Excuse me, what?
Have you ever had a new year resolution to eat healthier and get in shape?
Have you ever tried to get your beach body right 3 weeks before spring break and suffered through all the vegetables only to still look "fat" when it's bikini go time? Or, maybe you paid too much money for a dietician to write up an eating plan for you and wondered why you were so gassy, bloated and uncomfortable after a few days on it, and subsequently quit said plan after a week?
Do you look like you're a few months pregnant when you've been a good boy or girl and eaten all your broccoli and cauliflower rice the WHOLE week? Enter: frustration.
Fermentable ("a chemical reaction in which a ferment causes an organic molecule to split into simpler substances."(3))
and Polyols (sugar alcohols, like xylitol and sorbitol, think "artificial sweeteners").
FODMAPs are CARBS - "simple carbs". Carbs? I love carbs. They are delicious. Bread. Noodles. Cookies. Donuts. Cereal. Apples. Cauliflo- what? Cauliflower. Is a carb? Yes, and it may hate you. You already know if it hates you if you have bubble gut every time you eat it. I know it hates me.
Outdated ways of thinking are that only "white" things are sugars/carbs. Traditionally, we think of carbs being the things I listed above - the "whites" - sugar, pastries, rice, potatoes, bread, noodles, and so on. But many foods are carbs, and different carbs are broken down in our bodies by certain enzymes. Enzymes are substances produced naturally in our bodies, even as soon as we start to chew. A CARB that most people will recognize by name is the disaccharide Lactose (a double sugar molecule), and it's digestive enzyme is Lactase. Lactose, meet Lactase. Hi, nice to meet you. People who are "Lactose intolerant", do not have enough Lactase enzyme to break the Lactose down into it's monosaccharide components, glucose and galactose. If you eat it, Lactose then sits inside your digestive tract, which is lined with mucosal cells (like the inside of your mouth) and healthy gut bacteria, and starts attracting water. Gut bacteria are fermenters - the strains of bacteria that you need to properly break down foods. However, if you don't produce enough/any Lactase, Lactose molecules will travel further down than they should, and forced fermentation lower in your gut is what gives you diarrhea, gas, bloating, and cramping after you eat ice cream at your nephew's birthday party. Diarrhea, from the water drawn in, gas from the fermentation (think foam and beer burps), bloating (from extra water and air), and cramping (peristalsis and gas pain).
Still with me?
Sources on the internet differ in which foods they categorize as being HIGH or LOW FODMAP. That's a Google search that can get real confusing, real quick, don't recommend it. Instead, here are 3 of the sources I found to be most helpful: Kate Sclarlata is a Registered Dietitian who specializes in FODMAP diets, PaleoLeap has a great article that tells the whole story on FODMAPS, and Rachel Pauls is an MD who can walk you through an elimination diet step by step. Each of these sources has lists of high/low FODMAP foods for you to ponder.
The "Big 3" macronutrients are Carbs, Fats, and Proteins, and we need all 3 to live. Sorry, not sorry, keto.
"Carbs" (or Carbohydrates) are a macronutrient, and they are made up of various designs of Carbon, Hydrogen, and Oxygen molecules.
"Macro-" = BIG
Definition of nutrient (Entry 2 of 2) : a substance or ingredient that promotes growth, provides energy, and maintains life."(1)
You may or may not know that FODMAP carbs are notorious for triggering digestive symptoms of bloating, gas, cramping, and stomach pain, or even stressful bowel movement patterns such as mixed constipation and diarrhea. Lactose and gluten get all the blame, and gluten isn't even a FODMAP! It's a couple of proteins. So, unless you've been diagnosed with celiac disease, and unless you've experimented with specific eliminations or substituted certain foods, you may be unnecessarily eliminating foods that weren't the culprit.
Ever heard of IBS or Irritable Bowel Syndrome? Shall we guess what the symptoms of IBS are? "The signs and symptoms of IBS vary. The most common include:
Abdominal pain, cramping or bloating that is typically relieved or partially relieved by passing a bowel movement
Diarrhea or constipation — sometimes alternating bouts of diarrhea and constipation
Mucus in the stool." (2)
Pull it all together, will ya? You're all over the place. Stay with me...
