FODMAP recommendation - contradictory info on sites

Hello,
I wanted to see if anyone knows which FODMAP diet plan is the MOST ACCURATE. I have looked at several different sites with info on this, and it is so frustrating because they contradict each other on certain foods. The sites I have looked at are Monash University, Sue Shepherd's work (which I've already read not such things about) , and FoodIntol.
I have a 7 year old with these GI issues, so this makes it more difficult. She doesn't tell me when she is feeling nauseated or her stomach hurts, so recording symptoms is tough and can't always go off of this. Thus, needing the best resource for this, before I buy yet another book and buy more food that we should be avoiding.

Any info / insight would be greatly appreciated!

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When I was trying FODMAPS, I was given a printout from ibsgroup.org by a nutritionist. Besides Monash, I found lists from Stanford Hospital and the University of Arizona. Found those through Google and would send links, if I were better at doing that! I'm not sure there is a most accurate diet plan. I just picked a list and made notes on it from other lists to get the most complete suggestions I could. The reason I'm not sure there is a definitive plan is that I just briefly scanned a study from the University of Virginia in 2012 which was trying to determine if the diet was helpful. They seemed to think it is, however, the author commented on the difficulty of doing studies with such a complex diet and other reasons. Found that study on Google as well. Good luck. Tough to be 7 with these issues, and tough to be the Mom trying to help.

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Thanks for the reply. Did you ever get the book or app from Monash University? Just curious if you did and if you think it was worth the $$. I will check out Stanford and Univ of Arizona.

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No, I didn't buy anything from Monash--or anywhere else. Just figured I could "meld" the lists and try it on my own before I invested any money. As it turned out, mild gastroparesis intervened before I could really test the diet out, but the UVA study sounds encouraging, so I would definitely try the diet if I were having solely IBS symptoms. Hugs and good wishes for your daughter.

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Hi jayhope,
I downloaded the info from the sites you recommended. I'm not sure if you saw the link to ibsfree.net, but that is a very good website where you can type in questions, etc. Also, you can search the website for topics you may have an interest in. Or if you have questions about a particular food, it will direct you to previous discussions. Thanks again

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Dr. Jim Schwartz my gastroenterologist in Houston at Baylor recommended the fodmap diet for me. It has helped tremendously. I think the FODMAP app from Monash U. is really good. It would be a lifesaver for a newbie, and still useful for someone already familiar with the diet. It has the guide, shopping list, and filter for sensitivities. I also like the BM pro app for journaling symptoms. I need to find a local doctor now in the Raleigh, Durham, Chapel Hill (RDU) NC area that knows about fodmap. Any suggestions?

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This blog by Kate Scarlta, RD has updates to the FODMAP DIET as of April 13, 2013: http://blog.katescarlata.com/fodmaps-basics/fodmaps-checklist/

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Thanks Christina! I will check it out for sure.

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Hi Djak,

The reason why different sites (and medical doctors and dietitians/nutritionists/naturopaths) have different lists of FODMAPs is because the discovery of the effect of FODMAPs on GI problems is recent. A lot of research is still being done to determine the FODMAP content of different foods and how different FODMAP-containing foods affect GI function.

Monash University is the place where all the research is being done and where foods are being tested all the time. So information from there is the most accurate - but obviously, to be accurate and complete you want the most recent information from there. So the app (which is a recent product) is your best purchasable source, or the new cookbook Sue Shepherd (the dietitian and researcher who discovered FODMAPs and is involved in the ongoing research) has released probably has an up-to-date list of FODMAPs in it, too.

http://shepherdworks.com.au/shop/low-fodmap-recipes

However, the way of finding out what is known at the present moment, including things discovered in research yesterday, and of being sure that you are managing your child's diet in the best possible way given her individual symptoms etc, would be booking a Skype consultation with Sue Shepherd's practice. They email remote patients up-to-date lists and also of course provide guidance on following the diet with all its complexities (e.g. the additive effect of safe quantities of different FODMAPs).

http://shepherdworks.com.au/services/book-an-appointment

Hope that helps!

