Categories
Low FODMAP

How to Manage IBS with Low FODMAP Portions

The Low FODMAP Diet is not your typical diet, nor is it really comparable to other things you may have tried in the past. It is best described as a temporary learning experiment that involves elimination, reintroduction and personalization. These three phases help IBS sufferers understand their triggers and take control of symptoms. It is not intended for weight loss or to improve any other specific health condition aside from medically diagnosed IBS.

It’s also not an eat-this-not-that diet. While a list of foods to consume or avoid may work for diets like keto, low carb, or Whole30, low FODMAP revolves around portion sizes. While it is true that one should avoid high FODMAP foods, it is equally important to understand what constitutes a low FODMAP serving, since a low FODMAP food can easily become high FODMAP if consumed in larger portions.

My goal in this article is to shed light on a sometimes confusing and often overlooked aspect of the low FODMAP diet – portion size. I want to give you simple tips and tricks to better understand what a low FODMAP serving is, how to avoid FODMAP bombs, and how to plan meals taking into consideration portion sizes to avoid overflowing your FODMAP bucket.

Portion Size Basics for IBS

As a Registered Dietitian specializing in IBS, I get the following questions a lot:

  • Does portion size really matter? 
  • Do I need to measure foods with FODMAPs?
  • Can I eat several green light or low FODMAP food servings at one time?

The answer to all of these is YES!

How to Interpret Portion Sizes on the Monash App

If you look closer at the Monash app, you’ll see that each food has a traffic light color. This first color related to the FODMAP rating based on a typical serving size. For example, one medium pink lady apple is labeled red, meaning it is high FODMAP at a serving size of 200 grams or 1 medium apple.

If you tap on the pink lady apple, you will find that 28 grams or ⅛ of the apple is moderate in sorbitol. You will also find that 20 grams or ⅛ of a cup is low. This is not a lot of apple, but maybe a nice topping for your morning oatmeal. Many foods have varying traffic light colors based on different portion sizes. This allows us to enjoy small portions of some high FODMAP foods as long as we stick to the green light serving size.

Measuring FODMAPs

As a FODMAP-trained dietitian, I encourage my patients to aim for green light foods in recommended serving sizes, while mostly limiting or avoiding yellows, and generally avoiding reds. Monash is based in Australia, which utilizes the metric system. This means many food portions are provided in grams. By contrast, the English system is also often stated in cups and spoons. While I do think it is important to be aware of your portion sizes, I feel that a measuring cup will suffice. A food scale is not necessary, however not discouraged if you would like to be more precise.

What is FODMAP Stacking?

FODMAP stacking involves eating too many green light or low FODMAP foods at one sitting. While this may result in IBS symptoms for some sensitive individuals, it is something we may only consider if you are having poor response to the diet as a whole.

My advice here is to not overthink FODMAP stacking. Monash established cutoff values to identify foods as either green, yellow, or red, so you can consume several green light foods at one meal and remain low FODMAP. Monash states that it’s reasonable to eat several serves of a green light food at one sitting.

The Challenge with FODMAP Lists

While high and low FODMAP lists are prominent educational tools, they tend to oversimplify. Blueberries for example, are a common source of confusion. Monash defines a low FODMAP serving size of blueberries at ¼ heaping cup or 40 grams. Many lists will green light blueberries based on this reading, but personally, this sounds like a small serving size compared to strawberries, which are low at 10 medium berries or 150 grams. 

Similarly, sweet potatoes are low FODMAP at one half of a cup. Consuming more than this portion pushes the mannitol content into the red zone resulting in a high FODMAP serving size, which may be enough to trigger IBS symptoms in some. While this food is often labeled as low FODMAP per many FODMAP lists, one can easily consume larger portions at one sitting.

Common Food Items That are Easy to Exceed Low FODMAP Portion

Smoothies

Smoothies can easily be what we like to call “FODMAP bombs”. The recommendation is to consume only one low FODMAP fruit serving per meal or snack. It is so easy to exceed one serving of fruit when we are tossing multiple low FODMAP fruits into our blender. Feel free to use ½ of the recommended serving size for two different fruits such as 5 medium strawberries and ½ slightly greenish (unripe) banana into your smoothie to keep your fruit serving in check. 

