On this page you will find links to the best and most trusted resources available to help support the low FODMAP dietary treatment. All the links on this page have a scientific base and have a registered dietitians input into the information that appears on the sites.
Nothing can better the personalised advice from a dietitian and all the resources and tips on this page can further support the information your dietitians provides to you.
If you are a dietitian recommending low FODMAP resources to patients or if you are someone with IBS you can trust the information you read on the websites and resources found here. So stop reading this and get clicking on the links….
The ‘Must Buys’ Best Low FODMAP Resources
Whether you have access to a dietitian or not there are two ‘must buy’ resources that will help immensely with implementing and completing the FODMAP diet.
1The Monash University low FODMAP App is the source for all FODMAP contents of foods. It is a key resource for starting the low FODMAP restriction phase (for 4-8 weeks). It is also available as a booklet here
2. The ultimate resource for reintroducing FODMAPS Re-challenging and Reintroducing FODMAPS A self-help guide to the entire reintroduction phase of the low FODMAP diet
One more smartphone resource you could consider buying which combines elements of both the resources above but is not as detailed is FODMAP by FoodMaestro
The best introductory videos & podcasts for FODMAPs & IBS
Irritable Bowel Syndrome
This video provides an overview of the Pathophysiology of IBS and Common Functional Gastrointestinal Disorders (FGIDs). All done in just over 20 minutes! An amazing amount of information covered by Dr Lin Chang
For more on the medical management of IBS, including the all important first line dietary advice see this article; Managing IBS. Problems with GP’s, national guidance and the low FODMAP diet.
Irritable Bowel Syndrome & the low FODMAP diet
This video gives a brief overview of the low FODMAP diet for IBS and the research conducted by King’s College London in the UK.
How to FODMAPs trigger IBS symptoms?
Produced by Monash University this simple video provides a great overview explaining how FODMAPs trigger IBS symptoms
What are FODMAPs?
A useful set of videos on the entire FODMAP diet can be found on the My GI Nutrition website which is a collaboration between American research universities and Nestle. Start with their video What are FODMAPs?
The best low FODMAP Vegetarian & Vegan Resources
Implementing and adhering to the restriction phase of the low FODMAP diet while following other dietary restrictions or regimens makes the diet much more complex. Ensuring you are getting adequate nutrition and replacing foods appropriately on a low FODMAP diet when vegetarian or vegan is harder but it can still be done. Here are some of the best vegetarian and vegan low FODMAP resources to help you.
New research has found that cooking and processing techniques, such as prolonged cooking and pickling, can decrease the FODMAP content of vegetables. For those who rely on a vegetarian or vegan diet this practical advice could increase vegetable food options on a low FODMAP diet. For further explanation on these FODMAP food processing techniques see this article and for details on new plant based foods that have had their FODMAP content recently analysed have a read of this article.
For general nutrition advice when you are vegan I highly recommend you take a look at The Vegan Society website and their ‘nutrition & health pages‘. For specific nutrients that can be deficient when following a vegan diet see here.
Other useful articles:
FODMAPs for Vegans (2014)
Eating vegan on a low FODMAP diet (2014, Protein sources)
Going Low FODMAP on a Vegan Diet (pdf.) (2013, Recipes)
The best high FODMAP ingredients lists in food products & reading ingredients labels
Whether you are strictly restriction FODMAPs or you have reintroduced FODMAPs to tolerance levels, knowing which food products contain FODMAPs and which ones do not is invaluable information.
The key is to know which ingredients are high FODMAP ingredients and what typical products you will find them in. It is also worth remembering that the way food is processed can affect its FODMAP content sometimes in unusual ways, therefore do not assume anything and always check the label. Below are some excellent guides to help you plus low FODMAP certification programmes such as the Monash University or FODMAP Friendly can also be very helpful…
FODMAP by FM – This app has a barcode scanning device to check suitability of food products based in the UK
The best low FODMAP Fibre resources for irritable bowel syndrome with constipation (IBS-C)
For both the general population and people with IBS it is recommended to have 25-30g of fibre each day and this recommendation continues when following a low FODMAP diet. The low FODMAP diet can reduce fibre intake, although perhaps more importantly will also reduces the intake of foods with natural laxative effects. Both of these factors can increase the risk of someone who is prone to constipation becoming more constipated on the low FODMAP diet. For those who have constipation predominant IBS (IBS-C) maintaining a good fibre intake while on a low FODMAP diet may improve the effectiveness of the diet.
