Challenging FODMAP Reintroduction
Do you wish there was a way to do 8-weeks of FODMAP reintroduction in half the time? I’ve got you covered!
Are you saying there’s another way?
Yes, there is a way to challenge FODMAP reintroduction! However, just like the simplified low-FODMAP diet, there are pros and cons to cutting corners.
Pros:
- Shorter reintroduction time
- Overall less time following a strict low-FODMAP diet
- More variety and symptom-relief sooner
Cons:
- Not knowing personal symptom threshold
- Potentially greater symptom response
First, remind me what traditional reintroduction looks like?
No prob. With traditional FODMAP reintroduction, the rep food is reintroduced in small, medium, and large serving sizes over the course of three days. When symptoms begin to feel unacceptable in your body, you stop and do not proceed to a larger serving. Because the rep food represents the entire FODMAP group, your tolerance to that food should suggest your symptom response to other foods in that group. With this method of reintroduction, you will get to know your own personal symptom threshold, meaning that you will know how much of each FODMAP group you can tolerate and at what point the serving is too much. This is helpful for Phase 3, because it allows you to increase variety without anxiety. Wow, I’m basically Dr. Seuss. Quote me.
For foods that are well tolerated, you are able to include high and moderate servings freely in that FODMAP group. For foods that you have moderate, but manageable symptoms, you can include small and medium serves of those foods. And for severe symptoms, it would be best to avoid foods in this FODMAP group, or only have green/small servings of these foods going forward.
Let’s breakdown challenging FODMAP reintroduction.
Yes, let’s. In order to challenge FODMAP reintroduction, we choose a rep food and only reintroduce the largest serving. For example, instead of reintroducing the fructose group using 1 tsp honey on the first day, 2 tsp honey on the second day, and 1 Tbsp of honey on the third day, we would only reintroduce 1 Tbsp of honey. From this, you will definitely know whether or not you are sensitive to fructose following this challenge, but you may also have a greater symptom response that could have been avoided from starting with a small serving and working up. Like regular reintroduction, we wait 3 symptom-free days before reintroducing a new group.
I recommend that for people challenging reintroduction, they go back and do a regular 3-step reintroduction for foods that have a symptom response from the challenge, so they can find their unique symptom threshold and know how much of that group they can tolerate. It is helpful to know that you can have 2 tsp of honey but not 1 Tbsp, or 1/2 cup cow’s milk but not 1 cup, especially in situations where we can’t necessarily control the foods being served. Knowing your own specific symptom threshold can be a big sigh of relief.
Who is this method good for?
Right. FODMAP elimination and reintroduction is a long haul. My clients often get fatigued from doing the initial 2-4 weeks of elimination and then another 8 weeks of low-FODMAP and reintroduction. Challenging FODMAP reintroduction is good for:
- Those who qualified for a simplified low-FODMAP diet initially (i.e. Elderly, children, people who could potentially be harmed in some way (either physically or psychologically) by over-restriction of food)
- People who are fatigued or lacking motivation due to the extended timeline of regular elimination and reintroduction, or who have lifestyle barriers (i.e. inconsistent or unconventional job, lacking time or resources)
See below for a sample FODMAP reintroduction schedule.
| FODMAP Group | Rep Food | Serving Size |
|---|---|---|
| Fructose | Honey | 1 Tbsp |
| Sorbitol | Avocado | 3/4 medium avocado |
| Fructose + Sorbitol | Apple | 1 whole apple |
| Mannitol | Cauliflower | 8 small florets, raw |
| Lactose | Cow’s milk | 1 cup cow’s milk |
| Fructan (grains) | Wheat pasta | 1 1/2 cup pasta, cooked |
| Fructan (onion/garlic) | Garlic | 1 clove garlic |
| GOS | Green peas | 1/2 cup peas, cooked from frozen |
That’s all for now! The third, and final, step of the low-FODMAP diet is tailoring for the long-term by using your symptom responses, variety, foods you enjoy, and nutritional needs. If you need help and support with this you can work with me virtually 1:1 starting August 2nd, 2021! Stay tuned for details.
- 10 Ways to get Enough Fibre on the Low-FODMAP Diet
- Challenging FODMAP Reintroduction
- Phase 2: FODMAP Reintroduction
- The Low-FODMAP Diet Made Simple
- Phase 1: FODMAP Elimination
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