.
The fruit and veggies….
It really was the variety of vegetables we both missed the most. Courgettes, peppers and aubergines are actually some of our most favourite vegetables…however having them nearly everyday got a bit repetitive. Carrots, green beans and sweetcorn were other favourites on the diet and we would always have a supply of all of the above in the fridge or sweetcorn in a tin.
Fruit did not seem too restrictive as we naturally preferred fruits such as grapes and bananas to apples and pears, however it seems that apple is added to SO many products once you start looking. This includes many pre-prepared foods and drinks as a sweetener, including a fair number of the gluten free products. Baking treats and making snacks from scratch is a better idea, as well as using foods in their most natural form and flavouring yourself i.e. yogurt. With the summer now arrived and the increased choice of seasonal cherries, plums, nectarines & peaches (all high FODMAP) being available, it is a good time for us to be able to reintroduce these. We picked a good time to start the diet in this case as we look forward to these fruits coming into season…something to consider if this if important to you.
The most important meal of the day….
The meal that was most altered was probably breakfast. Not being able to eat wheat means you have to think about your breakfast options. Finding options like oatbran / oatmeal and re-discovering oldschool classics like rice crispies and cornflakes led us to making our own mix of different suitable cereals in a tub and adding some extra nuts, seeds and dried fruit for flavour and sweetness. We also made our own snack food (see our low FODMAP fruity flapjacks) which could be eaten as we travel around in our jobs or as a quick grab and go if rushed at breakfast (see our low FODMAP Oat Muffins).
Breakfast is something we always have, and just couldn’t function without something decent to kickstart the day. Some of our new blog posts to come will be on what we have for breakfast and some tips on getting a healthy start to the day. As part of our morning routine, dairy was also something that we changed and actually we are likely to continue with these changes. We have been discovering all the amazing non diary milks of which there are such a huge variety now including nut, rice, soya, oat and coconut, as well as the flavoured versions of these. We found they taste great on cereals and porridge or as a drink and in smoothies. We tend to use a mix of nut and rice milk mainly however did stick to cow’s milk in tea and coffee as we felt the alternatives don’t work so well. With the variety of semi skimmed for coffee, skimmed for tea and nut/rice milks for cereals, our fridge door is usually jam packed! Small amounts of dairy are still allowed when following the low lactose part of the low FODMAP diet, allowing you this flexibility (or fussiness).
Following the low FODMAP diet over the past 8 weeks has been the most practical and useful way of learning a lifestyle change that we would be advising clients on. This has enabled us to learn exactly how hard following a restrictive diet is when eating out, shopping, cooking and snacking. There is no doubt this will make our consulting more effective, and it has been great to provide a growing resource and share other resources that we hope will be useful for both clients and healthcare professionals. There are lots of more recipes to come for you to try (whether you are following the diet or not!) now….to tackle the reintroduction.
Practical Tips for a low FODMAP diet
The first week of a low FODMAP diet is by far the hardest. Shopping and cooking habits have to change. Plus you need additional time planning and shopping especially the checking ingredients labels! At first it is hard to remember what foods you can and cannot eat and also what recipes they fit into. This is probably why some people prefer to follow a meal plan for a couple of weeks (or the entire duration of the low FODMAP diet) or indeed why lots of people stick to the same low FODMAP foods for the duration of the diet. Buying a suitable lunch is tricky–mainly due to the lack of options of foods not containing wheat, onion or garlic. Buying snacks is tricky – snacks suddenly take a lot of planning which is probably why companies have created a range of low FODMAP snacks e.g. FODY Foods. Buying dinner out is tricky!! – There are often limited suitable options when eating dinner out. Even breakfast requires planning–breakfast is typically a wheat based affair after all. Easy to make mistakes in the first week but people need to remember there is no need to abort the low FODMAP diet if a few mistakes are made. You will still have reduced your overall load of FODMAPs during the first week!
As confidence in the diet increases you try more adventurous meals – but to start with I went back to basics. And for me this meant to start with ‘traditional English’ style-i.e. meat (or fish), potatoes and two veg. The pictures above are from recipes on the blog: Low FODMAP Roasted Salmon & potatoes (courgettes and carrots), Low FODMAP Succulent Fried chicken breast in gluten free flour and spices with mash potatoes & green beans. Then as your confidence grows you can make your own low FODMAP curries like my Beef Rendang. You cannot rely on sauces or gravy as shop bought ones inevitably have high FODMAP ingredients. Learn to flavour each part of the meal instead. By the way I also found omelettes extremely useful on a low FODMAP diet as you can put anything in omelette!
For some reason everyone one who has ever cooked collectively decided that every meal we cook has to have onion and garlic in it! Replacing these flavours on a low FODMAP diet is essential. If you miss garlic the best tip I can give is to buy garlic infused oil!-£3 in Waitrose or £1.50 in Tesco. Use fennel (49g) & the green part of spring onion as a great replacement for onion. You can use the green parts of spring onions and here is a great tip for the white parts: If you put them in a jar and change the water regularly they will start to grow more green parts! Additionally buy some herb pots with chives being another replacement for garlic and onion flavour. I really encourage everyone to buy some herbs they add so much flavour to meals that you forget about the garlic and onion. Also chives have a slight onion and garlic flavour and are low FODMAP. Make easy homemade dressings with your excess herbs like gremolata / pesto / pistou / chimichuri. Just adjust the traditional recipes to make them low FODMAP. Use a griddle to cook vegetables as this will also add additional flavour.
