Learn how to eat a Low-FODMAP diet to manage IBS, even if you eat a plant-based, vegan, vegetarian, or flexitarian diet.
So many people suffer from IBS (irritable bowl syndrome), the most common gastrointestinal disorder in the world, with a prevalence of about 10-15% among the population. Its hallmark symptoms are abdominal pain, diarrhea, and constipation, which can wreak havoc on one’s quality of life. It’s no surprise that people are turning to diet to help manage the symptoms of IBS. One leading area of interest is in the Low-FODMAP diet, which can help you manage IBS symptoms. However, many plant foods may fall under the FODMAP umbrella, so how can you follow a plant-based diet (such as vegetarian or vegan) while managing IBS? That’s exactly the question I asked my friend and colleague Kate Scarlata, MS, RDN, LDN, one of the country’s most prominent experts on IBS. She weighs in on what you can do to manage IBS while eating a plant-based diet in our discussion below. Check out my other blog on managing IBS while on a plant-based diet here.
Low-FODMAP Plant-Based Eating for IBS with Sharon Palmer and Kate Scarlata
Listen in on my chat with Kate Scarlata, internationally renowned expert on digestive health and IBS and nutrition. You’ll learn everything you need to know about eating a low-FODMAP plant-based diet, such as a vegan and vegetarian diet, while managing IBS. Check out our recorded interview below, as well as our transcribed chat on Kate’s best tips for managing IBS with a Low-FODMAP plant-based diet.
Listen in on Sharon Palmer’s chat with Kate Scarlata, RD, internationally renowned expert on digestive health and IBS and nutrition. You’ll learn everything you need to know about eating a plant-based diet, such as a vegan and vegetarian diet, while managing IBS. To see the entire blog and resources for this video, please check out: https://sharonpalmer.com/2016-04-19-eating-for-ibs-on-a-plantbased-diet-with-kate-scarlata-rdn/
How to Eat a Plant-Based Low-FODMAP Diet with Kate Scarlata
Sharon: What was the inspiration behind your new book?
Kate:Many of the books on the low-FODMAP diet on the market were antiquated; the research on FODMAPs continues to evolve. I have worked with thousands of people since 2009 implementing the low-FODMAP diet and wanted to share my tried-and-true; easy approach to this somewhat nuanced diet therapy to a wider audience.
Sharon: What made you become interested in a low-FODMAP diet?
Kate: When I was pregnant with my second son, my small intestine became entrapped with scar tissue from a previous ovarian cyst surgery. This complication, led to the removal of 6 feet of my small intestine, emergently. After the surgery, I experienced severe digestive symptoms that mimicked IBS. This prompted my interest in gaining a better understand of the role of food in exacerbating gastrointestinal symptoms. I began seeing more and more patients with digestive disorders in my nutrition practice, learned about the low-FODMAP diet in the medical literature and begin implementing it (for myself) and also in my interested IBS patients. My nutrition practice now, is limited to individuals with digestive health disorders. I am rewarded and reminded daily on how nutritional change can be a life-changer for people.
Sharon: Do you find that many people struggle with digestive disorders and that nutrition can play a powerful role?
Kate:Absolutely! What we don’t digest feeds our gut microbes –and these bugs play a big role in keeping our guts healthy and symptom free. When our gut microbes are imbalanced as observed in patients with digestive conditions, they play a key role in the onset of digestive distress. Since each person has their own gut microbial fingerprint, so to speak, diet needs need to be somewhat personalized. The medical literature in the area of gut microbial science continues to reveal that a variety of plant-based fibers play a positive role in gut health. Registered dietitians can adapt this research to provide a well-balanced diet that also offers symptom control in individuals with digestive symptoms. Slowly increasing tolerable fibers in patients with digestive health conditions rather than making drastic changes appears to be much better tolerated in my clinical practice.
Sharon: What is your best nutrition advice for those struggling with digestive conditions, such as IBS?
Kate: Work with a registered dietitian! Diet therapy needs, like the microbes in our gut, are very individual. The goal of any nutritional intervention is one that provides the greatest variety of wholesome foods. I do find the low-FODMAP diet is effective in calming down GI symptoms in many of my clients, but maintaining the elimination phase of the low-FODMAP diet is not advised. In fact, the low-FODMAP diet is a 3-part nutritional approach which includes the elimination phase where all high-FODMAP foods are eliminated (2-6 weeks), the re-introduction phase (about 6 weeks), when FODMAPs are systematically added back to determine which FODMAP sources trigger GI symptoms and lastly, the personalized phase where tolerable FODMAP foods are gently added back onto the plate.
Sharon: Tell us about your personal journey in the food and nutrition world.