Talking to most people here, at some point in life, past, present, or future, something will (or has already) either internally motivate or externally motivate you to live in a body that is healthy and that feels good. For some people, eating whole, nutrient dense foods is second nature. Whether it's because they were raised to eat that way or they learned to eat that way, it's become their norm. For other people, it's all fun and games until they are Fred Sanford sweaty with chest pain at 4am, but they just had their 40th birthday?! It's the big one Elizabeth, I'm coming to see you, Honey! Or, sometimes, a pandemic virus shakes the world up. And ... the scary reality is that the pandemic virus seems to have a particular vendetta against people who are diabetic and obese. This is where you should be saying "oh, shit" if your doctor told you last year that you are "obese and pre-diabetic" according to your yearly check up. Oh, and gave you a prescription for Linzess all in one appointment after you squeezed in that you had been having IBS symptoms. You Googled it. Your doctor agreed, sounds like IBS symptoms, take this pill until you can get in to see the GI doctor. "Hi, yes, I'm calling to make an appointment, I was referred by Dr. PCP to be worked up for IBS." "Yes, ma'am, our next available appointment will be January 18, 2021." "That's almost 6 months from now! I can't wait that long to figure this out, what am I supposed to do?! My stomach is making me miserable. Okay, I guess put me down then and if I can get on the cancel list, please call me." Good thing your doctor gave you that prescription! Did he tell you to investigate your diet? Suggest that perhaps what you are eating is causing your digestive and elimination problems? Maybe, but a pill is much easier. #HealthcareinAmerica2020.
Great. A 6 month wait. Now what? I'll fix this. I need to lose a little weight anyway, I'll start eating healthier, I've been doing fast food and diet Dr. Peppers too much lately, ugh. Okay! Grocery list composed, full of vegetables, and fruits, and yogurt, and low carb pizza with cauliflower crust, and zucchini noodles. Pick up Linzess on the way home from the store. Things are great! For a while... You text your friend, you didn't poop for 4 days and you are cramping so bad and now diarrhea! I thought this medicine was supposed to fix everything and I've been doing SO good with my eating?! All healthy stuff with one cheat day and all the water!
Lucky you, the friend you texted writes blog pots about stuff like this and she tells you - it's probably FODMAPs and sends you a link to read. She tells you, keep a food diary of everything you eat for a week and write down your symptoms every day. Keep a diary of your bowel movements and some descriptors (normal/soft, watery, loose, painful, etc.). Then, try and figure out if there are patterns on particular days or symptoms after a particular meal. Are you eating a LOT of any one thing? For example, it's really easy to eat eggs every day, and while eggs aren't a carb - they can be problematic.
If you find a pattern or you suspect a problem food, say, broccoli, you can do 1 of 2 things to start. You can eat it by itself, raw and cooked, document it in your diary, and see if you have symptoms after. Or - eliminate it, for 2-6 weeks. Completely. Cheesy broccoli counts, can't have that either. Continue to write everything down while you eliminate 1 suspect food at a time, and pay attention to whether or not your symptoms improve.
If you're a super investigator - there are food sensitivity tests. The one I have used and recommended is from EverlyWell. It's a great piece of the puzzle in figuring out foods that might make your body angry at you, and give you ideas on where to begin an elimination diet. Your results may surprise you.
Maybe now you can understand why probiotics are the trendy supplement. Probiotics are trendy in part, because we the people take a lot of antibiotics and a lot of acid reflux medications. Probiotics add the good bacteria strains we need to digest food, and can be a huge help in solving your stomach troubles!
So you read about FODMAPs. Maybe dabbled in it, maybe not. You're busy, you kept taking the Linzess, it's helping some. You make it to your GI Doctor appointment, talk about your symptoms, and you are told he/she wants you to do a colonoscopy to evaluate your symptoms. I'm rounding third, here, so I won't go into detail about colonoscopies and IBS diagnosis, but I want you to be informed. According to MDSave, the average cost of a colonoscopy and all it's frills is $4,469. Sure, if you have health insurance it will cover some of the cost, but that's a lot of money. And, just a last piece of food for thought - the research on using colonoscopy to diagnose IBS shows that a scary or alternative diagnosis was found in less than 2% of patients. IBS can be diagnosed non-invasively, and ultimately, even if you are diagnosed with IBS formally, a low FODMAP diet is a cornerstone of treatment.
In closing, the skin/outer shell of corn is made of a specific type of fiber called cellulose. Cellulose is a polysaccharide that humans don't make enzymes for. So, now we know, that's why there's corn in your poop.
This is a great picture if you are a visual learner, and the article it came from is awesome too!