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Low FODMAP Reintroduction Plan: How and Why to Add Foods Back

Low FODMAP Reintroduction Plan: How and Why to Add Foods Back

If you’re having digestive trouble (like bloating, constipation and abdominal pain), you might have considered a low-FODMAP dietSo it can be a bit confusing to hear that one of the reasons to try reintroducing FODMAPS is to improve digestion.

The goal of a low-FODMAP diet is to determine which FODMAP-containing foods irritate your body; they can cause issues in your gut by causing an overgrowth of non-beneficial bacteria. But our beneficial gut bacteria, which moderate many of our digestive processes, rely on the same FODMAP-containing saccharides for food, particularly fructans and galacto-oligosaccharides. These offer what are known as prebiotic fibers: beneficial food for beneficial bacteria.

Without adequate food, our digestion, mood and immune system can suffer. Reincorporating even just a small amount of these can help straighten out the gut bacteria balance – and improve digestion.

Everyone’s system is different: the type and amount of saccharides every individual can handle varies. Slowly reincorporating FODMAPS after being without them for a period of time can shed light on which ones truly upset your system and which ones you may be able to enjoy safely on an ongoing basis for the sake of your overall health, your gut bacteria and your diet’s breadth.

How and When to Reintroduce FODMAPS

If you’ve been on a low-FODMAP plan for over thirty days and have noticed an improvement in your symptoms, you may be ready to explore what is known as the FODMAP Challenge Plan. (Challenge, Re-Challenge and Reintroduction are often used interchangeably.) Your goal is to reintroduce one FODMAP at a time with a few days of rest (“washout”, as it’s sometimes called) in between reintroductions to assess your body’s reactions. You may find that you can tolerate one particular saccharide entirely, or perhaps a small amount of one and a medium amount of another.

Which FODMAPS to Try First

Begin with one category of FODMAPS at a time. We recommend beginning with galacto-oligosaccharides like white beans, chickpeas and kidney beans, as they’ll give you the most immediate prebiotic benefits. Many people like to reintroduce FODMAP foods they suspected were not digestive culprits at the beginning of their elimination trial (if you feel quite certain lactose was not a problem for you, start there) or with the foods they miss the most (if you’ve been dying to have an avocado since your elimination trial, start with polyols).

Not sure where to start? This study from Monash University in the American Journal of Gastroenterology lays out a sample challenge schedule in this order:

Fructose (ie. honey or mango)
Polyols – Sorbitol (ie. blackberries or avocado)
Polyols – Mannitol (ie. sweet potato or cauliflower)
Lactose (ie. yogurt or milk)
Fructans – Grains (ie. bread, buckwheat or rice)
    *test two from this group for a total of 6 days with a 3-day washout in between
Fructans – Vegetables (ie. garlic, leeks or onion)
    *test two from this group for a total of 6 days with a 3-day washout in between
Fructans – Fruit (ie. grapefruit or dates)
Galacto-oligosaccharides (ie. peas, black beans or almonds)

The Low FODMAP Reintroduction Plan Schedule

Reintroducing foods will happen on a rolling 6-day schedule: 3 days of challenging, 3 days of washing out. Except for the food you’re introducing, maintain a low-FODMAP diet during this entire reintroduction period.

On days 1, 2 and 3, you’ll consume one serving of a food from the FODMAP group you’ve chosen, increasing the serving size from small to medium to large each day as long as your symptoms do not return. If symptoms return, make a note for yourself and skip ahead to day 4, 5 and 6, which will be your washing out days: continue to eat a low-FODMAP diet as you were during your elimination.

Repeat this for each FODMAP group: fructose, fructans, lactose, galacto-oligosaccharides and polyols.  

The three days of washing out or restoring in between should provide you with enough time to note your symptoms and identify potentially problematic foods. They should also give you ample time to reset after a positive or negative experience with a challenge food.

Logging Your Symptoms and Moving Forward

Keep a food and symptom log as you move through the challenge period. You should start to see patterns of irritation if they occur. Maybe half a cup of yogurt (lactose) is fine, but a full cup is not. Maybe honey (fructose) is not a problem for you but onions (fructan) in any amount prove to be problematic.

After you’ve completed the challenge period, you should have a better sense of which FODMAPS are safe for you.

If certain categories – say, fructose and fructans – cause symptoms to flare up, you may need to consider a longer-term break up with those foods.

If one food in another category seems fine, you can explore adding in other foods from that same category a little at a time to note their effects. If white beans cause no issues, explore kidney beans, lentils and their relatives to see if the entire family of galacto-oligosaccharides get the go-ahead.

– Amy Height