Tips on challenging fructose, with Marnie Nitschke, expert gut health and FODMAP dietitian.
So many people these days have heard of the low FODMAP diet, and found it helpful in managing their IBS symptoms. The problem is, too many find they get ‘stuck’ on the elimination phase of the diet – feeling better, but frustrated by their limited range of food. We know that tolerance to FODMAPs will vary between people, and that systematic challenges are really the only way to judge your individual tolerance, and liberalise your diet. So how do you do it?
Here are some of Marnie’s tips.
- Working with a FODMAP trained dietitian is the best bet. It means personalised advice according to your health, and proper information about correct challenge foods and doses – as well as help in interpreting your response.
- It doesn’t matter where you start – it’s important to start somewhere! Just as important is the fact that you shouldn’t wait for your symptoms or diet to be ‘perfect’ before jumping in. As long as you’ve had a significant and sustained improvement in your symptoms with the low FODMAP diet, it’s time to start challenging.
- Challenging fructose isn’t as simple as eating your favourite high fructose food. Appropriate challenge foods will contain excess fructose, but not other FODMAPs that will cloud the result (and could give unreliable challenge results). An example here is that apples are high in both fructose and sorbitol, so they are not the best food to use for a fructose challenge.
- Try not to overanalyse! Remember that it’s normal to experience different gut symptoms with the reintroduction of FODMAPs. Wind, or changes in the frequency / consistency of your stool doesn’t mean you’ve ‘failed’ the challenge. It’s symptoms that interfere with life (eg. pain, feeling bloated and miserable) that we’re watching for.
- The best challenge information will be gained by testing a number of times, over different days, with slowly increasing doses of an excess fructose food. Honey is a good example here, and might look something like this:
- Finally, fructose is just one of the FODMAP sugars, and therefore is only part of the picture when challenging. If you don’t do so well, pick yourself up, be kind to yourself until symptoms have passed, and then think about tackling another FODMAP when you’re ready.