Reintroducing FODMAPs: Step 2 of the Low FODMAP Diet
You have successfully completed the FODMAP elimination phase and feel much better. What now? You are ready for the second step: reintroducing FODMAPs. This is an exciting time as you can start learning about the foods that trigger you.
After completing this step, you will know a lot about which foods you can have in order to maintain good symptom control.
Specifically, you will learn which ones you can re-introduce liberally in your diet, and which ones you can have in small amounts or only occasionally. In addition, there may be a few ones you will need to avoid (but not forever).
5 Key Things to Know about the Reintroducing FODMAPs
1. There is no set protocol for this phase, only generic guidelines
As soon as symptoms have considerably improved, you are ready to reintroduce the high-FODMAP foods that you avoided or reduced in the FODMAP elimination phase.
There are different approaches to this phase. An expert dietitian can help you determine the best one for you, according to your symptoms, anxiety level, and other considerations.
Researchers are still studying the best way to carry out the FODMAP challenges. Nonetheless, they have identified some key factors that are important to the success of this phase. I have outlined a few key guidelines below.
2. Challenge each FODMAP group separately
Over the course of 6 to 8 weeks, you will be able to challenge all the major FODMAP groups and subgroups one at a time. These challenges will allow you to identify which foods may trigger your symptoms. This is essential, as tolerance to each category may vary, and each one has distinct physiological effects on the gut.
During each challenge, it is important to continue eating a low FODMAP diet, with the exception of the new food introduced each week. This allows you to isolate each type of FODMAP and find the trigger of any potential symptoms without a doubt.
3. Record symptoms
It is key to record the types of symptoms you may experience during each challenge and their severity. A small amount of garlic or honey may not cause any or only mild symptoms. However, bigger portions may cause severe symptoms.
Keeping a food and symptom diary will help you track these differences in response to food challenges. The Monash FODMAP App can help with this. In addition, it will allow you to make informed decisions when personalizing your diet.
4. Keep re-challenging problem foods
IBS symptoms are known to wax and wane over time. Stress levels and other factors influence these changes. It is important to keep trying to challenge foods that “failed” the first challenge. This way, you can keep increasing the variety of your diet.
Even though you didn’t tolerate a challenge food at first, you may get different results 3-6 months later. Reducing the dose of the food tested and/or managing stress during the time of the challenges may also increase its tolerance.
5. Don’t do it alone!
It is ideal to have the guidance of a dietitian who is an expert in the low FODMAP protocol to complete this phase efficiently and correctly.
A dietitian like me can give you the exact foods and schedule of reintroduction, as not all high-FODMAP foods are good candidates for the challenges. And help you identify the best approach for you, interpret the results of the challenges, and personalize your long-term diet.
If you are ready to move on to this exciting part of your journey in managing IBS symptoms, I can help!