Instant Oatmeal

Instant oatmeal is low FODMAP at ¼ cup raw, but many of us eat a larger portion of this low FODMAP grain at breakfast time. If you are wanting to enjoy a larger, more satisfying portion, opt for rolled oats. These are safe at ½ cup raw.

Juices

Like smoothies, juices are concentrated sources of fruits and vegetables and can easily be high FODMAP. There are a few low FODMAP varieties such as cranberry, lemon, lime, tomato, and fresh squeezed orange juice, however Monash has not tested too wide a range.

It is best to use caution if you want to juice your favorite low FODMAP fruit or vegetable. It may be best to create a blend using a vegetable with no FODMAPs detected such as carrot or limit your low FODMAP fruit and vegetable to the serving of the whole, intact fruit or vegetable. For example, ½ cup of fresh squeezed grapefruit juice contains more than the low FODMAP serving size of ½ cup fresh grapefruit. 

Nuts and Seeds

Like juices, nuts and seeds are easy to overdo, especially if you are just snacking on nuts when hunger hits. Not sure about you but the low FODMAP serving of ten almonds is fairly easy to stick to.

Foods Without FODMAPs

If you look closely at the Monash App, you will see that some foods have the statement “FODMAPs were not detected in this food”. This means that one can eat multiple servings of this food at one sitting without having to worry about portion sizes.

Examples of No FODMAPS Foods Include:

  • Arugula
  • Carrot
  • Clementines
  • Cucumber
  • Grapes
  • Guava
  • Japanese Pumpkin
  • Papaya
  • Parsnips
  • Patty Pan Squash
  • Red bell pepper
  • Rhubarb
  • Rice
  • Strawberries
  • White Potatoes

Quick reminder, FODMAPs are carbohydrates, fibers and sugars. Therefore, pure protein sources such as eggs, poultry, pork, fish, seafood, beef and pure fats like oils and butter (only contains trace amounts of lactose which is not of concern) are low FODMAP.

However, watch out for seasonings and sauces as they often contain garlic and onion and the sneaky fibers inulin and chicory root, which pop up in lactose-free yogurts, protein powders, herbal teas, protein powders, granola bars, and more.

How to Interpret Food Labels for Serving Size

The serving size defined by the food label does not always correlate to the recommended or typical portion sizes provided on the Monash App. It is best to use the Monash app to help you determine how much you can safely enjoy at one meal. 

The ingredients on a food label are listed in descending order, which means the first ingredient is present in the highest amounts and the last ingredient the least. High FODMAP ingredients such as garlic and onion, even when present in portions less than 2%, should be avoided unless the food product is defined as low FODMAP.

Final Takeaways

  • Use the Monash App with FODMAP containing foods.Tap the specific food to discover the appropriate portion size so you can serve yourself the correct portion.
  • Measure FODMAP containing foods. A simple measuring cup can bring awareness to your portion sizes. While it is easier to eyeball a serving size, it may be a good idea to measure FODMAP containing foods especially when you are first getting started. 
  • As a rule of thumb, I often recommend limiting vegetables with a low FODMAP serving size to one to two per meal, unless “No FODMAPs detected” is displayed.
  • Limit fruits to one serving at each meal or snack.
  • If you are ravenous at meal time, include more no FODMAP foods into your meal so you do not have to be as concerned with portion control. Try adding rice, white potatoes, lean proteins, and healthy oils to help you stay full. 
  • Those who have poor response to the low FODMAP diet may want to take a closer look at FODMAP stacking or better yet, follow up with your FODMAP trained dietitian for more individualized recommendations.
Categories
Low FODMAP

Gut-Friendly Baking Essentials for the Low-FODMAP Diet

As we continue grappling with the “new normal”, many of us have taken comfort in the simple pleasures of baking. Baking provides a loose structure to our evenings, it involves the whole family, and there’s no better smell than a fresh batch of blueberry muffins hot out the oven. Though traditional recipes often call for high FODMAP ingredients that may trigger IBS symptoms, I’ve created a list of low-FODMAP baking essentials that are good for your gut AND your taste buds.