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Hi NikaOZ,
I have been following Kate Scalarta's website recently. She is a dietician in the US who has trained in FODMAP's by Monash University and is training others dieticians in the US. She follows Monash Universities updates and has been posting them on her site. This is helpful, because even though I would absolutely love to get their app, I don't have a smart phone. When the time comes around to upgrade my phone though, I am going to seriously consider getting one. Recently, Kate has posted info about quantities of FODMAPs which is helpful. I have noticed with my daughter that when she has wheat based products that are more sugary, she will get what I call the hard hiccups and then she will regurgitate. Thus, we've been avoiding whole grain and wheat breads altogether right now, until I can assess this better in the next couple weeks. Didn't want to play around this too much while she was still in school, as I feared what types of tummy troubles she would get. My suspicion is the total fructose load is the overall key with her, because of the fructans in wheat. This diet has really opened my eyes though and has helped a ton already. And to think, all the things I was buying for her to help with her constipation (higher fiber items with wheat in them) was causing alot of her tummy troubles to begin with. Even the Cliff bars that are supposed to be made with better quality ingredients, and they sell at Whole Foods, is one of her culprits. Thus, I don't buy them anymore. I've gotten all of my daughters upper GI issues resolved, no more reflux, regurgitation, tummy bloating, gas pains and excess gas almost totally diminished. Now, it's just the constipation I'm still left with. Thus, have to see if she's ok with some wheat breads with very little sugar in it. If not, will have to continue to find other sources of fiber that she is willing to eat. She is quite picky though and that's one of my biggest struggles. To make it worse though, her brother has a wheat intolerance. He has the opposite effect though, and ends up with the Big D. UGGHH. The joys of motherhood when cooking for the IBS family.

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Hi Djak,

I'm glad you have found such a helpful source of info. Wow, sounds like you are having lots of fun with your family! It's great you are putting so much effort into maintaining their health.

Just thinking about the FODMAP-free, child-friendly fiber issue -

I have to follow a very low fiber diet due to GP and CIPO, and my dietitian told me I was accidentally overdosing on fiber by adding cocoa powder to my milk. Apparently cocoa powder is actually very high in fiber! If your daughter is like most kids I'm guessing she probably likes chocolate, so this might be a way of getting some FODMAP-free fiber into her.

Other not obvious, high fiber foods that I have accidentally included in my diet, are gluten free pasta (apparently some varieties are high in fiber even though they are white - I'm not sure why - maybe because they are partially made from corn?), and gluten free white bread for which the blend of flours included linseed flour and rice bran (you couldn't see it, though - it looked the same as before the blend of flours was changed).

Quinoa and brown rice are gluten free, high fiber grains, which I'm guessing your daughter may have rejected because they look different, but you can buy these as breakfast cereals (quinoa flakes etc), pasta (e.g. brown rice spirals), and as flour for use in baking breads, muffins, and etc. I have also seen recipes in which quinoa is used to crumb things - maybe your daughter wouldn't notice if you used quinoa crumbs for kiddy food like fish fingers?

Oats are FODMAP free from what I understand, and are also a good fiber source and can be used in baking.

Another thought it that maybe you could add Citrucel powder to some of the child-friendly food you make her? I have never used this product so am not sure if it's tasteless, but if it is, she wouldn't even notice it so hopefully wouldn't turn her nose up at the food.

http://www.citrucel.com/Ch2_Benefits.aspx

Anyhow - you have probably already thought of and tried all these things :-).

