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Dietary Treatment: FODMAP

When we talk about the FODMAP dietary treatment, we are careful to refer to it as a “treatment” rather than a “diet.” By this, we mean that it is a process that happens in several stages. The goal is to eventually understand which foods with a higher FODMAP content you can actually eat. The treatment is a tool and a way to work with your diet to reduce your symptoms. For the best results, you should follow the treatment in several steps.

The FODMAP dietary treatment is carried out in several stages.

The FODMAP dietary treatment is done in several stages and begins with keeping a food and symptom diary to track what and how you eat and how your symptoms are. You can learn more about this as you follow the treatment in our app, Belly Balance. Try it for free!

Step 1

The first step is the elimination phase, where you only eat foods with no or very low FODMAP content. Even during the elimination phase, there is room to start reintroducing foods marked in orange. Once you’ve started with green-marked foods, you can often begin adding back the orange-marked ones after a few weeks, following the indicated portion sizes. We usually say to gradually sneak them back in—perhaps one day you might want to have a small amount of peas with dinner, or if sweet potatoes are served at a restaurant, you can eat them. This can help expand your food selection.

Step 2

The second step is the important reintroduction phase. If done according to the guidelines, as described in Steps 8 and 10, you will begin adding FODMAPs in increasing amounts to see what your tolerance is for the different food groups. You will test one food that represents each group, allowing you to better understand which groups you need to be cautious with and which you tolerate better. You might find that you’re not as sensitive to one or more of the groups, meaning you don’t need to avoid them unnecessarily. The goal of the treatment is to understand and learn how the different groups affect your digestion. This way, you can eat foods marked as red within your own tolerance level and thus avoid symptoms. At the same time, your gut bacteria get the nutrients they need, and your diet doesn’t become unnecessarily restrictive.

Step 3

For those who have completed steps one and two of the treatment, foods do not need to be completely free from FODMAPs. A low content is often fine, such as honey, apple in a pastry, a piece of avocado, or onion in a broth—as long as the overall amount doesn’t become too high. Threshold values have been established for the different categories. These thresholds allow you, once you’ve figured out which categories you tolerate better or worse, to eat foods that contain small amounts of FODMAPs. This makes life much easier, and you can choose when you might want or need to eat more FODMAPs. In these cases, your chances of avoiding symptoms increase if you consider the “Bucket” concept that we discuss in Step 5 of the digital treatment.

When you keep track of your food intake, your stomach usually becomes less troublesome, and at the same time, you can enjoy tastier and healthier meals!

Sofia Antonsson 
Reg. Dietitian, Belly Balance

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