5 Risks of the FODMAP Elimination Diet You Need to Know
So, you have SIBO or IBS—or think you have SIBO or IBS, based on the cries for help your gut keeps sending you—and you’ve heard that the low FODMAP diet can help ease your digestive symptoms.
While you may experience relief by following a FODMAP elimination diet, it may just be temporary or in the worst case give way to other issues related to your digestion and greater health. With that said, is a low FODMAP diet actually healthy or is there a better way to heal your gut?
Before jumping into five common risks of the FODMAP elimination diet, let’s first take a quick look at what FODMAPs are and what the low FODMAP diet entails.
What Are FODMAPs?
FODMAP is an acronym that stands for fermentable oligo-, di-, mono-saccharides and polyols.
In plain English, FODMAPs are a group of short-chain carbohydrates that the small intestine has trouble absorbing. When your gut bacteria uses these carbs for energy, hydrogen gas is produced, which may lead to digestive symptoms like:
bloating
constipation
cramping + abdominal pain
gas
FODMAPs also absorb water, mingling with bacteria and leading to fermentation in the colon, with diarrhea as another common side effect in sensitive individuals.
Digestion aside, FODMAP foods can even cause or exacerbate other health issues like migraines, joint pain, and inflammatory skin conditions.
Some people experience these issues from eating high FODMAP foods, which include but aren’t limited to:
beans, lentils + legumes
nuts high in galacto-oligosaccharides (GOS) and fructans like cashews + pistachios
wheat
dairy (lactose)
sugar + sweeteners
fructose in corn syrup and fruits like apples, pears, mangoes + cherries
vegetables high in fructans and mannitol like onions, garlic, Brussels sprouts + artichokes
processed meat
What Is the Low FODMAP Diet?
The low FODMAP diet plan involves three steps:
Following an elimination diet that excludes all high FODMAP foods
A gradual reintegration of one FODMAP food at a time (typically a few days apart) to see which ones trigger digestive issues
Excluding or limiting FODMAP food triggers in the long-term
Again, you’ll likely notice digestive relief in the initial stages of the elimination diet since you’re cutting out common dietary triggers. But if you stick to it for the long term, the potential risks of the FODMAP elimination diet just may outweigh the benefits.
5 Risks of the FODMAP Elimination Diet
Before you jump on the low FODMAP diet bandwagon, I want to make sure that you’re aware of certain risks associated with it.
1. Sticking with the Low FODMAP Diet for Too Long
One mistake I see quite often is following the FODMAP elimination diet for an extended period of time. The low FODMAP diet is only supposed to be used for a short period of time—usually three to six months.
Note: Regardless of your symptoms, the low FODMAP diet is meant to be more of a band-aid fix, not a long-term solution.
When you exclude FODMAP foods for an extended period of time, the chances of decreasing gut diversity are high, which can lead to...
2. Dysbiosis
I’ve said it hundreds of times but it bears repeating: A healthy gut microbiome is a diverse one, and you absolutely need good gut bacteria for your gut (and whole body and life!) to thrive.
However, dysbiosis—an imbalance in gut microflora including bacteria but also fungi and yeast—is one potential side effect of the low FODMAP diet. A major reason why this risk exists is that certain FODMAP foods happen to be prebiotic, meaning they feed gut bacteria so the good kinds can flourish.
When you restrict FODMAP foods, you not only starve bad bacteria but also the good kinds. In fact, a 2016 study in the journal Proceedings of the Nutrition Society shows that the low FODMAP diet plan runs the risk of reducing gut-friendly Bifidobacteria, which can complicate digestive symptoms even further. As the researchers put it, dysbiosis in IBS is “frequently characterised by a reduction in species of Bifidobacteria which has been associated with [a] worse symptom profile.”
Simply put, the low FODMAP diet may clear out the good along with the bad—and what you need instead is to strike the *right balance* of gut microbiota.
3. Nutritional Inadequacies or Deficiencies
When you looked at the high FODMAP foods listed above, you might have scratched your head. After all, fruits are rich in antioxidants, beans and lentils are rich in fiber, and dairy provides a good source of calcium…
As we can see, many foods that contain FODMAPs are actually healthy and part of a standard, well-rounded diet! So is a low FODMAP diet healthy if you exclude these food groups and items that are rich in macronutrients and micronutrients alike?
Well, not quite… especially if you stick to it for longer than you’re supposed to. Again, the low FODMAP diet is designed to be followed for only a limited period of time. But once you make it your go-to diet plan, you run the risk of developing nutritional inadequacies or even full-blown deficiencies—particularly when it comes to gut-protective fiber and bone-strengthening calcium.
4. Food Stress or Anxiety
Unfortunately, another potential side effect of the low FODMAP diet is getting stressed out about food or fostering an unhealthy relationship with eating.
If you’re constantly fixating over which foods you can and can’t eat, you’re setting yourself up for distress in several ways. After all, chronic stress can instigate IBS symptoms (yes, a stress belly is very real) and other research shows that strict adherence to the low FODMAP diet in subjects with IBS is associated with disordered eating.
It’s one thing to be mindful about your food choices—especially when you’re trying to heal your gut naturally and live a healthy lifestyle—yet it’s something else entirely when planning your meals becomes a source of anxiety in and of itself. Also, the FODMAP elimination diet is notorious for being overwhelming since it’s so restrictive, and options for what you can eat can seem few and far between. Food should nourish you, not intimidate you!
All said, this low FODMAP diet risk is a serious one to consider, especially if you already struggle with anxiety or have a history of disordered eating.
5. Not Uncovering the Root Causes of Your Digestive Issues
Last but not least, I often see people making the mistake of using the FODMAP elimination diet as a one-stop solution. Frankly, this approach won’t get you far.
As a functional dietitian, I understand and champion the role that food plays in healing gut imbalances, influencing stress, and contributing to your overall nutrition status. Yes, they’re all critical for optimal digestive health, but there are MANY other moving parts you need to consider to discover root causes and heal your gut for good.
When your body reacts to FODMAP foods, there’s a good chance it’s telling you that things need to change—and that’s not only limited to your diet! Whether your FODMAP reactivity is longstanding or newly developed, I urge you to ask yourself:
Am I moving too fast?
Is my stress getting out of control?
Am I being too hard on myself or engaging in self-sabotage and negative self-talk?
Are my personal and professional relationships healthy?
Am I taking enough time for self-care, mindfulness, and recovery?
Your lifestyle, relationships, and how well you take care of yourself all factor into your overall gut health. At the end of the day, understanding root causes and why your body can’t tolerate FODMAPs is the first and most important step to begin to heal your gut for good—and that’s where guidance from a registered dietitian comes in!
A Better Alternative to the Low FODMAP Diet
Now that you know more about the risks of the low FODMAP diet and understand that this protocol isn’t a magical cure-all, I hope you feel empowered to make proactive, informed choices to improve your digestion.
Of course, every body is different; what works for one person might not be ideal for another. That’s why functional testing and personalized, holistic approaches to healing are the name of the game in my dietitian practice.
I’d love to learn more about the nitty gritty of your digestive issues—and, naturally, discuss all things poop! Make FODMAP fears a thing of the past by scheduling a FREE 30-minute call with me today. Also, check out testimonials from clients who were once backed up and bloated and are now certifiable pooping pros. You got this!