I’m really excited for this next post because Sarah has been a huge source of information and support for me in my FODMAPs journey. Her story is so similar to mine, it’s eerie. And yet, it’s a comfort knowing there are others out there who have also been struggling without relief, been dismissed or overlooked due to vague symptoms, and been unwilling to give up in searching for dietary solutions. I’m so glad she’s agreed to share her background here.
On my honeymoon in Norfolk Island.
Hello everyone! I am Sarah, an American ex-pat who lives in sunny Perth, Western Australia and a long-time reader of Elise’s other blog, Hungry Hungry Hippie. I am also a big enthusiast of this new blog project, and I want to thank Elise for starting creating a space dedicated to providing information on following a plant-based low FODMAP diet. The Internet is filled with (often inaccurate) information about the low FODMAP diet, but there is a huge gap when it comes to those of us who like to fill up on whole plant foods. On one fructose malabsorption forum I frequent, most of the members seem to feel terrible eating vegetables and stick mainly to meats, fats and white rice. I understand how limiting your diet can get when your digestive system won’t cooperate, but I am determined to make this diet work with a plant focus!
Before I tell you a bit more about my experience with the low FODMAP diet, I want to highly encourage you to try some Elise’s recipes. There are simple and delicious. Currently, I am loving her FODMAP-free seitan. I was skeptical at first about the addition of brown rice flour (rather than the usual chickpea flour I add to my seitan, which is high in FODMAPs), but I am a convert! Though brown rice flour can be gritty, the texture of this seitan is amazing. I also highly recommend giving her granola a try. So crunchy and the perfect level of sweetness!
Before I get into the details about how the low FODMAPs diet helped me, I will give you a bit of background. For as long as I can remember, I have had digestive issues. Even when I was very little, I would suffer from fairly frequent cycles of what I would now call IBS-C. I also knew from a very young age that I was not able to tolerate sweet foods very well – even fruit! I remember telling my doctor in my very early teens that I felt like my food was fermenting in my gut. And you know what? It was! But there was no information about FODMAPs at that time. Instead, my doctor at the time (and may doctors thereafter) was rather dismissive, and chalked it up to my gender and automatically assumed I was high strung just because I was a good student. This doctor was but one among many to tell me I had IBS and to manage my stress, drink a lot of water, and exercise. All of which I already did, and none of which were apparently working.
This early experience had a big impact on me, and over time I began to think that the symptoms I was experiencing were all in my head. I even held the belief until very recently that IBS was just a diagnosis doctors give to women in a half-hearted attempt to tell them something and get them out the door. The reactions of many people close to me to my digestive distress only confirmed this belief. I was generally told that it was normal to be bloated and gassy, particularly for someone who was a vegetarian. However, I have been vegetarian for most of my life (18 years!), and I had a strong suspicion this was not about my vegetarianism. Even so, I pushed those feelings down and denied I had anything other than a ‘sensitive stomach’ for years. I continued to exercise 6 days a week, drink 3-4 litres of water a day, and ate heaps of fibre; yet still I saw very little relief. I found a lot of little things that did help, like doing yoga (I aim for at least minutes daily – I highly recommend this class), eating chia seeds and changing the ratios of soluble to insoluble fibre. However, I tried many more tricks that didn’t work at all…from supplements like slippery elm bark and HCl to warm lemon water and abdominal massaging. Even with the small changes, I could never rid myself of the bloating, pain, distension, wind, and constipation (sorry – no one ever said talking about IBS was pretty!). The worst symptom for me was actually acne. I didn’t have acne as a teen, yet the healthier my diet became, the more I started to develop acne. It was painful and scarring, and I was often told that I should clean up my diet even more or perhaps this was a sign of ‘detox’. As someone who never had an unhealthy diet and hasn’t touched meat for 18 years, I had a hard time swallowing the line that I was “detoxing”. I knew something else was going on, and now I know that my story is rather familiar among those who are helped by a low FODMAP diet.
