Low FODMAP Diet What are FODMAPs? FODMAPs or Fermentable Oligo­Di­Monosaccharides and Polyols are a specific type of carbohydrate found in certain foods. The family of FODMAPs include:

Lactose from dairy products. Fructans: garlic, onions, wheat etc. Galactans: legumes such as lentils, beans, soybeans etc. Fructose: honey, certain fruits, high fructose corn syrup etc. Polyols: stone fruits such as avocados, peaches, plums, cherries, apricots, nectarines

etc. and sweeteners such as xylitol, sorbitol, mannitol. Why shouldn’t you eat FODMAPs? FODMAPs create a few problems for your intestines that lead to Irritable Bowel Syndrome (IBS) and digestive system problems. The following symptoms can be caused by FODMAPs:

Gas Bloating Abdominal pain & discomfort Abdominal cramps Fatigue Weight gain with difficulty losing weight Feeling like you don’t completely empty your bowel when you have a movement Alternating constipation and diarrhea Inconsistently formed stools such as random changes in size, shape and color Passing mucus Sometimes feeling hungry shortly after meals Fatigue after meals Brain fog

How does this happen? FODMAPs draw a lot of water into your intestine which contributes to some of the symptoms listed above. Additionally, FODMAPs are not digested well and poorly absorbed which results in fermentation of the food that you eat. When your food ferments in the intestine, it causes the above symptoms as well.

Nikolas Hedberg, DC, DABCI, DACBN

Why can’t you digest them well? If you have taken a lot of antibiotics throughout your life then you may have too many bacteria in your small intestine or abnormal bacterial colonies in your large intestine. Normally, the large intestine has a lot more bacteria than the small intestine; but if this shifts due to antibiotics and poor diet then you won’t be able to tolerate FODMAPs very well. If there is bacterial overgrowth in your small intestine known as SIBO (small intestinal bacterial overgrowth), then there will be rapid digestion and fermentation of the food you eat which leads to your digestive system problems. This can be compounded by yeast overgrowth and/or intestinal parasites. Beans are a classic example of a FODMAP that has had many jokes made about their connection with gas. The gas produced by beans is a result of their fermentation in the bowels due to problems with gut bacteria. Not everyone gets gas from beans which means they are a great indicator of healthy gut bacteria. How long should you follow the low FODMAP diet? This depends on your current situation and what your doctor prescribes. Most individuals stay on it for approximately 2­6 weeks and then begin restoring healthy gut bacteria with specific prebiotic and probiotic­rich foods. The great thing about the low FODMAP diet is that you don’t need to be on it for very long to restore healthy digestive system function. Your doctor may prescribe an antibiotic or herbal medicines to suppress the growth of bacteria in the small intestine during this diet. If your stool analysis shows yeast overgrowth or parasites then this diet will be extremely helpful for that as well. The healthier your gut bacteria, the better you will be at fighting infections in the intestine. Can I combine the ketogenic diet with the Low FODMAP Diet? Yes. All you have to do is follow the ketogenic diet and eliminate any FODMAPs that are listed on the ketogenic diet. The purpose of combining the two would be to burn more fat, reduce inflammation and to reverse insulin resistance. How do I get started? Simply start eating low FODMAP foods and small amounts of the moderate FODMAPs as outlined on the next few pages. We have some excellent resources for you from the dietitian Kate Scarlata including a shopping list, recipes and list of foods. All of this material was founded by the Monash University Department of Gastroenterology where the research was done on FODMAPs.

