FODMAP diet gives woman direction

Teresa Arnold has recently gained six pounds, and she couldn't be happier.

Ms. Arnold, who is in her early 60s, stands a shade under 5-foot-4, and until recently had been struggling to weigh as much as 100 pounds. She is one of a large number of Americans — as many as 10-15 percent of the population — who suffer from irritable bowel syndrome. Though it does not do any physical damage to the body, IBS can be extremely uncomfortable and even debilitating.

Its symptoms include chronic constipation, chronic diarrhea, or both. Ms. Arnold said, "It got to feeling like I was wearing a tire around my middle. I wasn't gaining weight, I just felt bloated all the time."

Finally, a gastroenterologist recommended that she try the new low FODMAP diet. She has only been on it for a couple of months, and already she has gained the six pounds. Her doctor would like to see her gain four more.

FODMAP is not a fad diet. It is not even a fadmap diet. It was developed by Sue Shepherd, an Australian nutritionist and dietitian. The name comes from an acronym of foods she believes may cause problems for people suffering from IBS: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

That covers a huge variety of foods, from honey and apples to artichokes and ice cream to baked beans and cherries, and many, many more. The hardest part of the diet, Ms. Arnold said, is finding foods that don't have any of the proscribed ingredients in them.

The first time she went to a dietitian at the University of Michigan who specializes in the disorder and the low FODMAP diet, the dietitian told her to buy a snack food that was free from all FODMAPs.

"I went over to a grocery store and I stood there and I was nearly in tears looking at all of those snack foods I couldn't have. I finally found a Quaker rice cake with chips," she said. Only the kettle corn variety of rice cakes met the criteria for the diet.

Because of her IBS combined with her hypoglycemia (low blood sugar), Ms. Arnold has learned that she must eat throughout the day. Though she always used to eat three square meals a day, she now has breakfast followed by a snack or two, then lunch followed by a snack or two, then dinner followed by a snack (this schedule is only recommended for people with both IBS and hypoglycemia).

Rice now forms a large part of her diet, along with wild rice, and especially potatoes (her dietitian told her, "potatoes in all forms are your friends"). She can have hard cheeses and zucchini and green beans and strawberries. And she found a chicken broth, but just one, that is not made with ingredients that make her feel bad.

"It's a matter of reading all the stupid labels all the time. There is so much crud in our food. It made me very, very aware that there are so many things that they put in our food," she said.

So far, the ingredients that have been hardest to give up have been onions and garlic. Seasoning food can be a challenge for her now, but she has learned she can eat the green parts of green onions and cilantro and, for some reason, garlic-infused olive oil.

"Herbs are something I can experiment with. This has opened up a whole way of looking at food for me," she said, noting that she always used to strictly follow published recipes but now she has to make her own.

She has also discovered the joys of Tabasco sauce ("I never in my life thought I would be eating Tabasco sauce") and mayonnaise ("I was always a Miracle Whip girl").

The FODMAP diet has been shown to help 76 percent of people with IBS. One aspect of it is that a person on the diet can periodically try one of the foods that are not allowed for one day. If he doesn't have an unpleasant reaction to it, then he can go back to eating that food.

"My friends always said, 'I don't understand. If there is anyone who eats a balanced diet, it is you, Teresa,'" Ms. Arnold said. "But I need an unbalanced diet."