Before we get into it, a quick rule of thumb: high FODMAP foods are carbohydrates, fibers, and sugars. Fat and protein-based ingredients are low FODMAP,  which means your basic baking ingredients such as eggs, oil and butter (this contains only trace amounts of lactose which is not of concern) are considered low FODMAP. All spices used for baked goods (unless for some crazy reason your cookie recipe calls for garlic and onion), are low FODMAP.  Leaveners such as baking powder and baking soda, plus yeast are all low FODMAP as well. Be sure these are fresh to ensure the best results!

What flour should I buy?

Wheat flour is a common ingredient in many baked goods. While a small portion of wheat is compliant, we recommend swapping in a gluten-free flour instead of wheat-based all purpose flour. This way, you can enjoy a moderate serving or maybe even a little more. 

My favorite product here is Bob’s Red Mill Gluten Free 1-to-1 Baking Flour.

Source: Bob’s Red Mill

It’s much easier to substitute products like the above, because the proper ratio of flours and xanthan gum can be tricky and spendy. This gluten-free all purpose flour makes substitutions much easier with less room for error.

You may be wondering if the gluten-free baked goods often found at grocery stores and coffee shops are low FODMAP — not necessarily. While gluten-free does mean no wheat, barley or rye, it doesn’t mean that other high FODMAP ingredients like honey and apple pureé aren’t lurking. Like always, be sure to scan the label before adding to your cart.

Finding a Good Substitute for Milk

Lactose-Free or Non-Dairy Beverages

Cow’s milk is a common high FODMAP baking ingredient. A simple swap to lactose-free milk will ensure your final product tastes the same. Opting for an unsweetened almond milk, rice milk, and soy milk (made from soy protein) will likely result in similar outcomes. Check out this article for other low-FODMAP milk alternatives. Here is a common lactose free milk you can find at most grocers.

Source: Lactaid

Homemade Lactose-Free Buttermilk

Buttermilk is common baked good ingredient. I have not found a lactose-free buttermilk, however you can easily make your own by adding one tablespoon of lemon juice to one cup of lactose-free milk. Just let it sit a few minutes for the magic to happen!

Lactose-Free Evaporated Milk

Nestle Carnation Lactose-Free Evaporated Milk makes for a perfect swap for evaporated milk.

Source: Nestle

Whipped Cream

Okay, what is pie without whipped cream? Cool Whip contains high fructose corn syrup and possibly too much lactose due to the skim milk. You may want to try the non-dairy Reddi-wip made from almond and coconut milk instead.

Source: Reddi Wip

Or feel free to use regular dairy whipped cream, it is low FODMAP at one-half cup which is a pretty generous serving size.

Low-FODMAP Sweeteners

Cane sugar, granulated sugar, palm sugar, brown sugar, and just plain white sugar are all low FODMAP. Sugar is a key ingredient in many baked goods, so no substitutions are needed.

Corn syrup such as Karo Syrup is low FODMAP as it does not contain high fructose corn syrup. Other low-FODMAP sweeteners include rice malt syrup, stevia (watch out for inulin and chicory root which are often added), sucralose, and aspartame. Monk fruit has not yet been tested for FODMAP content, so best to approach with caution.

Honey, agave, golden syrup, coconut sugar, and molasses are high FODMAP in servings greater than one teaspoon, therefore, it is probably a good idea to swap these sweeteners with pure maple syrup. It is easy to exceed the low-FODMAP serving size with these sweeteners, which may push your portion into the red zone. Maple syrup is a perfect low FODMAP substitute and will yield excellent results. 

Source: Anderson’s

Watch out for polyols such as sorbitol, xylitol, mannitol, and maltitol. Erythritol appeared to be less of a concern since it does not reach the large intestines in significant amounts, however recent data suggests it may be a FODMAP trigger for some. I would discourage the sugar alternative Swerve and Lakanto as these contain monk fruit and erythritol.

What About Chocolate?

We really can not talk about low FODMAP baking without mentioning chocolate, right? Chocolate comes in many forms: cocoa, chocolate chips, and baker’s chocolate to name a few.

Milk chocolate is low FODMAP in small servings and dark chocolate has a little larger portion size. Cocoa powder used for recipes most likely falls within a low-FODMAP serving size for a single portion or two.

There is sometimes whey and lactose added to some chocolate chips, best to choose an option like this so you can enjoy a little larger serving and not be too concerned about consuming too much lactose.

Source: Guittard

A low-FODMAP serving size of dark chocolate is 30 grams (approximately one ounce).

Milk chocolate is low FODMAP at 20 grams, and white chocolate has a safe serving size of 25 grams.

It is important to calculate the total chocolate used in a recipe and divide it into how many serving sizes to determine how many servings you can eat and stay in this range. For example, if a recipe calls for  240grams of dark chocolate, you can eat ⅛ of the total recipe to keep your portion at 30 grams.

Rolled Oats

Oats are not only low FODMAP, but they also offer a nice fiber boost plus added health benefits. Oats are a versatile, inexpensive baking ingredient found in many recipes. No need to purchase gluten free oats unless you have Celiac disease. You can even blend dry oats in a blender to make oat flour, just watch portions based on how much rolled oats you used before blending to keep your portion at one-half cup rolled oats per serving.

Quick note about some other low FODMAP cereals. General Mills Corn Flakes and Rice Krispies come in handy for a variety of low FODMAP treats. These are great to have on hand for baking — nd of course breakfast.

For those looking to take a  short cut, here are a few low-FODMAP baked goods mixes that are easy to whip up with some simple add-ins such as eggs, oil, lactose free milk, or water.

Easy Low-FODMAP Baking Mixes

  • Bob’s Red Mill Gluten Free Chocolate Chip Cookie Mix
  • Bob’s Red Mill Gluten Free Pie Crust Mix
  • Bob’s Red Mill Gluten Free Muffin Mix
  • King Arthur Flour Gluten Free Yellow Cake Mix
  • King Arthur Flour Gluten Free Chocolate Cake Mix
  • King Arthur Flour Gluten Free Cookie Mix
  • King Arthur Flour Gluten Free Brownie Mix
  • Krusteaz Gluten Free Blueberry Muffin
  • Krusteaz Gluten Free Yellow Cake Mix
  • Krusteaz Gluten Free Chocolate Cake Mix
  • Pamela’s CornBread and Muffin Mix – great for cornbread, muffins, and savory tart crusts.

Gut-Friendly Recipes

Low FODMAP Peanut Butter Cookies and Low FODMAP Coconut Macaroons from A Little Bit Yummy are both absolutely delicious.

Source: A Little Bit Yummy

Low FODMAP Snickerdoodles by FODMAP Everyday will be a family favorite for sure

Source: FODMAP Everyday

The Best Low FODMAP Blueberry Muffin is honestly one of the best!  I really enjoy freezing a few to pull out later for a quick snack.

Source: FODMAP Everyday

Low FODMAP Black & White Brownies recipe by FODMAP Everyday is just decadent!

Source: FODMAP Everyday

Best Low-FODMAP Sugar Cookies by IBS Free at Last are the perfect canvas for your next holiday themed cookies.

Source: IBS Free at Last

Carrot Cake with Cream Cheese Frosting by Kate Scarlata RDN is one of my favorites, can’t resist carrot cake.

Source: For a Digestive Peace of Mind

We hope these ingredient swaps help you easily convert all your favorite high-FODMAP baked food into yummy low=FODMAP treats.

Be sure to try one of the recipes listed above or browse the respected websites to find your new favorite recipe. And as a reminder,  scan the UPC labels with the Spoonful App so we can help you feel more confident that you are choosing a low FODMAP alternative.

Categories
Low FODMAP

The Dietitian’s Approach to Low-FODMAP Milk Alternatives

Milk alternatives, also called nut milks, plant-based milks, and non-dairy beverages, have become a go-to low-FODMAP staple in recent years. There are lots of great non-dairy options to choose from and while it may seem overwhelming at times, these “milks” can serve as a fun, healthy way to add variety back into your diet.

As a low-FODMAP trained dietitian, IBS sufferer, plant-based milk connoisseur, and curator of several low-FODMAP grocery lists, I have read a LOT of milk alternative ingredient labels and drank a lot of low-FODMAP milk alternatives, so I feel pretty darn confident that I can help you discover something you’ll love. My goal in this post is to help you understand the nutritional differences between these plant-based beverages and find a product or two that keeps your gut feeling great.

Nutritional Profile of Cow’s Milk vs Non-Dairy Beverages

Milk alternatives offer quite a different nutrient profile than cow’s milk, which may be important to take into consideration when determining the best fit. Ensuring one consumes adequate protein, calcium, Vitamin D,  iron, and folate is especially important if you are swapping these plant-based milks for cow’s milk. Be sure to follow up with a dietitian to ensure you are consuming adequate nutrients if you are making these substitutes for children, during pregnancy, and if you have specific nutrition needs.

Here’s a quick breakdown of the nutritional content of the various non-dairy milks.

  • Oat, pea, rice, hazelnut, peanut, walnut, and soy milk provide similar calories as cow milk.
  • Unsweetened almond, coconut, hemp, flax, and cashew milk are lower in calories.
  • Fat content ranges greatly and is often present in larger amounts in coconut and nut-based milks.
  • Sugar content varies greatly. While there is no added sugar in cow milk there are twelve grams of naturally occurring milk sugar. Alternative milks contain no added sugar or are very low in added sugar, however sweeteners are often added in varying amounts. 
  • All milk alternatives are lower in protein except soybean and pea milk.
  • Pea protein milk has more potassium than cow milk and soy milk contains similar amounts of potassium. Many other milk alternatives are lower in potassium.
  • Many of the enriched milk alternatives have similar or more calcium and Vitamin D than cow milk.

Reminder: Cow’s milk, A2 milk, and goat’s milk) contain lactose, making them high-FODMAP beverages. Lactose-free milk is pretreated with a lactase enzyme at the time of processing, making it 100% lactose-free and low FODMAP.

What Milk Alternatives are Low FODMAP?

Almondmilk

Almondmilk is low FODMAP at one cup. Though it is one of the most popular plant-based milks, almondmilk often confuses people from a FODMAP perspective, because almonds are high FODMAP at serving sizes greater than ten. Interestingly enough, most almondmilks have no more than four to six nuts per cup, which explains why they’re often low in calories and protein.

Watch out for those with extra protein or fiber, since pea protein (pea protein has been removed from Monash app and FODMAP content is unavailable at this time), chicory root, and inulin are sometimes added.

Natural flavors are often added to almondmilks, which are unlikely to be high FODMAP. Natural flavors are more of a concern in quantities greater than 2% when referring to savory products due to potential for garlic and onion contamination. There are many options to choose from including sweetened, unsweetened, vanilla, chocolate – these are all low FODMAP.

Macadamia Milk

Macadamia milk, tested low at 1 cup, is a great low-FODMAP milk alternative. Feel free to indulge in this yummy, buttery nut milk – definitely one of my favorites. It foams up super well making it perfect for coffee drinks.

Source: Milkadamia.com
Do not be concerned with the one gram of pea protein.

Quinoa Milk

Quinoa milk (with and without chia) is low FODMAP at one cup per FODMAP Friendly. This milk is rather challenging to find in the US, however I did find this brand years ago and thought it was quite delish. If you are not a quinoa fan, this is not a milk for you since it definitely has a quinoa taste. Watch out for quinoa milk sweetened with agave since this can make it excessive in fructose.

Source: Lovewithfood.com

Rice Milk

Rice milk is low FODMAP at three-fourths of a cup and offers a smooth, light sweet flavor. Unfortunately, rice milk is low in protein, however it is often fortified with calcium, Vitamin A&D, and B12.

Source: dreamplantbased.com

Not FODMAP Tested, but Likely Low FODMAP

Hazelnut Milk

Hazelnut milk is likely low FODMAP, since hazelnuts are low FODMAP in moderate serves. My recommendation is to test tolerance at ½ cup and increase to full serve of 1 cup as tolerated.

