The low FODMAP diet is an awkward one to follow, but over 70% of people suffering from IBS symptoms who try it are said to have found improvement with it.
Evelyn Dorkel is a London-based registered dietitian with over 12 years of experience.
She works with time-poor city dwellers at firms like Deloitte, Bank of America Merrill Lynch, and Goldman Sachs, to help them improve their eating habits.
We caught up with Dorkel following the opening of JOVA, a health-focused co-working space in London, where she has created a Mediterranean menu that caters to gluten-intolerant, low FODMAP, and dairy-free diets.
Dorkel told Business Insider that one of the things clients come to her most with are digestive issues related to irritable bowel syndrome (IBS), such as bloating, excessive wind, abdominal pain, and diarrhoea or constipation.
To these clients she often recommends the "low FODMAP" diet which focuses on the reduction of certain fermentable carbohydrates.
FODMAP stands for Fermentable, Oligo-, Di-, Mono-saccharides and Polyols. They are essentially carbohydrates that the body's small intestine struggles to digest and are found in wheat, barley, garlic, onion, beans, and lentils, as well as certain fruit and vegetables.
The low FODMAP diet was established in Australia several years ago, and research in this field has since confirmed the benefits of patients with IBS symptoms following this eating plan, Dorkel said.
It has since gained traction in the UK. It was adapted by researchers at King’s College London and implemented at Guy’s and St Thomas’ NHS Trust in London.
First off Dorkel stressed the importance of discussing a low FODMAP diet with a dietitian to avoid misdiagnosis, nutritional deficiencies, and frustration.
"Improvement of symptoms is unlikely to occur if not followed correctly," she said, adding that there is a lot of misinformation on this topic out there.
Patients following the diet will first cut out certain high FODMAP foods. Dorkel said this typically needs to be followed, and strictly, for a month to six weeks to see any improvement. King's College suggests patients avoid these foods for up to eight weeks.
If patients have seen some improvement after following this diet, they will next gradually begin to reintroduce high FODMAP foods to work out where (and with which foods) their intolerance lie.
Once they've identified the food triggers of their symptoms, patients are encouraged to tailor their normal diet so that they only avoid the food causing the unwanted symptoms.
The low FODMAP diet is considered by some to be an awkward one to follow because of the types of foods you must avoid while following it.
For example, because wheat is a high FODMAP food item, lunchtime sandwiches are strictly off the menu, and avoiding garlic and onion, ingredients found in most marinades and sauces, can make dining out at restaurants difficult.
Some other high FODMAP foods are pretty surprising, too. Apples, pears, leeks, mushrooms, watermelon, celery, and asparagus are all high FODMAP foods to be avoided. People following the diet may also need to reduce their lactose intake, Dorkel explained.
As for what you can eat, here are some of the types of low FODMAP recipes that Dorkel came up with for Jova's menu, that could be adapted for anyone wishing to give the diet a go:
Despite the hassle, Dorkel said that in her experience, 70% of people with IBS will find improvement in the low FODMAP diet. This statistic is backed up by King's College research.
She added that current research is still looking into long-term effects of the diet and potential impacts of changes in the microbiota.