Kate:I was always strong in math and science classes but desired a career that would allow flexibility, as my biggest goal in life was to be an involved mom. I am the youngest of nine children, and being the last in line, I had a little extra time with my mom than my other siblings. We enjoyed a wonderful relationship. Becoming a dietitian seemed a little more realistic and flexible to me with my life goals than becoming a doctor. I could not be happier with my career path. By nature, I am a helper. I absolutely love being in a position to help people. Because most of my clients experience life altering digestive conditions, I feel very grateful that I can change their life trajectory with nutrition. Nutritional science is truly amazing.
Sharon: What is the main thing that people need to know about a low-FODMAP diet?
Kate: See above—regarding 3 phases. Elimination phase is NOT to be done life-long!
Sharon: What advice do you have for vegetarians and vegans who might benefit from a low-FODMAP diet?
Kate:When I implement the low FODMAP diet with vegans—I often limit the elimination phase to just 2 weeks, as the low FODMAP vegan protein options are limited. A common misconception is that all legumes are off the table for the low FODMAP elimination phase, but there are some legumes that have less FODMAPs than others! For the low FODMAP vegan and vegetarian ¼ cup canned chickpeas and ½ cup canned lentils per meal are a good option. FODMAPs are water-soluble making the canned varieties of these protein rich options lower in FODMAPs. Some of the oligosaccharides (fructans and galacto-oligosaccharides), water-soluble fibers, found in legumes will leach out in to the water in the canned product, and be drained off and not consumed.
Sprouting and fermenting can lower or raise FODMAP content in foods. Sprouted barley was shown to be low FODMAPs versus unsprouted barley which is rich in FODMaPs. Fermenting cabbage increases the FODMAP content, while fermenting yogurt, tends to lower the FODMAP, lactose. Pickling vegetables can lower FODMAPs. Pickled beets, onion and garlic are much lower in FODMAPs than fresh options and can be enjoyed in small portions on the low FODMAP diet. With all these low FODMAP diet nuances, working with a FODMAP knowledgeable dietitian can be extremely helpful! I have a registry of FODMAP knowledgeable RDNs on my site here.
Firm tofu is low FODMAP vs. silken tofu, which is high in FODMAPs. Again, this is due to the processing where the oligosaccharides (the “O” in FODMAP) in the soy are drained off in the firm tofu product and remain present in the silken tofu.
Soymilk made with soy protein alone (vs. the whole soybean) would be considered low-FODMAP. In the US, most soymilk is made with the whole soybean.
To boost protein via grains, quinoa and buckwheat are great low-FODMAP options.
Most nuts and nut butters are low-FODMAP in a 1-2 tablespoon limit per meal. Pistachios and cashews, however, are high FODMAP and should be avoided during the elimination phase.
For the vegetarian, any cheese low in lactose is considered low FODMAP including: Cheddar, Swiss, feta and Parmesan, to name a few. Additionally lactose free yogurt, such as Green Valley Organics is a wonderful low FODMAP option as long as the selections are low in FODMAPs (i.e. choose vanilla, strawberry or blueberry vs. peach.) Peaches are a source of polyols, the “P” in FODMAP.
My low-FODMAP Grocery Guide app via iTunes is a good resource to find foods low in FODMAPs at your market. All profits from the app go to fund the #IBelieveinyourStory campaign. Learn more here.
The #IbelieveinyourStory campaign– is a grassroots campaign I started to support and advocate for IBS patients last April 2017. The campaigns mission is 3-fold: to raise awareness of IBS, fund much needed research (NIH allocates just 12 cents per IBS patient.), and to provide educational resources for IBS patients. Through the campaign, we have raised thousands of dollars for IBS research.
I will be launching a video on April 1, 2018 and be encouraging others to join together in solidarity to support IBS patients. Please use the #IBelieveinyourStory hashtag to join the movement.
Check out one of Kate’s favorite plant-based low-FODMAP recipes below.
Kate Scarlata, MS, RDN, LDN is a Boston-based registered dietitian and New York Times best-selling author with 25+ years of digestive health experience. She was awarded best dietitian 2016 by Boston Magazine. She is a world-renowned low FODMAP diet expert, and invited speaker at numerous international and national gastrointestinal health conferences, from Harvard Medical School to Monash University. Kate specializes in digestive health including treatment for: IBS, celiac disease, inflammatory bowel disease, mast cell activation syndrome, and small intestinal bacterial overgrowth (SIBO) in her private practice in Medway, MA. Her passion is to help advocate for patients with gut disorders by helping them receive the best health outcomes and quality of life. Kate believes in the collaborative care process where the patient is at the central core surrounded by a quality innovative health care team. Kate Scarlata is the co-author of the New York Times Bestseller The 21 Day Tummy Diet, The 21 Day Tummy Cookbook, The Complete Idiot’s Guide to Eating Well with IBS, and co-author of The Low FODMAP Diet Step by Step. Check out my interview with Kate on her best tips for eating vegan with IBS here.
For Low-FODMAP plant-based recipes, check out some of my best: