Here is an excerpt from a Dec 2014 paper called Review article: the aetiology, diagnosis, mechanisms and clinical evidence for food intolerance:
There have been significant advances in understanding the scientific basis of gastrointestinal food intolerance due to short-chain fermentable carbohydrates (FODMAPs). The most helpful diagnostic test for food intolerance is food exclusion to achieve symptom improvement followed by gradual food reintroduction. A low FODMAP diet is effective, however, it affects the gastrointestinal microbiota and FODMAP reintroduction to tolerance is part of the management strategy.
We’re seeing plenty of people with digestive issues like IBS (Irritable Bowel Syndrome) and SIBO (Small Intestinal Bacterial Overgrowth), often with accompanying anxiety and depression, and a low FODMAPS diet may need to be considered. How do we know if we should consider it and how do we help out clients make this change?
This webinar is a way for you to learn more about FODMAPS for your clients and it’s a way for me to showcase the valuable work my friend Julie Matthews is doing in her BioIndividual Nutrition™ program. And for us to share the very cool new Victus software. I’ve actually signed up for the next training and I’m just super-excited to get the word out…which is another reason for the webinar! When I learn, I like to share what I learn!
Customizing a Low FODMAPS Diet for a Client with Anxiety and/or Depression
A webinar for health practitioners
Food Mood Expert Trudy Scott interviews Julie Matthews, co-founder of BioIndividual Nutrition Institute
In this webinar, aimed at health practitioners, we will discuss:
- The scientific rationale for recommending a Low FODMAPS (an acronym, deriving from “Fermentable, Oligo-, Di-, Mono-saccharides And Polyols) Diet for someone with anxiety/depression
- Defining oligosaccharides (fructans and galacto-oligosaccharides); disaccharides (lactose); monosaccharides (fructose) and polyols (sugar alcohols and more)
- What are high free fructose foods and the fructose malabsorption/anxiety and depression connection
- How to do a low FODMAPs diet elimination/provocation
- Why would you combine Low FODMAPS and SCD (Specific Carbohydrate Diet) for SIBO (Small Intestinal Bacterial Overgrowth)
- How the Victus software helps you create a diet/recipes for the Low FODMAPs Diet
- How to learn more about Julie Matthews’ Bioindividual Nutrition program (for practitioners), other special diets and the upcoming study group
Julie Matthews is a Certified Nutrition Consultant specializing in autism spectrum disorders, ADHD, and nutrition for pregnancy. Her approached is based on the BioIndividual Nutrition™ needs of each person. She provides dietary guidance backed by scientific research and applied clinical experience. Her award winning book, Nourishing Hope for Autism, has helped people around the world to make food and nutrition choices that aid the health, learning, and behavior of those with autism, ADHD, and other developmental delays. She presents at leading autism conferences in the US and abroad, and is the Nutrition Editor of the Autism File magazine. She is on the scientific advisory board for USAAA (U.S. Autism & Asperger Association) and the Autism Nutrition Research Center. She is the co-founder of Nourishing Hope and BioIndividual Nutrition Institute. Julie has a private nutrition practice in San Francisco, California, and supports families and clinicians from around the world with her nutrition learning tools and professional training courses.
Here is the link to register for the webinar. If you can’t make it at this time, register anyway to get a copy of the notes and audio:
Update: this event is over (it was done Wednesday January 21st, 2015.) Sorry you missed it!
Trudy, I find it very discouraging to see information about this diet. I don’t believe that there is enough evidence to show that cutting out the healthiest and most healing parts of my diet be eliminated. I just got myself on track. Furthermore, to target such an extremely vulnerable population with food taboos that might do serious harm is bordering on the unethical. How are we supposed to get our vitamins, minerals and enzymes? Oh, right, we should just pop more and more pills. If I listen to your advice, I would be reduced to eating nothing at all. The real problem is not in healthy affordable and beneficial foods. The real problem is junk foods and processed chemicals that fill about 99 percent of the supermarket. I have recently increased the fodmap content of my diet. I do take a probiotic. I am now feeling better and have a drastic reduction in ibs symptoms. I am also loosing weight and my skin never looked better. Please do not demonize my healthy food. Also, please have a forthright discussion with those who suffer with anxiety and depression and advise them to not jump on another dietary bandwagon based on sketchy evidence and fear.
Hi Madeline
I appreciate your feedback and I totally agree that junk foods and processed chemicals are a big issue and need to be removed! I would also prefer my clients to be eating real whole food and not needing supplements but the reality is that most people with anxiety/depression need the additional support.
I am so pleased you are feeling better and have a drastic reduction in IBS symptoms, are losing weight and have healthy skin – and have been able to add back FODMAPs foods. It sounds like you were on a low FODMAPS diet and I can’t help but wonder if this has helped you get to where you are today?
I do have to disagree with these comments: “targeting those who suffer with anxiety and depression”, demonizing healthy food and using fear. If this blog post came across as me using fear tactics, it was not my intention and I apologize. My goal here is to educate health practitioners about the possibility that FODMAPS may be something they need to consider with their clients who are still not doing well on a real whole foods diet that include FODMAPs foods. The big thing is bioindividuality – we are all unique and there is no one size fits all. Sometimes we have to remove seemingly healthy foods that may be a problem for that person at the particular time. We want to heal so some/all of these foods can ideally be added back.
I do also have to disagree with the comment about FODMAPs being “another dietary bandwagon based on sketchy evidence”. There are now 50 studies in pubmed when you search for FODMAPs http://www.ncbi.nlm.nih.gov/pubmed/?term=FODMAPs
I do agree that it is an emerging area of research and we do need more research as this paper states: Low-FODMAP Diet for Irritable Bowel Syndrome: Is It Ready for Prime Time?
“Evidence in the form of randomized controlled trials and observational studies have evaluated the mechanism of action and efficacy of low-FODMAP diet. This dietary intervention has showed promising results in symptom reduction in IBS patients. However, latest trials have also shown that the low-FODMAP diet is associated with marked changes in gut microbiota specifically reduction in microbiota with prebiotic properties. Implications of such changes on gastrointestinal health need to be further evaluated in future trials.” http://www.ncbi.nlm.nih.gov/pubmed/25410635
You’ll also find studies where FODMAPS is not in the study title/body. Here is one such study of relevance: Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers. “Fructose- and sorbitol-reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.” And “Improvement of signs of depression and of meteorism was more pronounced in females than in males.” http://www.ncbi.nlm.nih.gov/pubmed/11099057
We are simply doing our best to help our clients.
And questions from people like you are great – we should all ask questions always – it makes us more informed!
Trudy
Trudy, I admit that I was a little perturbed, and I apologize. It’s just that everywhere I turn, there are giant no-no signs on the nutritional highway. I can tolerate a small amount of almost any food (except anything containing corn and isn’t that a doozie?). So when I hear of promising new research that would pose a huge new set of restrictions, I naturally wish to bolt from the area. I am doing well on eggs, apples, carrots, broccoli, onions, natural peanut butter and full fat Greek yogurt and nuts. I have been able to remain free of processed foods. I can and do have gluten once in a while, with butter. Oh, and olives and hummus and broccoli. I think this adds up to a lot of fodmaps. Madeline
No need to apologize Madeline – as I said, asking questions are good! And I hear you on the “giant no-no signs on the nutritional highway” – it can be very confusing and seem very restrictive.
If you are doing well on these foods then you’re on to a good thing. Of the list you mention, I would just caution you with “gluten once in a while” (for reasons over and above FODMAPS)
Eggs for breakfast is a great start to Low FODMAP day. My 6 year old daughter needs to follow a low FODMAP diet. Keeps her gERD and stomach pain under control.
Wonderful – thanks for sharing Susan – the power of the right foods!
I have both IBS-C and anxiety. My Gastroenterologist told me to use Low-FODMAP. I am in reintroduction and had an IBS attack that started May 12 and just finished Sunday. Anxiety from an event on May 11 provoked it. I found out raw garlic is a problem for me. I also have an intolerance to lactose, but can eat hard aged cheeses. The lactose is aged out in the cheesemaking process; that is why. Just waiting for it to calm down so I can trial other fructan foods and see if it is fructan overall or which ones.
I frequently find the anxiety can trigger the IBS. I am a vegetarian and gluten-free, soy-free, corn-free. Hard cheeses and black beans didn’t bother me, though. Haven’t gotten to try any others, but will soon. Reducing the stress and anxiety is also part of keeping IBS under control, though. Am looking for ways to do that with my therapist that are within my religion’s guidelines. The therapist is also doing DBT for Neurodiversity with me, as I am also autistic.
Crystal
With anxiety I always start with addressing low serotonin with tryptophan or 5-HTP and low GABA with GABA. The best way to determine if someone may have low GABA/serotonin is to look at the low GABA/serotonin symptoms, rate them on a scale of 1-10 with 10 being worst, do a trial of the respective amino acid and rate the symptoms again right afterwards (in the next 2 to 30 minutes). Here are the symptoms https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/
If you are new to the amino acids (and other anxiety nutrition solutions like real whole food, quality animal protein, fermented foods, organic produce, health fats, gluten/sugar/caffeine removal, blood sugar control, gut health (IBS is covered in this chapter), pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
My book does have an entire chapter on the amino acids and many folks do really well implementing on their own. My online GABA Quickstart group program is helpful when you have questions and need guidance (and moral support/encouragement). More here about the program and purchase info https://www.anxietynutritioninstitute.com/gabaquickstart/
I am curious to hear how your religion’s guidelines affect the type of therapy you can do?
I do have your book, Trudy. If I can find someone to monitor me, I can probably try the 5-HTP. I’d want someone guiding me on dosage, though, so I don’t get serotonin syndrome. I’d be cautious with GABA, though, since I also have epilepsy. A GABA supplement can convert to glutamine in the brain and this can trigger seizures due to the excitatory effect of glutamine; this has been verified by my neurologist.
I am not supposed to do Eastern practices such as yoga and mindfulness because they can pull me away from Jesus. These go back to Buddhism and the teachings of Buddha contradict the teachings of Jesus; I follow Jesus, so I avoid these practices.
Crystal
The Amazing Aminos for Anxiety program will be opening up with support via a Facebook group and a monthly Q&A call. I’d discuss GABA with your neurologist again as it’s often used to help prevent seizures/epilepsy.
You may find yoga and mindfulness beneficial and discover they don’t actually pull you away – but always best to do what works for you.