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Thanks so much for all the good tips NikaOZ. Yes, getting the fiber in her is the tough part to keep her regular. Oh, and thank you so much for the tip on the Citracil with the smart fiber. You wouldn't believe how many different types of fiber supplements I had bought prior to knowing she had fructose malabsorption and they all caused her bloating and gas and then I think the trapped gas just made the constipation worse. I have searched and searched on the internet for different fiber supplements, and don't think I ever saw this one. Alot of the ones I had tried previously had sugar alcohols in them, wheat, psyllium, ect (all the no no's). Now that I know about FODMAPs it is such an eye opener and explains the WHY behind why all the stuff I tried was just making her symptoms worse and only made her constipation worse. It also seemed like the healthier things I tried to do diet wise for her, just made things worse. Certain foods and drinks definitely just shut her stomach down is how I used to describe it.

Also, thanks for the tip on the cocoa powder. I will definitely give this a try. What brand or kind do you put in your milk and do you need to add some sugar to it to make it taste like the nestle quick chocolate milk powder?? I have nestle quick cocoa that is 100% cocoa and it has 1 gm of fiber per tablespoon. Does your brand have more fiber?? Any input would be great. I guess every gram helps though when scrounging to add fiber. I tried regular quinoa but haven't tried the quinoa flakes yet. Have that on the list to try. My kids didn't go for the regular quinoa, but I think I need to hide smaller amounts of it in things.

Where are you getting your bread from and the pasta that is gluten free and made out of rice? We do have a whole foods and trader joe's in town, but they are a ways away. Thus, if you've seen these at traditional grocery stores that would be helpful to know or a brand name if you don't mind. It's just that i have wasted so much money on foods over the past 6 years trying to get more fiber in my daughter and just ended up throwing away b/c she refused to eat them. Thus, your info would be great. In the past, prior to figuring out she has fructose malaborption, I've tried flax seed, wheat germ, flax oil, was putting dates and all kinds of fruits in smoothies to get more fiber in her, bought a bread machine and wheat berries / rye berries to grind myself into flour so it would have all the good fiber in it, and it all backfired on me. At least now with FODMAPS info, I have something to go off of. Praise the Lord is all I can say. I have been beating my head against the wall for years with all of this, and then when I started making the wheat bread myself in my bread machine, my son starting having the opposite problem as my daughter and needing to make emergency bathroom stops. We've even had to run red lights on vacations because he needed to get to a toilet ASAP. Well, he's got a problem with wheat also, and did a test on him tonight and confirmed he has a problem with onions, so he's another IBSer. Thus, I am always open to any advise people have and appreciate all feedback. This is soo hard with kids, and I have been ready to throw in the towel a 100 times, but always bounce back somehow.

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Hi Dkaj-

I have found that Crystal Saltrelli has a good site, lots of YouTube videos and a well written book with FODMAP recipes called "Living Well with Gastroparesis". Hope this helps-

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Hi Djak,

My bread was made by a local baker and I'm not in the same country as you, so unfortunately the details of the loaves I was buying won't be of much help. If you have your own bread machine and feel like experimenting (as if you don't have enough to do with your time, right?), a handout I have about FODMAPs suggests these alternatives for making products for which wheat and rye are typically used: Amaranth, arrowroot, buckwheat, quinoa, oats, polenta, potato, millet, sorghum, sago, tapioca, rice and corn flours. It also suggests trying 100% spelt bread. My understanding is that spelt is an ancient form of wheat that is supposedly easier to digest, and has become quite popular as many people who struggle with wheaten products are OK with spelt. I don't know which of those alternative products are high in fiber but I imagine google could tell you.

The pasta I was buying was Orgran brand, and Orgran has stockists world-wide and their products can also be purchased over the internet. They make a number of gluten-free pastas and other gluten-free products that are high in fiber - you can check the fiber per serve in their various products here:

http://www.orgran.com/products (note the buckwheat pasta has a massive 8g fiber per 100g!)

