UVA Digestive
UVA Nutrition Services Health Center
Low FODMAP (Fermentable Oligo-, Di- and
Monosaccharides and Polyols) Diet
What are FODMAPs?
FODMAPs are a type of carbohydrate (or “sugar”) found in certain foods. Some people
may have trouble digesting FODMAPS, especially patients with irritable bowel syndrome, a
slow moving gut, or other bowel disorders. This is because FODMAPS are not easily
absorbed by the bowel. Symptoms include: abdominal discomfort, distention, bloating,
fullness, nausea and/or pain after eating foods containing FODMAPS.
The table below lists the names of the carbohydrates that are considered FODMAPs.
Fructans and Galactins Polyols
Fructose Sorbitol
Lactose Mannitol
Fructooligosaccharides Xylitol
Galactooligosaccharides Maltitol
Fructose* and Glucose
Fructose is a naturally occurring sugar found in fruit, vegetables, and honey. Fructose
intolerance can occur in people with irritable bowel syndrome and other bowel disorders.
Fruits and fruit juices with higher levels of fructose may cause gas, bloating, abdominal
cramping, and diarrhea.
Glucose is also a naturally occurring sugar. Fruits and juices with more glucose (and less
fructose) may be more “intestine friendly”. The tables in the following section list which
fruits, juices and other foods may be better choices for patients with FODMAP intolerance.
High Fructose Corn Syrup (HFCS) *
HFCS is an ingredient in many processed foods. HFCS is made up of almost half glucose
and half fructose. HFCS may be easily digested by some patients. Therefore, items with
HFCS, such as soft drinks, may be tolerated well if they are limited to 12 oz per day and
are taken with a meal.
* In some patients, even a small amount of processed fruit juice or HFCS may cause
intestinal discomfort and/or malabsorption.
Sorbitol
Sorbitol (or sorbose) is a sugar alcohol that is found naturally in fruits and fruit juices. It
is used as an artificial sweetener. It can also be found in many “diet foods” or “diabetic”
foods (such as diet soft drinks, sugarless gum, sugar-free jelly/jam, and other sugar-free
foods). It may also be found in liquid medications. Sorbitol often creates similar
symptoms as fructose – especially when fructose and sorbitol are ingested together.
General Guidelines
Eliminate products with ingredients that list fructose, crystalline fructose (not HFCS),
honey, and sorbitol on the label.
Avoid sugar alcohols. These include sorbitol, isomalt, lactitol, maltitol, mannitol,
xylitol, erythrytol, and lactatol. These are often found in “diet” or “diabetic foods” such
as diet drinks, ice cream, candy, processed goods, etc.
Limit drinks with HFCS. If used, drink less than the recommended serving size--less
than 12 oz of soda (may help to drink with a meal).
Check your medications for fructose and sorbitol. They are not always listed on the
label, so check with your pharmacist or the manufacturer.
Keep in mind the amount of fructose found in 2 apples (or 2 oz of honey) is the same
as the amount of fructose in 1 can of soda (note: apples have other nutritional
benefits).
Follow guidelines below to choose fruits, vegetables, and other foods that are friendlier
to your intestines!
Fruits:
Serving size is ½ cup
Limit to 1 to 2 servings per day.
Fresh or fresh frozen fruit may be better tolerated than canned fruit.
Keep in mind tolerance may depend on the amount you eat at one time.
Limit concentrated sources of fruit--such as dried fruit and fruit juices
Avoid eating large amounts of any fruit.
The foods listed as “Foods to Avoid” should not be eaten because of their high
FODMAP content. These are otherwise healthy foods.
Intestine Friendly Foods to Avoid if Questionable
FODMAP Intolerant Foods/Foods to Limit
Bananas*, blackberries, Apples, apple cider, apple Other fruit juices or
blueberry, grapefruit, juice, applesauce, apricots, drinks, sugar-free
honeydew, kiwifruit, cherries, dates, grapes, jam/jelly, dried fruit,
lemons, limes, mandarin lychee, mango, peaches, canned fruit in heavy
orange, melons (except pears, pear juice, plums, syrup, other fruits
watermelon), oranges, prunes, watermelon
papaya, passion fruit,
pineapples, raspberries,
rhubarb, strawberries,
tangelos
Vegetables:
Serving size is ½ cup (most vegetables) or 1 cup of leafy green vegetables
Limit to 1 ½ to 3 servings per day.
Cooked vegetables may be tolerated best as cooking causes a loss of free sugars.
Keep in mind tolerance may depend on the amount you eat at one time.
Intestine Friendly Foods to Avoid if Questionable
FODMAP Intolerant Foods/Foods to Limit
Bamboo shoots, bok choy, Artichokes, asparagus, Avocado, corn,
carrots, cauliflower*, celery, some beans (baked beans, mushrooms, tomatoes,
cucumber*, eggplant*, green chickpeas, kidney beans, other beans
beans*, green peppers*, leafy lentils) beetroot, broccoli,
greens, parsnip, pumpkin, Brussels sprouts, cabbage,
spinach, sweet potatoes, cauliflower, fennel, garlic,
white potatoes, other root sugar snap peas, leeks, soy
vegetables products, okra, onions,
peas, shallots
Other Foods and Food Additives:
Intestine Friendly Foods to Avoid if FODMAP Questionable
Intolerant Foods/Foods to Limit
All meats Rye and rye products (rye Limit products with
All fats bread and crackers), wheat HFCS if symptoms
Yogurt and hard and wheat products (cous- still continue
cheeses cous, cream of wheat, wheat If you experience
All eggs crackers, pasta, wheat bran, symptoms with
Aspartame (Equal® etc.) lactose, try limiting
and Nutrasweet®) Honey milk, cottage cheese,
Saccharin (Sweet ‘n Flavorings with fructose or and other lactose-
Low®) sorbitol containing foods (see
Sucrose (table Desserts (ice cream, candy, Lactose Intolerance
sugar) cookies, bars, popsicles) handout)
Glucose sweetened with fructose or
Maple syrup sorbitol
Cereal or other processed
foods with sorbitol or fructose
on the label
Sherry and port wine
Sweeteners such as sorbitol,
mannitol, xylitol, maltitol, and
isomalt used in sugar-free
gum, candies and mints
* Possible gas forming foods may need to be avoided
Medications:
Many liquid medications and some personal care items may contain lactose or the sugar
alcohols (sorbitol, mannitol, xylitol, maltitol, isomalt). Examples include: liquid pain
relievers (including liquid gel caps), cough medicines, and cough drops. If possible,
choose a tablet or caplet form instead of liquid medication. If you have eliminated
FODMAPs from your diet and are still having symptoms, talk to your pharmacist to see if
any of your medications contain lactose or sugar alcohols.
Additional Resources:
Visit: [Link]
o Go to Nutritional Issues in Practical Gastroenterology and find August 2007
article on “Clinical Ramifications of Malabsorption of Fructose...”