Book Review: The Complete Low-FODMAP Diet

If you suffer from any kind of digestive problems, you’ll know how refreshing it is to see doctors acknowledge that what you put in your mouth has some bearing on how things go on the other end.

Drs. Sue Shepherd and Peter Gibson have managed to write a surprisingly easy read on the subject.

They start out by explaining the difference between IBS, food allergies and intolerances, celiac disease, and IBD like Crohn’s and ulcerative colitis. Then they launch into the basics of how and why to follow the low-FODMAP diet, including tips on eating out, kids on the diet, and dealing with other comorbid health conditions. It even includes diet plans for a variety of different circumstances, such as also being diabetic or vegetarian. The second part of the book is chock full of recipes that really do look yummy.

The Complete Low-FODMAP Diet does a good job of explaining how to use diet to figure out which groups of foods are most problematic for you. It will also help you determine how much you can have without problems. First you cut out all FODMAPs for a couple months, then you reintroduce them one at a time, by group. If a food is a problem, you then challenge it in a smaller quantity. In this way, you can arrive at a diet that is far less restrictive than the initial low-FODMAP diet.

I was very pleased that the book managed to avoid a couple of my top pet peeves!

The authors reminded people to get screened for celiac disease prior to going wheat-free, and that they repeatedly emphasized the importance of a strictly gluten-free diet for celiacs.

They also managed to acknowledge that even if a person has celiac disease, Crohn’s disease or other known digestive disorders, diet can play a role in reducing symptoms and healing. On top of this, they did call out the difficulty in maintaining a nutritionally adequate low-FODMAP vegetarian or vegan diet.

I love the low-FODMAPS approach to digestive disorders for several reasons:

  • It is highly individualized.
  • The research backs it up.
  • It’s easier than other diets that have similar effects.

I do take issue with the book in a few places. First off, the book mentions low fat diets being important, with nothing to back that up. There are no studies cited on that topic, and they admittedly state that fats do not contain FODMAPS. This seems to be a vestige of the old popular “wisdom” that fat is bad for you, thrown in for no apparent reason. The recipes often call for things like canola oil, which I’d sub out for healthier fats like ghee, olive oil, or animal fat. They also call for the leanest cuts of meat and removing skin from chicken. This is not necessary for a low-FODMAP approach.

The other problem I have with the recipes is that they rely heavily on wheat replacement foods. They mention using spelt without drawing attention to the fact that it contains gluten. And while they do remind the reader that not all gluten-free breads, pastas, and cereals are low-FODMAP, they include them in the recipes and meal plans at most meals.

These meal plans will certainly help a lot of people. Not everyone is ready to go completely grain-free, and not everyone needs to. Processed foods are a reality for most people. I see these meal plans as a stepping stone toward an even healthier diet.

My last issue with the book is that while they do mention SIBO, they consider it “highly controversial.” Then they go on to describe their findings by basically describing SIBO!

I’m speculating here from my experience with SIBO – The difference seems to be that they focused their research just on the large intestine, which is where the bacterial colonies typically live. In SIBO, the colonies are also in the small intestine, where they do not belong. The same breath test that is used for SIBO is used in their research. But in SIBO testing, they look for an extra spike in the hydrogen and methane production, which you wouldn’t see if SIBO were not present.

The authors do not need to believe in SIBO in order to have produced a great treatment for it. I was happy to skim over their skepticism and apply their findings, despite disagreeing on the validity of SIBO as a diagnosis.

Another thing I loved about the book is how the authors mentioned alternative treatments such as hypnotherapy, herbs, and acupuncture. While they didn’t go so far as to validate these treatments, they put them out there for consideration and acknowledged the benefits some people gained. They also touched on the gut-brain connection, the connection of stress to gut issues, and the way that fatigue and fibromyalgia can both be related to digestive issues. They stuck to their research when making recommendations, without laying claim to the whole, only truth. I always respect that!

I highly recommend this book to anyone with digestive issues. Check it out!

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