Unfortunately the cocoa powder I was buying is another local product, but I found this info about the fiber content of cocoa and the process that improves the taste, that you may find helpful:

http://www.livestrong.com/article/112056-cocoa-powder-nutrition-information /

My dietitian explained to me that cocoa powder and cocoa something else - I can't recall what - are made from the cocoa bean so are high in fiber, but cocoa butter is made from the oil and so doesn't have fiber (but is very high in fat).

Perhaps if your cocoa powder is low in fiber it may be a product made from a blend of a number of things as opposed to pure cocoa powder? Health food shops in your country may sell pure cocoa powder or products made predominantly from cocoa powder, and perhaps you could mail order if there are none within driving distance.

When I was looking up the cocoa powder information, I came across this mention that carob flour has an unbelievable amount of fiber per cup - and carob is often used as a chocolate substitute so perhaps your daughter may like the taste (especially if you don't tell her it's a health food alternative to chocolate)!

http://www.livestrong.com/article/366229-carob-fiber/

Good luck with it! It's great that your kids have you on their side!

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Sue shepherd is the guru of low FODMAPS.... She has done so much research on the topic not to mention the publications she has written books and journal... My dietician follows the sue shepherd she has also worked with her and has articles co written by the 2 of them... I swear by dietician... I would not be alive if it wasn't for my dietician!!!!!!

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Thanks for the info mphotographer. I don't have Crystal Saltrelli's book, but do follow alot of her information and check out her you tube video's. I also received her her free ebook that was an introductional 10+ page guide for gastroparesis. I love her site. I saw recently she did have a post and audio interview with Kate Scarlata,RD on FODMAPS. Crystal also just had breath testing done for SIBO, but I don't know if she posted her results on that. It's just interesting to me that alot of her recipe's are FODMAP friendly. Your post brings up a question I've had for quite some time though, if anyone can answer because it seems to me like most if not all of these various GI illnesses people suffer from all follow similar diets. It does make me wonder though with these various diets for IBS, IBD, and GP if alot of these cases start out as IBS and then turn into worse conditions if you don't figure out your food intolerances that bring on the malabsorption issues with the various symptoms of bloating/ gas/ constipation or diarhea, reflux, regurgitation, etc.
My daughter has dietary fructose intolerance. We did take her to Mayo Clinic and they did the endoscopy, 24 hour impedience test, and the 4 hour gastric delay test on her. Ultimately after all testing was done, we did figure out she the fructose intolerance and they ruled out anything more severe. My Dad has had IBS his whole life which brought on reflux and he would aspirate at times. Ultimately he became type 2 diabetic (which he now has under control) but did end up with neuropathy and is in alot of pain every day. Then we have chron's disease that runs on my mom's side of the family. My husbands side of the family has lactose intolerance and tree nut intolerances, eczema, hives. Thus, we are surrounded by tummy issues from all sides of the family tree and just curious if anyone else has had this same question and ever figured out the answer to this.

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Hi NikaOZ,
Thank you so much for the links on the buckwheat Orgran site, and all the other articles. I did try to look up more info on the citracil with smart fiber (methycellulose) to see if this is a fodmap/fructan for sure b/4 buying, because I thought I saw somewhere that it was possibly a sugar alcohol, but couldn't find anything. (I'm going to check the IBSfreenet site next. I did go out to Kate Scarlata's, RD's blog though, to see if she had any info on it, and if you haven't checked out her site or blog, she just posted more new info on June 1st. She stays up to date with Monash Universities continual research and lab findings....... And GUESS WHAT, Carob powder and cocoa have now been added to the high fodmaps list. UGGGHHHH!!! Here's the link. http://blog.katescarlata.com/ This is what is so frustrating with all of this, you think you find an alternative, and then bamm, you hit another brick wall. I still may give some of these a try though, because I know that sometimes this can all be on an individual tolerance levels and serving size is another factor.

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Oh no! Oh well, I suppose I'm meant to be staying away from the yummy stuff anyway, given that high fiber = trouble for me ;-p.

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P.S. Thanks for tipping me off about that update!!

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