(Updated 2017) by Lee Martin MSc RD
Please note not all the information in this post (from 2013) is based on the latest research information and clinical practice advice regarding the reintroduction phase of the low FODMAP diet. The article has been left here for reference however after reading it you can read a more recent post entitled Reintroducing foods on the low FODMAP diet, Watch out for misinformation
The good news however is that the first ever book dedicated to reintroducing FODMAPs is now available to purchase on Amazon. The book is entitled ‘Re-challenging and Reintroducing FODMAPs – A self-help guide to the entire reintroduction phase of the low FODMAP diet‘. For more details visit the website www.reintroducingfodmaps.com
Having now completed the low FODMAP diet for the full 8 weeks (time does really fly!) the next phase was to reintroduce the foods high in FODMAPs back into our diet. Following the low FODMAP diet had become part of our daily eating routine, and after 4 weeks it quickly became fairly easy to follow with not much thought needed regarding appropriate choices required. However, the diet is not designed to be forever, rather it is designed to reduce the overall load of FODMAPS in the diet to reduce severity of symptoms – and then to re-introduce to your personal tolerance levels. This became tricky for us, given that we do not have a clinical diagnoses of IBS and were not looking for a significant reduction of symptoms. We did however find a change in symptoms from following a low FODMAP diet and as such were very interested to identify the exact problem FODMAP foods which increased symptoms when we reintroduced them.
Some tips about how FODMAP reintroduction’s can practically be done
Fisrt you need to keep the low FODMAP diet rolling along in the background whilst reintroducing the right amount of test FODMAP food. We found it can be difficult to incorporate this into meal planning, especially as you are meant to test a particular FODMAP food three days in a row.
One option is to just cook the same low FODMAP meal three days in a row and increase the dose of the test food (if your not getting any symptoms of course). We decided to do it the harder, but more interesting way and incorporate the test foods into meals & snacks and an example of how we tested a high FODMAP food is shown below.
Example FODMAP Challenge
Test Food: Mushrooms
Test FODMAP: Polyols
Test Amount Day One: 40g (roughly 4-5 mushrooms depending on size)
Test Meal Day One: We had a meal at a chain restaurant and the chicken dish I ordered came with, what I’m going to guess, is about 40 grams of mushrooms or maybe just slightly less. Which worked out perfectly for my test on Day One!
Test Amount Day Two: 80g
Test Meal day Two: Gluten free pasta with homemade pesto & mushrooms
Test Amount Day Three: 120g (usually half a pack of supermarket bought mushrooms)
Test Meal Day Three: Garlic (infused oil) & parsley mushrooms on gluten free toast
I chose mushrooms because 1. I love them, 2. I missed them & 3. They fit into loads of meals I would usually cook 🙂 like this Polenta & Mushroom dish I cooked yesterday. Indeed I could also have used this meal as a suitable low FODMAP meal with a test food (mushroom) to challenge.
Some tests are definitely easier than others however; for example when you test fructans (such as wheat, onion, broccoli) which are found in many foods you will be glad there are some foods containing fructans that can be had as a snack rather than needing to incorporate them into a full meal. Bringing fructans back into the diet by trying 2 slices of bread was easy and enjoyable, and provided the first opportunity to enjoy some delicious fresh bread! There are many different foods which contain fructans, and so you should always test a few different ones (or more if you want), especially if you feel fructans are a particular problem for you.
There are no rules to what foods you choose when it comes to the re-introduction phase, but it is likely more support may be required. At this point we would recommend for anyone following the diet to speak to your healthcare professional for more assistance and some pointers of where best to start. Make sure you do complete the re-introduction phase fully so that you can incorporate as much variety of low FODMAP and high FODMAP containing foods into your diet. A wide variety is key to your digestive health and you may even find benefits once they are reintroduced. It is understandable why some people are reluctant to complete this phase fully especially if their symptoms have been significantly reduced by the diet and the thought of getting those symptoms back are quite scary.
IBS symptoms experienced from the reintroduction of high FODMAP foods may in some cases seem worse than before the low FODMAP diet was started
It is worth noting that the symptoms experienced from the reintroducing of high FODMAP foods may in some cases seem worse than before the low FODMAP diet was started. This may be due to slight changes in your tolerance levels to FODMAPs due to not having these foods in your diet for 4 weeks or more as well as changes to your gut microbiota. Foods high in FODMAPs are also prebiotics, meaning they provide food for the good bacteria in your gut, which is a good thing and is an important part of a balanced healthy diet. By not consuming foods containing these prebiotics you may affect the natural flora in your gut which could lead to more gastrointestinal and other problems in the future. This is a very interesting topic which is being researched as part of the whole FODMAP evidence base. The main aim is to ensure you keep yourself and your gut healthy for the long-term.
Further articles on how to challenge FODMAPs and navigating the Reintroduction Phase of the low FODMAP diet
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 on the logo for more details.
We recently travelled around the world and blogged about following a modified low FODMAP diet. See more on our FODMAP travel section.