Welcome back to my “FODMAP Explained” Series! This is a set of articles I have dedicated to explaining the acronym FODMAP. You will also find practical tips to avoid symptoms while including as wide a variety of foods as possible. In this article, we discuss the letter “P” in the acronym FODMAPs: Polyols.
Polyols: the “P” in FODMAP
The “P” in FODMAP, polyols, are also called “sugar alcohols”. You can recognize them as their name almost always ends with “ol” (sorbitol, maltitol, erythritol, etc.). Why are these carbohydrates problematic? Our small intestine absorbs them very slowly. While they are sitting there, they have an osmotic effect: they draw water, contributing to symptoms of bloating and diarrhea. In addition, they may be poorly absorbed and end up in the large intestine. There, our gut bacteria ferment them and produce gas. Whether you get any gut symptoms usually depends on the amounts of polyols you eat at one meal.
Polyols in the Low FODMAP Diet
During the elimination phase of the low FODMAP diet, you will need to reduce your intake of polyols to minimize your gut symptoms. There are two polyols that are naturally found in some fruits and vegetables. These are:
- Sorbitol: found mostly in fruit, for example, blackberries, avocados, and stone fruits
- Mannitol: found mostly in vegetables like mushrooms, cauliflower, and celery
But there are other polyols in sugar-free products such as mints, gums, some candy bars, chocolate, and other processed foods. Manufacturers use them as low-calorie sweeteners to replace sugar:
You may have noticed the warning that eating excess amounts of these sugar-free products may cause diarrhea.
Bottom line: what can you eat?
During the elimination phase, it is best to avoid all sources of polyols, including the fruits and vegetables mentioned above and all sugar-free products (see the Monash University FODMAP App for a complete list). When you are ready to reintroduce FODMAPs, your dietitian will guide you on how to reintroduce mannitol and sorbitol separately to find out which ones may be triggering symptoms for you. Many people can tolerate one but not the other. Others may tolerate both but in small amounts. Finally, some people can enjoy both without any issues at all.