The Low FODMAP Mediterranean Diet: What You Need to Know
If you’re interested in nutrition, you’ve probably heard of the Mediterranean diet. After all, it’s consistently ranked as the #1 Best Diet Overall by nutrition experts. It’s been shown to reduce the risk of many chronic diseases and is an excellent way of eating for overall health.
However, if you’re living with irritable bowel syndrome (IBS), you may be following a low FODMAP diet to help manage your symptoms. You probably don’t want to miss out on the benefits of the Mediterranean diet, so you may be wondering – is it possible to follow a low FODMAP Mediterranean diet?
Today, we’ll review what foods are included in Mediterranean and low FODMAP diets and provide tips for combining the two to improve your overall health and manage your IBS.
What is the Mediterranean Diet?
The Mediterranean diet is a way of eating that originated in the countries bordering the Mediterranean Sea. It emphasizes fresh fruits and vegetables, whole grains, nuts, legumes, fish, and extra virgin olive oil.
The Mediterranean diet is more than simply a dietary pattern – it’s a way of life that focuses on not only what you eat, but how you eat and live. It emphasizes the importance of enjoying meals with friends and family and being physically active in addition to its guidelines around what to eat.
The Mediterranean diet has been studied extensively and has been shown to have many health benefits. These include:
- Reduced risk of heart disease.
- Protection against brain aging and reduced risk of Alzheimer disease.
- Reduced risk of type 2 diabetes.
- Reduced risk of certain types of cancer.
- Improvement of non-alcoholic fatty liver disease.
- Reduced inflammation in the body.
What is the Low FODMAP Diet?
If you’re living with IBS, you might have heard about or tried the low FODMAP diet. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are types of carbohydrates that are poorly absorbed by the body and rapidly fermented by your gut bacteria.
To understand why FODMAPs can worsen symptoms in people with IBS, it’s important to understand how IBS works. While we’re still learning about what causes IBS, we do know that people with IBS have what’s called “visceral hypersensitivity.” This means that your threshold for pain in your organs is lower than normal.
When FODMAPs are fermented by your gut bacteria, they can cause an increase in gas production. For people with visceral hypersensitivity, this gas production can be quite painful.
The low FODMAP diet is often used to for the management of IBS symptoms. It typically has three phases: the elimination phase, the reintroduction phase, and the maintenance phase.
During the elimination phase, all foods containing FODMAPs are eliminated. This involves limiting wheat-based products, onions, garlic, most legumes, certain dairy products, and many fruits and vegetables.
Once the elimination phase is completed and symptom relief is achieved, you move onto the reintroduction phase. During the reintroduction phase, you’ll systematically reintroduce the different types of FODMAPs one at a time so that you can determine exactly which FODMAPs cause symptoms for you.
Finally, once you’ve reintroduced all the different high FODMAP foods, you’ll move onto the maintenance phase. This involves limiting the FODMAPs that caused symptoms for you, while consuming the high FODMAP foods that didn’t cause symptoms.
Unfortunately, many people avoiding FODMAPs do not move on from the elimination phase. This means that they are severely restricting their diets. Also, people do not always replace high FODMAP foods with low FODMAP alternatives. This often leads to not consuming enough fibre. Since fibre is an important source of fuel for our gut microbes, this can be a problem if you’re following a low FODMAP diet long-term.
The Mediterranean Diet and IBS
Unfortunately, there are currently no studies looking at the effects of a low FODMAP Mediterranean diet on IBS symptoms. However, a recent review article looked at the effects of the Mediterranean Diet on the immune system and reviewed whether combining the two diets made biological sense.
In IBS, we often see an imbalance between the “good” and “bad’ bacteria in the gut. This is associated with increased levels of inflammation in the intestine. Given that we know that the Mediterranean diet can help lower markers of inflammation in the body, it’s possible that following a low FODMAP Mediterranean diet could lead to lower levels of inflammation in people with IBS. While studies still need to be conducted in this area, it’s an exciting potential treatment option.
What Can I Eat on a Low FODMAP Mediterranean Diet?
Luckily, there are still plenty of foods you can eat on a Low FODMAP Mediterranean diet!
Extra virgin olive oil is the fat of choice on the Mediterranean diet. It contains mostly monounsaturated fats and is also high in antioxidants. Try drizzling it over salad, using it in marinades or sauces, or drizzling over cooked pasta or vegetables.
Low FODMAP Vegetables
Vegetables are an important source of fibre on the low FODMAP diet. Try to include a wide variety of low FODMAP vegetables. These include carrots, cucumber, lettuce, oyster mushrooms, parsnip, potatoes, and spinach.
You may also feel comfortable including vegetables that are low FODMAP at smaller serving sizes. These include eggplant (1 cup), green beans (15 beans), green bell peppers (1/2 cup), broccoli (heads only, 3/4 cup), cabbage (3/4 cup), corn (canned, 1 cup), zucchini (1/3 cup), and Roma tomatoes (1 small).
Low FODMAP Fruits
Low FODMAP fruits are another important source of fibre. Some popular low FODMAP fruits include bananas (firm, as FODMAPs increase as bananas ripen), oranges, kiwis, and papaya.
For increased variety, you may also want to include fruits that are low FODMAP at smaller serving sizes. These include blueberries (1/4 cup), pineapple (fresh, 1 cup), raspberries (30 berries) and strawberries (5 medium).
Low FODMAP Grains
Grains are an oft-neglected part of the low FODMAP diet, but there are actually many low FODMAP grains that you can enjoy. Try brown rice, buckwheat, oats, quinoa, or spelt sourdough bread.
Aim for at least two legume-based meals per week. While it’s true that many legumes are high FODMAP, canned chickpeas (1/4 cup) and canned lentils (1/2 cup) are both low FODMAP options.
Legumes are an excellent source of fibre, which helps keep you regular and provides fuel to your gut microbes.
The Mediterranean diet recommends a moderate intake of fish. Aim for at least two servings of fish per week. Try to include oily fish like salmon, tuna, and sardines. They are high in omega-3 fats, which have been shown to reduce inflammation.
Just because you’re following a low FODMAP diet to manage your IBS symptoms doesn’t mean you can’t reap the benefits of a Mediterranean diet. With a few small tweaks, you can easily adapt the Mediterranean diet to be low FODMAP.
Not sure where to start with low FODMAP Mediterranean diet meal planning? Schedule a free 15-minute phone call to chat about how our Registered Dietitian can help you reach your health goals.