The articles linked below will give you some practical tips and additional information to help ensure you maintain your fibre intake from low FODMAP foods.
Getting enough fibre on a low FODMAP diet (Monash Uni)
Getting Enough Fiber on a Low-FODMAP Diet (Patsy Catos, Dietitian)
Sources of soluble and insoluble fibre on a low FODMAP diet:
Dietary fibre series- soluble fibre (Monash Uni)
Dietary fibre series – insoluble fibre (Monash Uni)
For general advice on fibre and where to find a range of plant based fibre sources from the diet download this fact sheet from the British Dietetic Association: BDA Fibre Food Fact Sheet
Finally if you are really struggling to get enough fibre from food sources on the the low FODMAP diet or on your own personalised modified FODMAP diet then you can consider using a fibre supplement. It is best to discuss this with a dietitian to talk through options as adding in a concentrated form of fibre to the diet (even if it is low FODMAP) could increase symptoms. There are two excellent articles from Monash University, linked below, which provide more information on fibre supplements suitable for a low FODMAP diet and additional information on fibre & FODMAPs.
Fibre supplements & IBS (Monash Uni)
More than FODMAPs: fermentable fibres & IBS (Monash Uni)
The Best Probiotics for IBS
Probiotics can be a useful and effective treatment option for people with diagnosed IBS or functional gastrointestinal symptoms. It can however be a bit confusing knowing which probiotics have any research evidence behind them and which ones are just good marketing! Thankfully there are some very good websites, mainly designed for health professionals, which provide links to the researched probiotcs.
Starting with the Probiotic Database by Optibac; you can search the evidence for the specific probiotic strain you are interested in and find out what medical conditions it has been researched in. Annoyingly however the articles do not link to the specific brand of probiotcs unlike the other two resources below.
The Clinical Guide to Probiotic Products websites provide a brilliant resources for health professional and consumers on evidenced based probiotcs available in USA. The same Clinical Guide to Probiotic Products website is repeated but for products available in Canada. The resources links the researched probiotic strain and the product it is found in. I recommend this website to anyone searching for a probiotic to suit their gastro condition who wishes to try the available probiotics on the market. Big thanks to Prof Whelan who first mentioned these very useful resources.
If you are interested in reading research papers the two most practical reviews on probiotics and their use in gastrointestinal symptoms are as follows: 1. The rather lengthy titled British Dietetic Association systematic review of systematic reviews and evidence‐based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update) which unfortunately is not open access. 2. The slightly older Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice – an evidence-based international guide (2013) which is open access.
Suitable probiotics for the low FODMAP diet
If the restriction phase of the low FODMAP diet has not improved your symptoms then probiotics could be worth a trial. However as yet there is no evidence that probiotcs will improve symptoms in those who do not respond to a low FODMAP diet (watch this space however as our research group have investigated this!). It is perhaps a better option to try probiotics before you even attempt a low FODMAP diet. Otherwise it is best to wait until the end of the low FODMAP restriction diet to try a probiotic so you are not implementing two interventions (treatments) at once.
You can also trial a probiotic after you have reintroduced FODMAPs back into your diet after completing the reintroduction phase. There is a theory that probiotics may help improve tolerance levels to high FODMAP foods but this has not been evaluated or proven.
There are thousands of probiotics available but only a very small minority have been shown to improve functional gastrointestinal symptoms and IBS. The probiotics with the best evidence for their effectiveness in bowel disorders, such as IBS, and available in the UK are as follows.
