Today’s topic: gut health. I know that gut health is not a topic typically brought up in polite conversation. Well, maybe it should be. If you’re among the millions of Americans who suffer with uncomfortable gastrointestinal (GI) tract symptoms on a regular basis, you’ll want to know how to eat to beat digestive problems. See what Kate Scarlata, RDN, LDN, the co-author of The Low-FODMAP Diet Step by Step, A Personalized Plan to Relieve the Symptoms of IBS and Other Digestive Disorders, has to say about getting relief.

Irritable bowel syndrome and the low FODMAP diet

One in four of us have tummy trouble on a regular basis, and an estimated 25 to 45 million Americans suffer from Irritable Bowel Syndrome (IBS).  

IBS causes gas, bloating, cramping, pain and altered bowel function.

The low-FODMAP way of eating is based on an approach created by researchers at Monash University in Australia. According to Scarlata, research shows that up to 75% of people with IBS can get relief from their symptoms by following a low-FODMAP diet.

A low-FODMAP eating plan may also benefit those with other GI conditions, such as celiac disease (along with a gluten-free eating plan.)

 

When it comes to digestive woes, the authors know what they are talking about. In addition to providing the latest research about personalizing a FODMAP plan and 130 delicious recipes, Kate, and her co-author and recipe developer Dede Wilson, discuss their experiences in the book. Kate had a major intestinal resection nearly 23 years ago that resulted in debilitating digestive symptoms.  Dede was diagnosed with IBS in 1990.  Both have successfully used the low-FODMAP diet to manage their issues.

Here’s more from my interview with Kate.

What are FODMAPS?

FODMAPs are a group of certain carbohydrates (sugars and fibers) found in higher levels in many everyday foods, such as apples, garlic, traditional yogurt (not Greek), and products made with wheat. Because some people can’t properly digest them, FODMAPS can pull water into the small intestine, and they are rapidly consumed by gut microbes (the bacteria present in the gut), which results in excessive gas production. If you have a sensitive gut, water and gas can contribute to symptoms of bloating, alteration in bowel habits, and pain.  Additionally, the microbes that feed on FODMAPs create compounds that may also play a role in the symptoms of digestive distress.

Why did you write a book about FODMAPS? 

I co-wrote the The Low-FODMAP Diet Step by Step because I wanted IBS patients to have an easy-to-understand approach to following the low FODMAP diet.  I have created ways to make the approach less daunting and realistic through my work with thousands of patients to implement the low-FODMAP diet.

The most important point about the low-FODMAP approach is that is it a three-part nutritional intervention. The first part is a two to six-week elimination phase where high-FODMAP foods are taken out of the diet.  The second part is the challenge, or reintroduction, phase. During this phase, FODMAPs are systematically added back to the diet to help you identify which FODMAP sources trigger symptoms, and which FODMAPs do not. The third phase is the integration phase, when tolerated FODMAP foods are slowly added back to the diet.

The goal of the low-FODMAP approach is to eat the most varied and enjoyable diet as possible while maintaining good symptom control. However, balance is important. Cutting out too many foods on the low-FODMAP diet may also reduce some healthy microbes in the gut.  We encourage the challenge and integration phases of the low-FODMAP diet so that you can follow an eating plan with as much variety as possible to maintain symptom relief and keep your gut healthy.

Why are digestive disorders increasing?

In my opinion, we are seeing an increase in digestive issues due to a a variety of reasons including the use of antibiotics and antimicrobial soaps, high fructose corn syrup (a concentrated source of FODMAPs) and food additives. For example, emulsifiers in highly processed foods such as ice cream, salad dressing, and mayonnaise, cause gut inflammation and altered gut microbes in animal studies.

Pollution, stress, and other factors also alter and disturb the balance of microbes that inhabit our gut and support health.

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Read: What your gut bacteria say about your health

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Do you think it’s difficult for people to be properly diagnosed with IBS and other digestive disorders? 

In America, talking about gut health is often viewed as taboo. Although our views on talking about it is slowly changing for the better, many patients would rather suffer in silence than address their symptoms. A recent study found that primary care doctors fail to ask about GI symptoms quite often as well during physical exams, which further compounds the problem.

On a scale of 1-10 (10 being the best), how exciting is the evidence about the effects of what you eat on digestive health and overall wellbeing? 

I would say we are at about a 10+ in this area! The evidence continues to mount daily that the gut is the window to health.

What we eat impacts the trillions of microbes that live in our intestine. We know these microbes affect our chances for chronic diseases including diabetes, obesity, non alcoholic liver disease, and depression.

It’s a very exciting time to be a dietitian interested in gut health. I truly believe all dietitians should be watching the research closely so that they can best communicate findings to patients and other consumers.

There are so many new studies looking at how FODMAPs may affect health. A 2017 study showed that when breastfeeding moms of infants with colic decreased their FODMAP intake, the infants’ colic symptoms decreased.

While more research is needed about the effect of mom’s diet on colic, the study offers hope to parents. Another interesting study looked at how the low-FODMAP diet may help reduce inflammation in the body. Inflammation can give rise to chronic conditions including heart disease and cancer.

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Click here for tips about how to discuss your digestive issues with your doctor

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