This acne appeared 8 years ago, when I switched from vegetarian to vegan diet, and it was accompanied by an increase in some of my digestive symptoms. As so many vegans I knew described vast improvements from making the switch to a vegan diet – from weight loss to improved digestion to beautiful clear skin – I became even more puzzled about what was wrong with me. I had exactly the opposite experience, as the switch actually seem to cause additional symptoms. Resolving the cognitive dissonance was a struggle, and I convinced myself for a long time that my new diet had helped…at least slightly. However, eventually I had to admit that my ethical brain and my second brain* (i.e. my GI system) were not in agreement, and I went on a quest in an effort to find relief.
Unfortunately, I was trying to solve them all separately, but it would later turn out that they were all related! I have always been a relatively healthy eater. Even as a child, when I was given the task of picking vegetables for our dinner from the garden, I would eat half of the vegetables before they made it inside! I never really believed that the foods I loved could be causing me such grief because I ate what some might consider an ‘optimal’ diet (if there is such a thing). My diet was based mainly on vegetables, with regular consumption of healthy plant-based proteins, healthy fats, moderate consumption of grains and fruit. I saw a number of professionals about my woes, but nothing I tried seem to work.
Fast-forward to 2011 when I read about the low FODMAPs diet. I am a pretty hardcore skeptic, so my first encounters with the information were accompanied by sighs and exclamations of another food trend based on pseudo-science. However, when I saw it on Elise’s blog, my mind opened just a little bit. I had read her blog long enough to know that she suffered from many of the same GI issues as me, and I also suspected that, as a nurse, she would have looked at this information critically. So I set off to read as many journal articles as I could. When I realised that it was indeed possible that all of these healthy foods I loved so much could be the very things causing me digestive distress, I knew I had to at least try.
Late last year, I finally took the leap and consulted with a dietician who specialised in the low FODMAPs diet. I went through a 6 week elimination diet, followed by systematic introduction to each of the FODMAPs. Through this process I discovered my biggest triggers are fructose, sorbitol and fructans. This was huge, as prior to the diet I was eating apples (fructose and sorbitol), garlic and onions (fructans) daily! I also discovered that I could not eat galactans (legumes) in large amounts, and I definitely couldn’t eat them with another group – particularly fructans. This is a huge finding, considering the most common option for a vegetarian when dining out is a bean-based veggie burger on a wheat bun!
Now I know why this delicious tofu burger from The Juicy Beetroot always causes me grief! (But it’s worth it…sometimes.)
I won’t lie and say that I think eating a low FODMAP diet as a vegetarian who loves vegetables is easy. I don’t think it is. I have found through the elimination diets that some of my favourite foods (like apples) are off-limits for me, and other favourites can only be consumed in small amounts (like kale). However, I will say that it gets easier as I learn more about what I can replace old staples with and where my boundaries are with old favourites. The challenges aside, eating low FODMAP has brought me something even more important: the freedom to choose. I can choose to eat something that will cause me symptoms, or I can choose to abstain. Before, I could never seem to find a pattern, and I felt so out of control. Hummus wouldn’t bother me one day, but it would the next. I felt fine at the beginning of the day, but would always end up in pain by the end.
Like so many other IBS sufferers, I had tried eliminating so many foods over the years, but it never worked until I learned how to reduce my daily FODMAP load. After years of feeling like I was crazy, followed by years of frustration as my symptoms increased, I was finally in control. Sure, I still get frustrated when I have symptoms or when I have to make the choice between eating something I love or staying symptom free. I also have periods in which I rebel, and I throw caution to the wind because I just want to eat without so much thought and planning. However, it is not so much easier to bring myself out of those moments of frustration because I am armed with both a rational explanation and the tools to put it into use.
This post is already exceedingly long, so I will close here. If Elise will have me again, I would like to write a follow-up post. I’d like to share a few ways I have learned to cope with FODMAP restrictions. I am particularly looking forward to sharing my tips with you about travelling on a low FODMAP, plant-based diet. In a few weeks time, I will be preparing and packing for another trip to Tasmania, so it will be an opportune time to document my preparations and share with you what I’ve learned about maintaining a low FODMAP diet on the road.
Finally, I just have one closing comment to those people who laughed at a much younger me when I claimed food was fermenting in my gut: who’s laughing now?
Wedding in 2010.
* There’s some really interesting research out there on the gut-brain axis. I highly recommend this podcast episode as an introduction.
Thank you so much Sarah. Yes!! I will have you again!!