Vivomixx (formerly VSL#3)
Vivomixx (formerly VSL#3) VSL#3 is the first probiotic most health care professionals had heard of for treating IBS and is probably still the one most recommended (although Alflorex prehaps has the stronger research evidence). Confusingly its branding has changed in different countries and in Europe VSL#3 is known as Vivomixx while in the United States its trademark is Visbiome. Therefore make sure you buy these brands and not the old brand of VSL#3. VSL#3 / Vivomixx has been used in several IBS studies and in other medical conditions and if you are interested follow the link here for a list of the research articles. In regards to IBS & FODMAPs the best quality and most important research study using VSL#3 / Vivomixx (in my opinion) was published in 2017: A Diet Low in FODMAPs Reduces Symptoms in Patients With Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial. This article is open access. In the study VSL#3 was found to be just as effective as the low FODMAP diet at reducing IBS symptoms over 4 weeks. The 4 weeks low FODMAP diet reduced levels of bifidobacteria. Interestingly however patients taking VSL#3 with the low FODMAP diet did not see a reduction in their bifidobacteria. There was no additional benefit of taking VSL#3 with a low FODMAP diet in terms of reducing symptoms but it does seem these two interventions can be used together without any detrimental effects. Indeed the use of Vivomixx with a low FODMAP diet may prevent the reduction in bifidobacteria as this study showed. If you would like a really good summary of this research study then read this AGA Journals blog post: Can a Diet Low in FODMAPs Reduce IBS Symptoms in the Real World?
Very recently the use of VSL#3 in all randomised controlled trials in IBS have been put under review: Systematic review and meta-analysis: Efficacy of patented probiotic, VSL#3, in irritable bowel syndrome This review highlights that the pooled data from RCT’s using VSL#3 show it is no more effective than a placebo although there is a trend towards overall symptom improvement and VSL#3 seems well tolerated in IBS. Additionally the mechanism by which VSL#3 may help improve symptoms in IBS it is still not known…..
When taking these probiotics follow the manufactures guidelines. For general guidelines on taking probiotics see this useful fact sheet (pdf) created by the British Dietetic Association: BDA Probiotic Fact Sheet and also this blog post by Monash Probiotics for IBS.
Patients feedback from using these probiotics is mixed. Some find they help improve symptoms while others find no benefit at all. A small minority find the probiotics make their symptoms worse.
The best Prebiotics for IBS & suitable prebiotics for the low FODMAP diet
Prebiotics are non‐digestible selectively fermented dietary fibers, found in a range of plant based foods, that specifically promote the growth of one or more bacterial genera in the gastrointestinal tract and therefore provide a potential health benefit to the host. Thus it is important to have prebiotcs in the diet for this reason.
Due to their effect on the gut microbiota prebiotics may improve gastrointestinal symptoms. People with IBS and indeed people without gastrointestinal symptoms may take a prebiotic supplement in an attempt to improve their gut health. Common prebiotics added into foods include inulin and fructooligosaccharides (FOS) which are both oligosaccharides and account for the ‘O’ in the FODMAP acronym fructans.
The problematic factor for people with gastrointestinal symptoms is prebiotics are found in lots of high FODMAP foods in the form of fructans and galacto-oligosaccharides (GOS) (both oligosaccharides) and can trigger gastrointestinal symptoms. Additionally the prebiotics used as supplements e.g. inulin are also very high FODMAP and any beneficial effect of improvements in gut microbiota will be at the detriment of increased gastrointestinal symptoms that can be experience from taking the prebiotic. A recent systematic review of prebiotics in IBS summarised that prebiotics as a whole do not improve GI symptoms but do increase bifidobacteria (Read the research here: Wilson et al, 2019 Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials). It is therefore not a good idea for people with IBS or other functional gastrointestinal disorders to take a prebiotic supplement without giving it some consideration.
There is however one prebiotic supplement that can help reduce IBS symptoms and is suitable on a low FODMAP diet.
