The Challenge Diet
Now that I’d cleared me and my diet of as much of the fermentable sugars as I could (it’s important to be really rigorous about this in the exclusion phase), I started by adding in a couple of foods from each of the ‘banned’ food groups, one group at a time – a challenge diet. After each challenge, there’s a process of eliminating all the FODMAPs foods from my diet again – and obviously when challenging it’s really critical to carry on avoiding foods from the other groups so as to not confuse any symptoms. The elimination process between the challenges was a shortened version of the initial phase – 3 days if I had no symptoms from the challenge, or at least 5 days (or however long it took to be symptom free) if I did have symptoms.
I started with the polyols group – wine, beer and artificial sweeteners, avocado, cherries, watermelon, pears, mushrooms….lots. The challenge was to eat 1 – 2 servings of apricot, avocado nectarine or snow peas, which I did whilst continuing to exclude all the other FODMAPs groups. I found that after 3 or 4 days I wasn’t getting any symptoms of bloating (hurrah for wine and beer!), and moved on through the various groups :
Fructose: challenge was to add 1 tbspn honey or eat a mango a day. Not a bad challenge! I was fine with this one too.
Lactose: challenge by using 1 -2 cups of milk or yoghurt (not diet/low sugar varieties, because of the polyol artificial sweeteners). This one did make me a little bloaty, so I did a 5 day break from all FODMAPs instead of the usual 3, until my symptoms subsided.
Fructo-oligosaccharides: part one was onions – and lots of them! Starting with cooked, and then – gulp – raw. This was a great challenge as cooking without onions had been hard! I think I went a little crazy with the onions, and had a session with way too much raw onion (I know, it sounds kinky, right?) which made me feel fairly sick. Won’t do that again. Part two of the test, done separately, was garlic. All good. God, I love garlic.
Wheat Fructans: my favourite challenge as it meant I could add bread to my diet again! I started with rye bread for 2 days, had 1 day off, and then tested barley. I hadn’t eaten pearl barley in years, and discovered I rather liked it! It makes a pretty good substitute for brown rice or cous cous (which is of course, wheat). Barley and rye were both fine. Then it was time for the biggy – the one I’d pretty much suspected was the problem all along – wheat. In the form of wholemeal bread.
And of course, as I’d thought, this was what I had the strongest reaction to. After a few days of wheat, I was back to wearing larger clothes, feeling uncomfortable, sluggish, bloaty and full. I needed the full 5 days low FODMAPs to recover from that! Next up was….
Galacto-Oligosacharides/Galactans – lentils and legumes, cabbage and sprouts. Apparently everyone reacts a bit to this group – hence the famous beans=wind symptoms – but it was nothing too serious for me, so I counted this one a pass.
And In Summary….
The biggest difficultly was eating out. Finding somewhere where I could avoid wheat, milk and onion/garlic and a wide variety of fruits and vegetables was a very tricky combination! I ate an awful lot of sushi during that time. And drank lots of sake! Luckily, I like sushi, but needed to bear in mind little hidden traps such as that miso and soy sauce can contain wheat. I discovered that I really didn’t like most gluten free breads (gluten is the wheat protein, not a sugar, but it’s convenient when eating out to refer to gluten free – as if there’s no gluten there’s unlikely to be wheat sugars either), and that they can go mouldy really quickly if not refrigerated.
On the upside; I lost about 8lbs in weight. This wasn’t the point of the diet at all, but as I was a couple of stone overweight anyway, it wasn’t unwelcome! I think it was a combination of not eating out, and pretty much stopping snacking, that did it. My diet was really pretty healthy in the first place – though my portion sizes were too big – and whilst I don’t really snack much (I rarely if ever eat chocolate bars or crisps for instance) there is something about writing down everything that passes your lips for rationalising your intake of food!
The findings? Well, probably the first thing to say is my symptoms are not at all severe. I think this is because more or less at the same time as I was trialling FODMAPs, I had corrected a non dietary issue (via surgery) which was causing the majority of my symptoms, so what I have left is really quite mild. But I do find that my symptoms are worst if I overindulge in lactose, and wheat sugars (the fructans group). They also worsen depending on my menstrual cycle – I’d be really interested to hear from gals who may have the same issue?
My strategy now is to try to have wheat free days. It’s not too hard, knowing that if I abstain most of the time, it’s OK to allow myself the occasional toast/pasta day! I also use lactose free milk 99% of the time. It tastes sweeter than normal milk, but that’s usually OK. Bit trickier in savoury cooking, but you can adjust for that normally. (Be wary of lactose free yoghurt in savoury dishes eg tandoori chicken – it can be hard to mask the sweetness!!)
I hope that if you’re going through a FODMAPs challenge or are reading this because you’re looking for answers to your symptoms, that it’s been of help. But I would say – get in touch with a dietician before starting out. It really is worth it; and fodmaps may not be for you if there are serious underlying causes of your bloating.