It’s easy to cook without onion & garlic. A lot of people say they cannot cook without onion and garlic. The diet forces you into thinking of alternatives and nowadays I use a lot less onion and garlic because I have found more interesting ways to flavour my food rather than relying on the same two ingredients all the time.
Living without gravy or sauces: as I mentioned shop bought sauces or gravies are usually unsuitable.Plenty of alternative flavourings are available however e.g. mustards, pickles, some chutneys and other condiments that can be used. If you cannot live without a gravy or sauces then you will have to learn to make low FODMAP ‘traditional’ sauces. Long before Bisto or Dolmio was created we actually made our own sauces and stocks although for an easy option ‘Flavour pots’ are available (some are Low FODMAP and do not contain onion or garlic). I have also left a link to a low FODMAP stock recipe in the image above.
Make your own cereal mix: I mentioned you have to plan for breakfast and I say this mainly to make it cheaper and more interesting. Cheaper because replacing bread with gluten free bread or using gluten free cereal can be expensive and it doesn’t taste that great. Oats are a great breakfast and you can also use Rice Krispies and Cornflakes but that gets pretty boring and doesn’t really fill you up. Only use small amounts of some ingredients – I bought lots of different low FODMAP and moderate FODMAP breakfast ingredients and created my own cereal mix. Be careful not to use too many of certain ingredients e.g. desiccated coconut, dried fruits etc. otherwise you may make the cereal high FODMAP. Check the Monash low FODMAP app for appropriate portion sizes of foods.
You end up eating at home more: The effort of going out for only a limited choice of meals means you end up thinking ‘I might as well make this at home’. You will cook more: You end up cooking more to ensure lunches were available at work. This is time intensive and because of this you spend more time cooking and shopping. It is not as hard as first thought, or felt, in the first week! Routines are very easily formed and following the diet becomes second nature. I highly recommend making your own snacks otherwise when you are hungry you may be tempted to cheat and buy that nice looking pastry! On the blog I have a few recipes such as Low FODMAP Oat bran Muffins, Low FODMAP Flapjacks which are both amazing snacks and for a treat Low FODMAP Lemon Polenta Cake.
Issues with a low FODMAP diet
I realised I was eating the same veg all the time! For the first few weeks I was mainly eating aubergines, peppers and courgettes which soon got boring and may cause some people to lose interest in the diet and ‘cheat’. And if I was doing this then I assume many people are doing this….
Expense of gluten free foods – Gluten free foods are expensive and in my opinion do not taste that nice. An exception is Mrs Crimbles Coconut Macaroons which are pretty awesome. Tip: visit supermarkets at end of the day to get discounted gluten free bread, or even better request product samples from gluten free companies you will be surprised how many you can get and they can get you through the low FODMAP restriction phase. Also another tip – Gluten free flour tends to need more liquid when baking. I liked the Doves Farm flour, it seemed the best for baking and there pasta was probably the best as well.
I ate more meat and fish on a low FODMAP diet, mainly due to lack of pulses & lentils we often used to bulk out dishes or to replace meat and fish. This may have increased the expense of the diet. Actually pulses and bread were the things I missed the most on the diet.
‘Constipation’ for some is common on a low FODMAP diet. Very gradually over the 8 weeks my stool consistency and frequency had changed. I wasn’t constipated but this is something to bear in mind for those who already have a tendency towards constipation. If when looking at the Bristol Stool Chart you score of 1, 2 or possible 3 at the start of the diet then be more aware. I will assume it was the change in type and frequency of my fibre intake as well as the natural laxative effects that FODMAPs produce, but also perhaps an increase in protein from meat that impacted on these changes.
Dairy may go missing on a low FODMAP diet. Some people may avoid all dairy even though they can still eat it in certain amounts while others do not like the alternative milks available. Think about your individual preferences: if the only time you usually had milk was with breakfast and now you are eating gluten free toast for breakfast then obviously a reduction in calcium is something to bear in mind…
Eating out: it is easy to make mistakes or cheat when eating out often due to a lack of suitable options and this applies to snacks as well.
Lack of variety on a low FODMAP diet: if not experimental or lack cooking skills, or indeed lack time to prepare and cook food, then a low FODMAP diet will be more difficult. A lack of variety may also create boredom and may affect adherence to the diet when mistakes are made.
Unexpected benefits of a low FODMAP diet (aside from any symptom improvements)
On the plus side for me I discovered/rediscovered forgotten foods & new foods. I now love swede, either mashed or roasted and swede can also act as a carbohydrate replacement. Frozen spinach is simply amazing – it goes in so many dishes and is so cheap! I used also polenta to replace pasta because I didn’t like the gluten free pasta and this is cheap and tastes great when additional flavourings are added e.g. herbs, oil/butter, cheese etc.!
Good news! The first ever book dedicated to reintroducing FODMAPs is now available to purchase on Amazon. The book is titled ‘Re-challenging and Reintroducing FODMAPs – A self-help guide to the entire reintroduction phase of the low FODMAP diet’. Click below for more details.
Looking for The Best Low FODMAP Diet Resources, click here.
Dietitian authored articles on the FODMAP dietary treatment available here.
For dietitian approved low FODMAP recipes see here.
We recently travelled around the world and blogged about following a modified FODMAP diet. See more on our FODMAP blog Travel section.