The prebiotic called Bimuno has had several studies to assess its efficacy in gastrointestinal disorders and its impact on the gut microbiota. The original study included a group of 44 patients with IBS who took Bimuno for 4 weeks. Bimuno was found to significantly increase levels of bifidobacteria, improve stool consistency and reduce bloating and flatulence (compared to placebo). Read the research here: Silk et al, 2009 Clinical trial: the effects of a trans‐galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome (open access)
Bimuno has also been shown to reduce IBS type symptoms (abdominal pain, bloating, flatulence) in the general population. Read the research here: Vulevic et al, 2018 Effect of a prebiotic galactooligosaccharide mixture (B‐GOS®) on gastrointestinal symptoms in adults selected from a general population who suffer with bloating, abdominal pain, or flatulence (open access)
In a study further conducted in Spain the efficacy of Bimuno was compared to a low FODMAP diet. In patients with likely functional gastrointestinal disorders and flatulence symptoms 4 weeks of Bimuno increased the abundance of Bifidobacteria while 4 weeks low FODMAP diet deceased bifidobacteria. Both the low FODMAP diet and Bimuno decreased gastrointestinal symptoms significantly expect for flatulence in the Bimuno group. Two weeks after stopping taking Bimuno the symptom reduction remained although when patients went back to eating high FODMAP foods unsurprisingly their symptoms also returned. Read the research here: Huaman et al, 2018 Effects of Prebiotics vs a Diet Low in FODMAPs in Patients With Functional Gut Disorders (open access)
Finally in a recently published study Bimuno has been used in conjunction with a low FODMAP diet to improve gastrointestinal symptoms of those diagnosed with IBS in an RCT. The group that took Bimuno in combination with a low FODMAP diet had better symptom improvement than those who only did the low FODMAP diet suggesting a synergy between the two therapies. Despite taking the prebiotic Bimuno this did not prevent a decline of bifidobacteria from following the low FODMAP diet for 4 weeks (this may be due to the low dose used). Interestingly this study was also the first to show that even 7 days on a strict low FODMAP diet can significantly impact the GI luminal environment by causing higher stool pH, and lower butyrate production. Read the research here: Wilson et al 2020 β-Galactooligosaccharide in Conjunction With Low FODMAP Diet Improves Irritable Bowel Syndrome Symptoms but Reduces Fecal Bifidobacteria
Take home messages for the prebiotic Bimuno:
- Could be useful at reducing symptoms in the general population with IBS type symptoms without having to change diet or follow a low FODMAP diet
- In those diagnosed with IBS it could be used in conjunction with a low FODMAP diet and make it more effective
- Bimuno may not always improve flatulence symptoms and may not improve levels of bifidobacteria in all those with diagnosed IBS but may improve levels of bifidobacteria in some people with functional gastrointestinal symptoms
Finally remember a short term reduction in FODMAP prebiotics can improve IBS symptoms but can also decrease levels of bifidobacteria. Therefore once the 4 week restriction phase of a low FODMAP diet is complete it is important these FODMAP prebiotic fibres are reintroduced to personal tolerance levels to protect against any unknown long term side effects of long term FODMAP restriction on the gut microbiota.
Most Trustworthy low FODMAP & IBS Websites
The IBS Network is the national charity supporting people living with Irritable Bowel Syndrome. The charity provide an extensive amount of information and support for people with IBS and if you become a member you can access their IBS Self Care Programme. This provides you with comprehensive information about the nature, causes and management of IBS. I am one of the expert advisers who volunteer their time for the IBS Network. The IBS Network also provide local support groups run by trained expert patients.
A treasure trove of low FODMAP information all based around the scientific research. A Little Bit Yummy is the place for all low FODMAP information. Amazing recipes that are simple and creative and don’t cost the earth with input from dietitians so you know they are suitable.
For some more fantastic and practical low FODMAP recipes I love Cook Low FODMAP even though it is not being updated with anymore new recipes unfortunately.
Reintroducing FODMAPs the only website dedicated to the reintroduction phase of the low FODMAP diet. Got a question on how to challenge and reintroduce FODMAPs? Check out the extensive FAQ section on the website.
Low FODMAP Food Products
All food products by FODY are certified low FODMAP by the Monash University programme. Their products are available in the USA & Canada (see here) and have recently started shipping low FODMAP products to the UK (see here). They also have great information on the website.
It is very hard for a Facebook group to create a trustworthy and professional support group. I was very actively involved in Low FODMAP Recipes & Support when it had 10,000 members and it was excellent. The admin team are exceptional and are keen to promote dietetic input and scientific research around the low FODMAP diet. This group must be going from strength to strength as it now has 35,000 members (plus)! and although I am no longer actively involved I hope it is still just as good so check it and and see what you think.
More coming soon so bookmark this page and check back soon…(last updated April 2019)