Our everything-you-need-to-know guide is here to help you better understand who the low-FODMAP diet is designed for, how it works, and how to maintain a whole-food, plant-based diet as you heal your digestive issues. Forks Over Knives spoke with gastroenterologist Will Bulsiewicz, MD, MSCI, who offered his best advice on confidently taking control of your health with the low-FODMAP diet.

In this article you’ll learn:

• What Are FODMAPs?
• What Is the Low-FODMAP Diet?
• Are High-FODMAP Foods Bad For You?
• Who Should and Shouldn’t Go on the Low-FODMAP Diet?
• How Long Should You Be on a Low-FODMAP Diet?
• What Else Might Be Causing Gut Health Issues?
• Can You Be Whole-Food, Plant-Based While on a Low-FODMAP Diet?
• Our Favorite Low-FODMAP Recipes

What Are FODMAPS?

The acronym FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols,” which are certain types of short-chain carbohydrates that aren’t easily digested.

Most digestion occurs in the small intestine, where food is broken down, nutrients are absorbed into the bloodstream, and waste is then pushed into the large intestine. But the small intestine has trouble absorbing nutrients from FODMAPs, because the human body doesn’t produce the enzymes needed to break down these specific types of short-chain carbs; instead, it relies on the trillions of microorganisms that live in our large intestine to do this task. When the small intestine encounters FODMAPs it pulls in extra water to move these foods to the large intestine, which can cause bloating and other GI issues.

Once the food reaches the large intestine, gut bacteria begin to ferment it and get it ready for excretion. While this fermentation is a natural and healthy process, the bacteria can produce excessive amounts of gas when encountering difficult-to-break-down FODMAPs, leading to all the unpleasant symptoms associated with IBS.

What Is the Low-FODMAP Diet?

While people with healthy gut microbiomes are able to digest FODMAPs without issue, those with sensitive digestive systems have a much harder time. The good news is that your gut can be trained to better tolerate the foods it once struggled with, which is where the low-FODMAP diet comes in.

“The [low-FODMAP] diet is generally reserved for people who are having digestive health problems that include food intolerances,” explains Bulsiewicz. “What that means is that when people consume normal foods in a normal serving size, they have unpleasant symptoms like bloating, abdominal pain, cramping, diarrhea, constipation, and nausea. The [low-FODMAP] diet is an approach that allows them to improve their symptoms and eventually to reintroduce these foods that they have struggled with.”

The low-FODMAP diet is typically broken down into three main stages:

• Eliminating high-FODMAP foods from your diet to establish a baseline.
• Reintroducing high-FODMAP foods one at a time so you can determine which are triggering unpleasant symptoms.
• Customizing your diet by figuring out the specific portion sizes of high-FODMAP foods that are tolerable and integrating them back into your normal diet in those portions.

“A properly constructed low-FODMAP approach involves restriction, but it’s just a temporary restriction,” says Bulsiewicz. “Then it’s all about reintroduction, which can be quite complicated. Generally, I recommend that people do it with the support of a dietitian or someone who’s an expert on the topic.”

Are High-FODMAP Foods Bad for You?

The short answer is no! High-FODMAP foods are not intrinsically bad or dangerous unless you have a specific allergy or condition, such as celiac disease. High-FODMAP foods include fruits, vegetables, and whole grains, which are some of the healthiest foods you can eat.

“The vast majority of FODMAPs are actually prebiotic, meaning that they are good for the gut microbiome,” Bulsiewicz explains. “[By] avoiding high-FODMAP foods, you’re depriving yourself of all of the beneficial nutrients that are found in that food, such as polyphenols and phytochemicals and vitamins and minerals. When we categorically remove these foods, it’s potentially problematic because not only are we getting into a restrictive dietary pattern where you are more likely to have a nutritional deficiency, but you are negatively affecting the gut microbiome.”

So while it can be tempting to blame your digestive woes on the foods themselves, it’s better to look at the low-FODMAP diet as a technique to slowly make friends with these foods rather than a way to avoid them. Creating a flourishing gut microbiome that can tolerate a wide range of foods is key to fewer digestive problems in the long run and better health throughout your life.