Nikolas Hedberg, DC, DABCI, DACBN

VEGETABLES ARUGULA, BAMBOO SHOOTS, BOK CHOY, BEAN SPROUTS, BELL PEPPERS, CARROTS, CELERIAC, CHIVES, COLLARD

GREENS, COMMON CABBAGE, CUCUMBER, EGGPLANT, ENDIVE, FENNEL BULB, GREEN BEANS, GINGER ROOT,

KABOCHA SQUASH, KALE, LETTUCE, PARSNIP, PATTY PAN, POTATO, RADISH, RUTABAGA, SCALLION (GREEN PART

ONLY), SPINACH, SWISS CHARD, SUMMER SQUASH, TOMATOES, TURNIP, OIL INFUSED W/ GARLIC OR ONION,

WATER CHESTNUTS, ZUCCHINI

BREADS & GRAINS GLUTEN FREE BREAD (CHECK INGREDIENTS), CORN/RICE /QUINOA PASTA, RICE CAKES, POTATO & TORTILLA CHIPS,

RICE (BROWN, WHITE, BASMATI), QUINOA, OATS (LIMIT TO ½ CUP COOKED), QUINOA FLAKES, SOURDOUGH SPELT

BREAD, POLENTA, CORN TORTILLA

NUTS & SEEDS 10 - 15 MAX OR 1 - 2 TB

ALMONDS, MACADAMIA, PEANUTS, PECANS, PINE NUTS, WALNUTS, PUMPKIN SEEDS, SESAME SEEDS, SUNFLOWER

SEEDS, 2 TB CHIA SEEDS, 1 TB FLAX MODERATE FRUCTANS/GOS

LIMIT TO ONE CHOICE PER SITTING BEET ROOT <4 SLICES, BROCCOLI <1/2 CUP, BRUSSELS

SPROUTS <1/2 CUP, BUTTERNUT SQUASH <1/4 CUP, GREEN PEAS <1/3 CUP, POMEGRANATE <1/2 SMALL, SAVOY CABBAGE <1 CUP, SNOW PEAS <10 PODS, SWEET CORN <1/2 COB, DRIED CRANBERRIES OR RAISINS (1 TB LIMIT), CANNED PUMPKIN <1/4 CUP, BUCKWHEAT GROATS (KASHA) 1/8 CUP, *CANNED

CHICKPEAS ¼ CUP, ½ CUP CANNED LENTILSHERBS

BASIL, CILANTRO, CORIANDER, ROSEMARY, PARSLEY, TARRAGON, THYME

OTHER ESPRESSO, TEAS (BLACK, WHITE, GREEN, & PEPPERMINT),

FIRM TOFU, TEMPEH, COCOA <3 TSP

FRUIT BANANA, BLUEBERRIES,

CANTALOUPE, CLEMENTINE, COCONUT, DRAGON FRUIT,

GRAPES, HONEYDEW, KIWIFRUIT, LEMONS, LIMES,

MANDARIN, ORANGES, PAPAYA, PASSION FRUIT, PINEAPPLE, RASPBERRIES, RHUBARB, STARFRUIT, STRAWBERRY,

TANGELOS

SWEETENERS PURE MAPLE SYRUP, TABLE

SUGAR, BROWN SUGAR

ALCOHOL LIMIT TO 1 DRINK IN GENERAL

MOST WINE & BEER, VODKA, GIN, WHISKEY

1 SERVING OF FRUIT PER MEAL MAX 1 MEDIUM ORANGE OR BANANA

OR ¾ CUP BERRIES, MELON, PINEAPPLE OR RHUBARB

CHEESE BRIE, CAMEMBERT,

COLBY, LACTOSE FREE COTTAGE CHEESE, CHEDDAR, CHEVRE

(GOAT CHEESE), FETA, MOZZARELLA,

PARMESAN, SWISS

BEVERAGESLACTOSE FREE MILK,

COCONUT MILK (CANNED), HEMP MILK,

ALMOND MILK

OTHERCHECK INGREDIENTS

LACTOSE FREE ICE CREAM, LACTOSE FREE

YOGURT, SORBET

FRUIT BANANA, BLUEBERRIES,

CANTALOUPE, CLEMENTINE, COCONUT, DRAGON FRUIT,

GRAPES, HONEYDEW, KIWIFRUIT, LEMONS, LIMES, ORANGES,

PASSION FRUIT, PAPAYA, PINEAPPLE, RASPBERRIES,

RHUBARB, STARFRUIT, STRAWBERRY, TANGELOS

SWEETENERS TABLE SUGAR, GLUCOSE, MAPLE

SYRUP, ASPARTAME, STEVIA

MODERATE POLYOLSLIMIT TO ONE MODERATE CHOICE

PER SITTING AVOCADO <1/8, CELERY <1/4

STALK, LYCHEE <5, SWEET POTATO <1/2 CUP

LOW LACTOSE

NO EXCESS FRUCTOSE

LOW FRUCTANS/GOS

LOW POLYOLS

LOW FODMAP DIET CHECKLIST

by Kate Scar lata RDN, LDN

© KATE SCARLATA 2014 | KATESCARLATA.COM | FOR A DIGESTIVE PEACE OF MIND, LLCReference: Monash University low FODMAP App; UDSA nutrient databank. Disclaimer: The information provided is not intended to provide medical advice or to diagnose or treat medical diseases. It is strictly for informational purpose. Before undertaking any course of treatment, seek the advice of your physician or health care provider, as the information provided does not replace their medical advice.

Always check ingredients on packaged foods to ensure they comply with the latest low FODMAP diet guidelines.