“When you’re struggling, it’s because the gut microbes are fermenting [FODMAPS] in a way that’s inefficient and gas producing,” says Bulsiewicz. “Your gut microbes can be trained to do better.”

Who Should and Shouldn’t Go on a Low-FODMAP Diet?

The low-FODMAP diet is not meant to be a weight-loss technique and should only be used by people struggling with digestive issues related to food intolerances. While weight loss may occur on the diet, Bulsiewicz emphasizes that it’s important to get enough calories and nutrients while on this diet.

“People who have a history of disordered eating should not be doing this, especially not independently,” he recommends. “They should only do it with the approval of someone who’s managing their disordered eating so they can be in a good place before moving forward with it. Also, if a person has a complex medical condition, such as active Crohn’s disease, and they’re losing weight, then it’s not the time to do something like this. You have to get your disease under control first before going on a low-FODMAP diet.”

How Long Should You Be on a Low-FODMAP Diet?

The low-FODMAP diet is meant to be temporary, with the goal of resuming more normal eating patterns as soon as possible. Total time spent on the diet will vary from person to person. Typically, the elimination phase lasts two to six weeks and then high-FODMAP foods are slowly reintroduced based on your symptoms and sensitivities. The entire process should only last a few months, says Bulsiewicz.

“Ultimately, we want a diet of abundance,” says Bulsiewicz. “The most important rule for gut health is to eat a wide variety of plants. The advantage of a properly constructed FODMAP approach is that it allows you to, number one, feel better. Number two, understand what the source of your problem is. Then number three, to actually have a strategy to bring that food back on board and tolerate it.”

Bulsiewicz says that you’ll know the low-FODMAP diet has worked once you’re able to enjoy a wide variety of foods free of unpleasant symptoms. Remember, the idea of going on the low-FODMAP diet isn’t to eliminate large categories of food: It’s to slowly retrain your gut microbiome to tolerate the foods that typically trigger it.

“Ease into it and give your body a chance to catch up and adapt to what you’re doing,” Bulsiewicz recommends. “It’s similar to exercise. If you haven’t worked out in a while, you wouldn’t pick up the heaviest weight in the gym. You’d start small and work your way up from there. It’s the same with high-FODMAP foods. As with anything, you’ll get better the more you practice.”

What Else Might Be Causing Gut Health Issues?

There are myriad other reasons for digestive problems besides FODMAP sensitivities. As you work on retraining your gut, it’s likely your physician will also recommend lifestyle changes to help bolster the impact of your dietary changes. Bulsiewicz says there are many aspects of our modern lives that lead to gut issues.

“It’s the lack of sleep, it’s the electronics in the evening before you go to bed, it’s the absence of exercise, it’s the medications, and it’s the large amount of processed foods present in our diet,” he says. “These are all disruptive to the balanced community of microorganisms in our gut.”

Stress can also play a significant role in chronic gut health problems. A 2020 review published in Current Opinion in Behavioral Sciences indicates that the relationship between our mental health, gut microbiome, and dietary choices is deeply interconnected. Depression, anxiety, and other psychological conditions can influence the reactivity of gut bacteria and cause flare-ups of digestive issues. When beginning the low-FODMAP diet, be sure to talk with your doctor about how mental health may be playing a role in your intestinal discomfort.

Can You Eat Whole-Food, Plant-Based While on a Low-FODMAP Diet?

The low-FODMAP diet was created with omnivores in mind, which means it can often be more restrictive for people who follow a whole-food, plant-based diet since meat and dairy are already off the table. Bulsiewicz shared some thoughts on how to get enough calories and nutrients as a vegan who’s traversing the low-FODMAP path.

“I think it’s important to include all of the major [plant-based] food groups,” he says. Don’t eliminate an entire group of food. Instead, opt for low-FODMAP options within that groups. “For example, people may often have issues with whole grains, and those issues are usually specific to wheat, barley, and rye. You can opt for a low-FODMAP option like quinoa.”

While we always recommend going directly to your doctor for health care advice, you can check out this full list of FODMAP foods to get a general idea of what you’ll need to eliminate if you’re exploring a low-FODMAP diet. Bulsiewicz also offers an online class in FODMAP intolerance that includes techniques on reintroduction, healthy recipes, and handy kitchen tricks.

“Be patient, because it takes time,” Bulsiewicz recommends. “It’s not meant to be a quick fix. It’s meant to be about your long-term health and allowing you to have a diet that is sustainable and enjoyable.”

Our Favorite Low-FODMAP Recipes

High-FODMAP foods such as beans, wheat, lentils, and fibrous veggies are some of the healthiest foods on the planet, and diets rich in these foods have been linked to lower rates of heart disease, certain cancers, and Type 2 diabetes. However, should you need to temporarily cut back on these foods to retrain your gut, here are some healthy WFPB recipes you can enjoy on a low-FODMAP diet:

• Sweet Potato Jalapeño Poppers
• Cantaloupe-Cucumber Soup
• Blueberry Farro Grain Bowl
• Jerk Grain Bowls with Air-Fried Plantain Chips
• Berry-Stuffed Breakfast Sweet Potato

The post Everything You Need to Know About the Low-FODMAP Diet appeared first on Forks Over Knives.

A puzzling chronic disorder that affects more women than men, irritable bowel syndrome (IBS) can be relatively mild, or it can seriously interfere with your daily life. Symptoms often include abdominal pain, gas, bloating, diarrhea, and constipation.

In this webinar, integrative gastroenterologist Angie Sadeghi, MD, shares the latest on what doctors know about IBS and gut health, and how plant-based nutrition and other lifestyle strategies can help. Dr. Sadeghi discusses:

• Is it IBS or something else? Understand the symptoms.
• How food allergies, food sensitivities, and IBS are linked—plus a doctor’s take on the low-FODMAP diet.
• How integrative medicine can treat IBS by blending evidence-based nutrition and lifestyle strategies with cutting-edge medical approaches.

WATCH THE REPLAY

Originally aired Oct. 14, 2020

The post Webinar Replay: How to Eat to Relieve IBS and Heal Your Gut with Dr. Angie Sadeghi appeared first on Forks Over Knives.

I read The Forks Over Knives Plan and decided to try the whole-food, plant-based way of eating. I also vowed to have a healthier, more active lifestyle overall. I focused on three things: eating 100 percent plant-based with no oil and very little salt, eating on a regular schedule, and walking daily.

Staying mentally tough each and every day was the biggest challenge when I started. I had over 100 pounds and multiple diseases to conquer. But I was inspired reading other success stories online of people who had beat obesity and other diseases with a plant-based diet. This helped me stay positive and upbeat until I was able to get past that initial shock. 

The Payoff of Going Plant-Based

Sticking to the whole-food, plant-based diet paid off. Within six months of adopting this new lifestyle, I reversed fatty liver disease, sleep apnea, high blood pressure, hypertriglyceridemia, irritable bowel syndrome, and Cushing syndrome. I was able to discontinue all medications. And on top of that, I lost an astonishing 120 pounds. I no longer needed gastric bypass surgery.

I have kept the weight off for over a year now. My family and friends are overjoyed with my newfound health.

There are other important factors in a healthy lifestyle, but diet is really the key. Early on in my transition to WFPB, an entrapped nerve in my leg forced me to stop exercising for three months: Because of my new diet, I gained just 1 pound during that time. 

It’s been a pleasant surprise to find that I can still eat many of my favorite foods—slightly modified, of course. I still love barbecue, but now it’s barbecued smoked sweet potatoes, chickpeas, and pit beans. I also love whole-food, plant-based pizza and mushroom gyros!

Sharing the Health

Today I inform others of the dangers of childhood obesity and tout the incredible health benefits of a plant-based lifestyle. I spread the word at churches and libraries and via radio and television appearances. 

If you’re thinking of going plant-based, here are my tips: Don’t try to re-invent your own wheel or change everything that is already comfortable and familiar to you and your family, as it can be overwhelming. The average family eats only six to eight different meals per month. Start with figuring out how to make 100-percent plant-based versions of your usual go-to meals, and make them as healthy as possible. Once you’ve got your base of six to eight favorite meals, then you can start exploring the never-ending options out there. Almost anything you already eat can be prepared in a whole-food, plant-based way. If you like pizza, eat pizza. If you like tacos, eat tacos. If you like salads, eat salads. 

Hopefully, my story will reach someone who needs to hear it, just as others’ stories encouraged me in this journey.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Faced with Gastric Bypass Surgery, I Tried a Plant-Based Diet Instead appeared first on Forks Over Knives.

The Australian study, published in July in the European Journal of Nutrition, used a cross-sectional format to compare 44 subjects on a long-term Paleo diet with 47 controls following a diet typical of national recommendations in Australia. The Paleo dieters were separated into two groups, “strict Paleo” versus “pseudo-Paleo,” based upon how closely they followed the tenets of a Paleolithic diet—no processed foods, legumes, grains, or dairy products.

The findings? When the researchers analyzed participants’ gut microbiota they found that the two Paleo groups were similar to each other but significantly different from the control group. Drilling down further, they identified three specific types of bacteria that varied between the groups: Bifidobacteria, Roseburia, and Hungatella.

Healthy Gut Bacteria: Bifidobacteria and Roseburia

Both Bifidobacteria and Roseburia are considered part of healthy gut microbiota.

They help metabolize complex carbohydrates such as fiber and resistant starch to produce short-chain fatty acids that play an important role in the health of the gut and the entire body. They maintain intestinal barrier integrity to prevent leaky gut, suppress pathogenic microbes while promoting anti-inflammatory ones, stimulate the release of hormones, regulate the immune system, control the metabolism, and even impact mood.

Bifidobacteria

Prior studies have found that Bifidobacteria protect against irritable bowel syndrome and obesity. In this study, Bifidobacteria were significantly more abundant in the control group and virtually nonexistent in the Paleo groups. Bad news for the Paleo gut.

Roseburia

Roseburia has been shown to protect against inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis. Once again, the non-Paleo control group had significantly more Roseburia in their microbiota. It’s worth noting that there was a trend toward even lower levels in the strict Paleo group compared with the pseudo-Paleo group, suggesting that adherence to the Paleo diet was further depleting the levels of this protective, anti-inflammatory bacteria.

Bad Gut Bacteria: Hungatella

And finally, there’s the undesirable: Hungatella. These bacteria are known to produce the precursor molecule for trimethylamine-N-oxide, or TMAO. Recent studies have shown us that TMAO is bad news. When certain gut microbes (such as Hungatella) metabolize carnitine or choline—commonly found in red meat, egg yolk, and high-fat dairy—they produce the precursor TMA in the gut, which is transformed into TMAO in the liver. It then goes on to wreak havoc throughout the body. TMAO positively correlates with coronary artery disease, stroke, kidney disease, type 2 diabetes, and Alzheimer’s disease, among others. Increased TMAO is an independent risk factor for cardiovascular death and death from any cause.

 In this study, the Paleo groups had significantly higher counts of Hungatella microbes compared with the control group.

The Relationship Between Whole Grains, Hungatella, and TMAO

But does the extra Hungatella in the Paleo groups translate into higher TMAO levels? Unfortunately, the answer is yes. The TMAO levels of the control group, pseudo-Paleo, and strict Paleo groups were 3.9, 5.5, and 9.5, respectively. Once again, we see a trend in which adherence to the Paleo diet yields worse results.

Now here’s where it gets interesting. It turns out that all three groups consumed similar quantities of meat. So why were TMAO levels in the control group dramatically lower than those in the Paleo and pseudo-Paleo groups?

Further analysis revealed that both serum TMAO concentrations and Hungatella abundance were inversely associated with whole grain consumption. This suggests that the whole grains in the control diet were suppressing the Hungatella and interfering with the production of TMA. This might also explain why the pseudo-Paleo group, which consumed more grains than the strict Paleo group, had a lower TMAO level. Grain consumption was also significantly and directly associated with higher levels of beneficial Roseburia and Bifidobacteria.

Is the Paleo Diet Good or Bad for Gut Health?

Bottom line: The Paleo diet has some good features, particularly the elimination of processed foods and dairy, but the elimination of whole grains and legumes was always based on theory and not science. Now we have research on the Paleo diet showing us that strict adherence to the diet comes with serious consequences for the gut, it’s time to reward our gut microbes with fruits, vegetables, whole grains, legumes, seeds and nuts in abundance and with maximum diversity.