GRAINS Gluten free pasta (rice, quinoa, corn)Millet OatsOat branPolentaQuinoa (black, red, white)Rice (brown, white, basmati)Rice bran BRAND NAME CEREALSAncient Harvest Quinoa FlakesBob’s Red Mill Mighty Tasty Hot CerealCheeriosEden Organics Brown Rice Flakes Hot CerealEnvironkidz Gorilla MunchEnvironkidz Peanut Butter Panda Puffs BREADSUdi’s White Sandwich BreadSourdough (white, wheat, spelt)Food for Life Multi Seed English muffinsMillet BreadFood for Life Brown Rice TortillasRudi’s Plain TortillasCorn tortillaFLOURS AND BAKING SUPPLIESBisquick Gluten-Free Pancake and Baking Mix Dark chocolate Flour (corn, millet, quinoa, sorghum, buckwheat, rice)King Arthur GF Multi-Purpose flourNamaste (perfect flour blend, waffle& pancake mix, brownie mix, blondie mix, muffin mix) Pure Maple Syrup Starch (potato, tapioca, corn)SteviaSugar (palm, brown, granulated)

SPICESAll SpiceBlack pepperCardamomChili powderChinese Five Spice CinnamonClovesCoriander SeedsCumin Curry PowderMustard SeedsNutmegPaprikaSaffronStar AniseTurmeric

PROTEINBeefChickenFishEggPorkLambTuna (canned)Tofu (firm)

NUT BUTTERSmucker’s Peanut ButterSkippy Peanut ButterTeddie Peanut Butter365 Smooth Almond Butter (Whole Foods)NUTS/SEEDS (allow one handful per sitting)Almonds Brazil nutsChestnutsChia seedsMacadamiasPeanutsPecansPine nuts Poppy seedsPumpkin seeds (pepitas)Sesame seedsSunflower seedsWalnuts

PRODUCEVEGETABLESAlfalfa sproutsArugulaBamboo shootsBean sproutsBeets (limit to 4 slices)Bok choyBell peppersBroccoli (limit ½ cup)Bok ChoyCarrotsCapersCabbage (common, red)Corn (half a cob)CeleriacCelery (1/4 stalk) ChivesChili pepperCollard greensCucumberEggplantEndiveFennel bulbGingerGreen beansKale Kabocha squash Leek (green leaves only)LettuceOlives (green, black)Parsnip

Potato, whiteRadishRutabagaScallions (green part only)SpinachSeaweed (nori)Summer squashSweet potato (limit to ½ cup)Swiss chardTurnipsTomatoWater chestnutsZucchiniFRUIT (limit to one serving per meal)Avocado (limit to 1/8)Banana (small)BlueberriesCantaloupeCoconutClementineDragonfruitGrapesHoneydew melonKiwifruitLemonLimeOrangePapayaPassion fruitPineapplePlaintainRaspberriesRhubarbStarfruitStrawberriesTangeloHERBS Basil CilantroLemongrassRosemaryParsleyTarragonThyme

DAIRYCHEESECheddarSwissColbyParmesanGoat HavartiBrieFetaCamembertMozzarellaMILKLactose freeCoconut milk (canned only)Almond milk Hemp milk YOGURT/KEFIRGreen Valley lactose free yogurtLifeway kefir (plain only)

OILS/CONDIMENTS Avocado oilButter (sticks and spreadable)Canola oilCoconut oilDairy blend (70% butter, 30% oil)Extra virgin and virgin olive oilOlive oilPeanut oilRice bran oilSesame oilSunflower oil Vegetable oil JAMS/SPREADSFish SauceMarmalade jamMayonnaiseMiso Paste MustardOyster sauceRice wine vinegar Sarabeth’s (Cranberry Relish, Strawberry Rhubarb Spreadable Fruit)Soy sauceWasabi

SNACKS+SWEETS Aleia’s (almond horn cookies, peanut butter cookies)Barney Butter snack pack (smooth, raw+chia, cocoa+coconut)Blue Diamond Almond Nut ThinsGilbert’s (Super Dooper Snickerdoodles, Sensational Sugar cookies) Ginnybakes (chocolate chip love + buttercrisp love mini cookies)Justin’s dark chocolate peanut butter cupsKettles Baked Potato Chips (sea salt)Keo frozen dessert (chocolate, coconut)Laiki rice crackers Lundberg Rice Chips (sea salt)Mary’s Gone Crackers (original)Rice CakesSimply gum (mint, cinnamon, ginger) Snyder’s GF PretzelsTortilla Chips88 Acres dark chocolate sea salt bars

BEVERAGESCoffeeCranberry Juice (100%, containing no HFCS)Tea (black, green, peppermint, white)Water

References: Packaged food ingredient lists, USDA National Nutrient Database, Monash University low FODMAP diet app. The opinions of For a Digestive Peace of Mind, LLC and the information gathered at www.katescarlata.com and in this handout are not intended to provide medical advice or to diagnose or treat medical diseases. It is strictly for informational purposes. Before undertaking any course of treatment, seek the advice of your physician or health care provider, as the information provided does not replace their medical advice. © For A Digestive Peace of Mind, LLC, 2016.