TL;DR: In a study examining long-term adherence to the Paleo diet in healthy Australians, the Paleo diet was associated with unhealthy changes to the gut microbiota that included lower counts of protective species, such as Bifidobacteria and Roseburia, and higher counts of inflammatory species, such as Hungatella. This shift in the microbiome was more pronounced with strict adherence to the Paleo diet and associated with increased production of TMAO, an independent risk factor for death from heart disease and other causes. The elimination of whole grains from the Paleo diet was the principal factor contributing to these changes in the study.

Ready to get started? Check out our Plant-Based Primer to learn more about adopting a whole-food, plant-based diet. 

The post Is the Paleo Diet Good for Gut Health? We Finally Have an Answer appeared first on Forks Over Knives.

While eating a SAD diet, I was never severely obese, but my Body Mass Index (BMI) showed that I was heading in that direction. I hit a BMI of 26 BMI at my heaviest. I was not feeling the energy I once had.

Embarking on a Plant-Based Journey

One weekend in 2014, my husband and I stumbled upon the documentary Fat, Sick and Nearly Dead. The film was an eye-opener and definitely struck a chord with both of us. Afterward, we challenged each other to go on a juice fast for five days. We chose to start the fast on a Friday. This gave us the weekend to relax, chill, or whatever might come about while we were going through the detox.

When we woke up on Saturday, we didn’t feel so great. We hadn’t had coffee in 24 hours. My head was pounding! We decided to stay in and watch more documentaries. We chose Forks Over Knives because it was a “suggested” documentary based on the previous show we watched. Needless to say, the Forks Over Knives documentary changed our lives forever. After we completed our five-day juice detox, we started the journey of plant-based eating immediately.

Vegan vs. WFPB

Early on, we didn’t really understand the difference between going vegan and eating a whole-food, plant-based (WFPB) diet. We assumed that as long as there was no meat or dairy in a food, we could eat it and it would be a “healthier” alternative. We started experimenting with a lot of the processed fake “meats” and “cheeses” to help us overcome cravings. We quickly realized that the taste of these foods wasn’t like what we were used to, so it was pretty easy for us to move past those items.

It wasn’t until we decided to take T. Colin Campbell’s online nutrition course through eCornell university that we really learned and understood the importance of a WFPB diet. The course helped us understand why processed foods, refined flours, sugars, and oils are so unhealthy for the body.

Sharing Our Nutrition Knowledge

After completing the nutrition course, we had so much more knowledge about WFPB eating. It really empowered us to share what we learned with whoever was willing to listen.

For some people, it went in one ear and out the other. Fortunately, many of my family members took an interest—my mother, especially. She had recently been diagnosed with cancer. She knew that changing her diet was essential to a successful recovery after her chemotherapy treatments. While visiting her in the hospital, we were absolutely amazed by the food options: hamburgers, french fries, baked potatoes loaded with butter and sour cream, and even milkshakes!

I cooked healthful plant-based meals to bring my mom in the hospital. The doctors and nurses saw what she was eating and were pleasantly surprised. The sad thing, though, is that they never outright acknowledged that this was a better diet for my mother’s health than the meals the hospital offered.

When my mother returned home from the hospital, she continued her plant-based way of life. She stressed its importance to my father, who has now also adopted this diet.

Discovering Forks Meal Planner

My husband and I own a small printing company in Colorado. Our time is spent mostly working on our business, so we have little time to spend in the kitchen. We’d used a couple of online meal planning services for convenience. Unfortunately, most of them included oils and refined ingredients. There were few WFPB diet options, so the choices are limited.

Then we discovered Forks Meal Planner, which has been a big help in sticking to a WFPB diet because it makes it easy to decide what to eat and how to shop. I enter the recipes that I want to make for the week ahead and it automatically creates a consolidated grocery list of what and how much I need to buy, organized by aisle. That is my favorite feature of the planner: I can get in and out of the grocery store quickly and without distractions.

Before discovering Forks Meal Planner, it was such a pain trying to come up with quick and easy healthy lunches. Now I make four servings for each meal, which allows us to each eat a healthy dinner at night and have another full serving for lunch the next day. Not only has it helped control my weight and keep my energy levels high but also it has also saved us more than $100 a week, since we’re not eating out every day for lunch. A few of my favorite recipes include Paella, One-Pot Chili Mac, Hopping John Grits, and Hearts of Palm Tapenade.

Eating to Beat IBS

Since I transitioned to WFPB, the most noticeable difference is that I no longer take any over-the-counter drugs. I haven’t taken an antacid or upset stomach medication since I began my WFPB journey over six years ago. I no longer need to make quick pit stops at public restrooms while I’m out and about. My IBS is gone!

At first, I thought I’d miss a lot of the old foods I used to eat and would have cravings or feel like I was deprived, but I don’t feel that way at all now. My palate has really changed. I am an advocate for WFPB eating, and I share my experience and how I eat with my friends and family.  Doing that has inspired several of my family members to adopt a WFPB diet, and although none of my friends have adopted a WFPB diet, they’re becoming aware of the potential benefits of this diet by witnessing my example.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post How I Beat IBS and Acid Reflux with a Plant-Based Diet appeared first on Forks Over Knives.

By all measures, I should have been happy. I had a good, well-paying job, a beautiful wife who loved and cared for me and whom I loved, and a wonderful home. This didn’t stop my dark thoughts. Most days I would come home from work, get heavily intoxicated, and remain that way for the rest of the day.

It wasn’t like overwhelming depression was a short phase in my life, either. I remember similar thoughts reverberating in my head as I lay in bed in high school. In university, I remember taking as many pills as I could get my hands on and feeling disappointed and scared when, to my surprise, I woke up the next morning. I don’t know if it was the fear of stigma, but I didn’t want to talk about it. I built walls to hide how I was feeling on the inside. I often felt like an actor playing a part in my own life.

I obviously wanted the depression to end. I just didn’t know what to do. I tried self-medication, and I was prescribed antidepressants. It really wasn’t until after the depression lifted that I was able to look back with hindsight and realize what had changed.

The adage is true: We are what we eat. Our bodies break down the foods we consume and use the base parts to make up every cell—every bone, muscle, vein, and organ. Our diets impact our chemistry and our mental health. It wasn’t until I changed my diet and my mood improved that I was able to look back and see the connection.

I was lucky. Friends suggested we watch the documentary Fat, Sick and Nearly Dead. Wow, am I glad they did. It started my wife and I on a plant-based path that lead me away from depression. I lost 50 pounds and was able to heal myself from lifelong Irritable Bowel Syndrome. Every step along the way I gained health and longevity—and unlocked happiness. For the first time, I could look ahead with hope. Eventually, I gave up all added oil, sugar, and salt, and I was able to quit smoking and drinking.

Knowledge is power. The more I learned, the more dedicated I became. I cannot speak highly enough of the documentary Forks Over Knives for the eye-opener it was. I owe a great deal of gratitude to Dr. Joel Fuhrman, too; his books ignited my thirst for the scientific support of a whole food, plant-based diet. I was elated to find the work of Dr. Michael Greger at nutritionfacts.org, and I’ve watched all the videos available on his website.

I no longer seek to alter my state of mind through drugs, alcohol, and food. Now, each day I strive for optimal health and only consume foods that nourish me. I’m excited to experiment with recipes and spices and am astounded by the amazing variety of foods and flavors that are available with this way of eating. I feel the opposite of restricted.

This year, after being on a 100 percent whole food, plant-based diet for nine months, I set an ambitious goal. I had been hearing a lot about vegan athletes, so I started running at the beginning of 2017. Only six months later, in June, I entered my first race of any kind—the River Valley Revenge Ultramarathon in Edmonton, Alberta, Canada. That day I ran for 70 miles, mostly in the rain, in Edmonton’s first-ever 100-mile trail run. Sixty-two percent of racers didn’t finish the race, and I ran the farthest of any non-finisher. This is something that would have been impossible on my old diet, but now my body is able to push farther than I ever thought possible.

This message of health is so powerful, everyone needs to hear it. People likely will not change overnight. It took me some time to change, but now I have shed the darkness that overwhelmed me and found a passion for healthfulness. Know that you are not alone and that you can find happiness, hope, and health.

The post How I Conquered Severe Depression with a Whole Food, Plant-Based Diet appeared first on Forks Over Knives.