LOW FODMAP GROCERY LIST

FODMAP Friendly Living! A few menu and snack ideas to satisfy you and your sensitive belly.

FODMAP friendly Breakfast

• Oatmeal topped with strawberries and blueberries (about ¾ cup total) and 2 TB. sliced almonds

• Udi’s white bread toasted with thin layer peanut butter (Smucker’s/Teddie brands) topped with ½ sliced ripe banana

• Erewhon Corn Flakes or Crispy Brown Rice (gluten free) cereal with Lactaid or rice milk and ½ ripe banana, sliced and 1 TB. sliced almonds or pumpkin seeds

• EnvironKidz Gorilla Munch with lactaid or rice milk and blueberries • Banana pancakes: Namaste waffle and pancake mix or Bisquick gluten free

pancake and baking mix prepared with fodmap friendly ingredients and add ½ mashed ripe banana, 1 TB. almonds or walnuts and cook as directed. Drizzle of maple syrup

• Green Valley yogurt (check ingredients avoid those with honey), (or other lactose free yogurt) topped with ¼ cup Bear Naked Vanilla Almond granola and ½-­‐1 cup strawberries

• Chappaqua Simply Granola Vanilla and Flax with rice milk and an orange • EnvironKidz Panda Puffs with rice or lactaid milk and ½ grapefruit

FODMAP friendly Lunch and Dinner Suggestions

• “Rice Bowl”: scoop of brown rice, layered next with chopped Boston lettuce, cherry tomatoes, and scallion (green part only) top with grilled chicken or shrimp, and grated cheddar. Add fresh lemon juice and olive oil drizzle for dressing.

• Tuna Salad Lettuce wraps: Tuna mixed with Hellman’s mayonnaise, lemon juice and fresh dill, served in Bibb lettuce leaves and a side of Baked Kettle potato chips (not the whole bag!)

• Grilled cheddar, ham and tomato sandwich (use Udi’s White bread or other fodmaps friendly bread choice)

• Tostada Pizza-­‐Cook 1 lb. ground chicken with 1 TB. chili powder (choose chili powder without added onion), 1 tsp. cumin, 1 tsp. paprika and ½ tsp. salt in non-­‐stick skillet. Add ½ cup of water and simmer until cooked through and no longer pink. Top Tostada shell with 2 heaping Tablespoons of meat mixture. Top with sprinkle of grated cheddar cheese. Bake until cheese melts.

• Stuffed Baked Potato: Scoop out hot potato filling and mix with 1 TB. Lactaid milk and 2 tsp. butter. Sprinkle with cheddar cheese and mash to blend and place back in hot potato. Top with sautéed red peppers and chives.

• Lean piece of grilled steak (London broil or Flank), Bibb lettuce salad with grated carrots, cherry tomatoes and orange pepper slices with lemon juice and olive oil dressing and roasted potatoes.

• Rice pasta tossed with fresh chopped tomatoes, garlic infused oil (don’t eat the garlic!), and fresh basil. Serve with lean, center cut pork chop and sautéed zucchini.

• Quinoa sautéed with red pepper slices, pine nuts and olive oil and roasted chicken or grilled fish.

FODMAP friendly Snacks!

• Glutino pretzels and cheddar cheese • Rice cake with peanut butter and ½ ripe banana sliced and topped with few

sliced almonds • Rice crackers and Swiss cheese slices • Lactose free yogurt (Green Valley) with blueberries and 1 TB. almond slices • ½ sandwich with Udi’s white bread filled with sliced chicken, Bibb lettuce

and tomato slice • Celery stick filled with peanut butter (just one) • Lundberg Rice Chips (sea salt) • Schar Cheese bits • Schar table crackers with slice of cheddar and 18 grapes

Always read manufacturer labels to verify all ingredients are FODMAPs friendly and work with your dietitian and physician to provide appropriate medical guidance. Research is ongoing in FODMAPs and food analysis so this handout may need to be modified with advances in research. ©2012 Kate Scarlata, RD www.katescarlata.com