This milk is delicious and offers a yummy hazelnut flavor to oatmeal, tea, coffee, and more. I love the simple ingredients found in this brand!

Source: Elmhurst1925.com

Flax Milk

Flex milk has not been tested by Monash but is likely low FODMAP based on the nutrition facts. One tablespoon of flax seeds is ~55 calories and one cup of unsweetened flax milk is less than 30 calories, which falls within a low-FODMAP serving size. Flax milk boosts a good dose of those heart healthy Omega-3 fatty acids.

Source: GoodKarmsFoods.com

Walnut Milk

Walnut milk has not been tested but Monash but likely low since the nutritional values of one low-FODMAP serving of walnuts falls within one cup of walnut milk.

This milk alternative boosts heart healthy Omega-3 fatty acids and provides a rich, bold, nutty flavor. It is perfect in coffee, hot and cold cereals, smoothies, and more.This is one of my favorite brands, I really appreciate the fact that it contains only walnuts and milk!

Source: Elmhurst1925.com

Milk Alternatives to Approach with Caution

Cashew Milk

Monash now has a few certified low-FODMAP cashew milks that are safe at one cup. FODMAP Friendly also tested cashew milk using activated cashews that made the cut at one cup. Based on these results, this dietitian would deduce that the majority of cashew milks are low FODMAP at one cup. However, I have some hesitations with the brands that use 4 times as many nuts in the milk-making process, as this may push the galactan content too high.

My recommendation is that if a cashew milk contains five grams of fat or less, it is likely low FODMAP, and if the fat content is greater than five grams it is likely high FODMAP.

Coconut Milk

Coconut milk is low FODMAP at three fourths of a cup per Monash–not the canned coconut milk, but rather the aseptic cartons or boxes. These are sometimes labeled UHT, which stands for Ultra High Temperature, a process that kills bacteria yielding to longer shelf lives.

Just watch out for certain fibers such as chicory root and inulin, since they make this beverage high FODMAP. The canned coconut used for cooking, often used in curries, has an even smaller low-FODMAP serving size. Watch portions when using coconut milk and check the Monash app for more specific details next time you want to try this creamy tropical nut milk.

Soy Milk

This popular milk alternative can be high or low in FODMAPs based on the processing. Soy milk made from soy protein is low FODMAP at one cup, however finding a US-based brand that uses soy protein is not easy, aside from 8th Continent Soy Milk. (This is the only brand I have been able to locate). Soy milk in the US is often made using soybeans, which makes it high FODMAP due to the galactans.

Source: 8thContinent.com

Pea Protein Milk

Pea protein milk is likely low FODMAP, however Monash has retested some different pea protein powders and the FODMAP content is now in question. Many of the pea protein based milks contain small quantities of pea protein, likely resulting in less of a FODMAP load. Pea protein is found in Ripple Milk and some of high-protein almond and flax milks.

Best to approach with caution and test tolerance with a small portion before trying a full serve. Feel free to continue enjoying if you have had good luck with this beverage

Oat Milk

Oat milk is low FODMAP at 1/2 cup. Larger portions are high in fructans, making it high FODMAP. Enjoy this scrumptious milk in moderation and double check ingredients. While the majority appear low FODMAP, I have seen chicory root added to Quaker’s Oat Milk before it was pulled from the market.

By far my favorite oat milk is OATLY! This tastes amazing in coffee and cereal, but honestly it’s perfect by itself or served alongside your favorite low-FODMAP cookie.

Source: Oatly.com

Final Thoughts

Feel free to experiment and try out some of these low-FODMAP milk alternatives, opting for unsweetened options if using for recipe substitutions.

Seek assistance from a dietitian if you were previously a large milk drinker and are looking to swap in a low-FODMAP milk alternative. Also seek professional assistance if you are pregnant, nursing, or modifying cow’s milk intake in a child or someone with specific health concerns. Remember, lactose-free milk has the same nutritional content as regular cow’s milk.

Avoid milk alternatives containing these ingredients: inulin, chicory root, and excessive amounts of honey or agave.

Use caution with protein fortified milk alternatives since pea protein is often used and may be high if present in larger quantities.

Do not be concerned with these ingredients that are often added to milk alternatives:

  • Cocoa 
  • Coconut cream
  • Gums – Gellan Gum, Xanthan Gum, Locust Bean Gum. Gellan gum, Guar gum, carrageenan
  • Malt extract
  • Monosodium Glutamate (MSG)
  • Natural Colors
  • Natural Flavors
  • Oils – sunflower oil, canola oil, safflower, etc.
  • Rice protein
  • Salt and Sea Salt
  • Soy Lecithin
  • Sweeteners: Sugar, Cane Sugar, Brown Rice Syrup, Evaporated cane juice, or Cane Syrup)
  • Sunflower Lecithin
  • Tapioca Starch
  • Tapioca Starch
  • Vanilla
  • Vitamin and Mineral Blends. These micronutrients are often added to improve nutritional value. Calcium Carbonate, Vitamin A Palmitate, Vitamin D2, Ergocalciferol (D2), D-alpha tocerpherol (vitamin E), Vitamin E acetate, Folic Acid, Riboflavin (B2), Vitamin B12, Dipotassium Phosphate, Tricalcium Phosphate, Tricalcium phosphate, Magnesium Phosphate, Potassium citrate, Zinc oxide, Ascorbic Acid. 

We hope this article helps clear up any confusion you had about finding a suitable low-FODMAP milk alternative. Now it’s time to start sipping. Cheers to finding your new favorite!

Categories
Low FODMAP

How to Choose a Low-FODMAP Cheese

Cheese is one of the more nuanced foods within the low-FODMAP diet. Some cheeses contain a higher FODMAP load than others, and you can’t always tell a low-FODMAP cheese by looking solely at the ingredient list. As a general rule of thumb, we recommend aged cheeses, as much of the lactose will have been removed during the cheese-making process.

This article takes a deep dive into the cheese aisle, giving you tips and advice for choosing a delicious, gut-friendly cheese. If you’d like to get the FODMAP content of a specific cheese product (like the one in your fridge), you can always scan its barcode with the Spoonful App.

How Cheese is Made (and why it matters)

To start the cheese making process, an acid or live culture is added to milk, which converts the milk sugar (aka lactose) into lactic acid. Next, rennet is added to the acidic milk causing the milk solids or casein to start curdling. The whey is now separated and strained. (Whey is often dried and made into whey protein powder and used as an ingredient in a variety of foods.) From there, the cheese is set in molds and left to ripen for days, months, or even years. Some cheeses are even made with bacteria or mold before or during the aging process, which adds depth, flavor, and uniqueness.

Source: My Little Italian Kitchen

So why do we recommend aged cheeses? When a cheese is aged, it gives the microbes and enzymes adequate time to break down the milk proteins and sugars. This, in turn, reduces the lactose content to very low levels. making it more likely to be compliant with the low-FODMAP diet. On the flip side, new or fresh cheeses that have had less time to ripen can be high FODMAP due to excess lactose. Cheese foods and sauces can also have excess lactose due to the addition of ingredients like milk solids, whey, or milk protein concentrate. 

Finding Low-FODMAP Cheese Section on the Monash App

Monash University has tested a wide variety of cheeses and many are in fact low FODMAP at small and moderate servings. Often larger portion sizes result in a greater lactose load and high FODMAP. Portion control is key when talking cheese. Remember, you can enjoy a low FODMAP serving of cheese at each meal or snack if spaced out by at least three to four hours, for those who like to indulge frequently.

While Monas has tested a large number of cheeses, the reality is that there are approximately five hundred different varieties of cheese and the majority have not been tested. Does this mean you can’t enjoy your favorite cheese if it hasn’t been tested? Absolutely not. Feel free to enjoy any aged cheese as long as the sugar content (or sometimes declared as only carbohydrates) is 1 gram or less on the nutrition label. If the carbohydrate or sugar content is 1 gram or less, the cheese is low FODMAP. Why? Monash states that a low-FODMAP serving of lactose is 1 gram or less per serving.

Look for cheeses with <1 sugar

Here is an example of an untested cheese. Because the nutrition label says 0 grams of sugar, it would be considered low FODMAP.

Low FODMAP is Not a Dairy-Free Diet

It’s important to remember that you can consume a variety of dairy products on the low-FODMAP diet. In addition to aged cheeses, feel free to enjoy lactose free milk, lactose-free yogurt, lactose-free ice cream, and lactose-free cottage cheese, as long as these products contain no other high-FODMAP ingredients. You can also enjoy small portions of cream, sour cream, and a splash of milk in your tea.

Source: Spoonful App

Tip: Dairy products treated with lactase enzymes are considered lactose-free and low FODMAP, even if the sugar content is greater than 1 gram.

However, take note that goat milk, sheep milk, and A2 Milk are all considered high FODMAP due to excess lactose content. Opt for lactose-free milk until your triggers are known.

Low-FODMAP Cheese Varieties

Below is a list of gut-friendly cheeses that are considered compliant in their original form. 

  • Camembert cheese
  • Cheddar cheese
  • Feta cheese
  • French Comte cheese
  • Goat also known as chevre (plain) cheese
  • Haloumi cheese
  • Havarti cheese
  • Monterey Jack cheese
  • Mozzarella cheese
  • Pecorino cheese
  • Quark cheese
  • Queso Fresco cheese
  • Swiss cheese
  • Colby cheese
  • Brie cheese
  • French Gruyere cheese
  • Manchego cheese
  • Soy cheese  (this is low per Monash, however, you may need to look over the food label to ensure other high-FODMAP ingredients were not added)

These cheeses are low FODMAP in smaller serving sizes (refer to the Monash App for more details).

  • Cottage cheese
  • Cream cheese 
  • Sour cream 
  • Ricotta cheese
  • French style creamy cheeses

Label Reading Advice for Cheese

If you’re looking at a variety of cheese that hasn’t been tested by Monash (And oh no! You’ve forgotten your Spoonful App!), here are a few examples that will help you form your own determination of low and high FODMAP.

Gut-Friendly Cheese Label

Dubliner Cheese

Total carbohydrates is 0 grams, which means that this cheese is low FODMAP.

Not so Gut-Friendly Cheese Labels

Velveeta Original Cheese

The added milk protein concentrate likely contributes to the extra lactose.

Merkt’s Sharp Cheddar Cheese Spread

Total sugars = 3 grams, which means that this cheese is high FODMAP. In this case, the added reduced lactose whey and reduced protein whey likely contribute to the extra lactose.

What About Vegan Cheeses?

Vegan cheese received the pass from FODMAP Friendly’s testing lab in Australia, however I would approach this category with caution. Many US-based vegan cheeses are made with cashews and pea fiber, which are both high in FODMAP content. Natural flavors in vegan cheese may contain garlic or onion, so if this is present in quantities greater than 2%, you may want to call or email the manufacturer to inquire if either garlic or onion is present.

Miyoko’s Vegan Cheese

Let’s look at Miyoko’s Rustic Alpine cheese as an example. Its ingredients are:

Organic Cashews, Filtered Water, Organic Coconut Oil, Organic Rice Miso (Organic Rice, Water, Salt, Alcohol, Koji Culture), Nutritional Yeast, Fermented Oregano, Flaxseed And Plum, Sea Salt, Cultures.

This would be considered high in FODMAPs due to the cashews and plum.

High and Low-FODMAP Cheese Ingredients

Below is a list of common ingredients that will help you determine gut-friendly cheeses from their counterparts.

High-FODMAP Ingredients

  • Garlic
  • Onion
  • Leeks
  • Shallots
  • Natural flavors if present in quantities greater than 2%
  • Inulin – while not common, it may be added to some cheese-based foods

If these ingredients are added to cheese in quantities >2%, the cheese may contain excess lactose. If any of these are added and the cheese contains <1g of carbs/sugar, then it would be considered low FODMAP.

  • Whey
  • Milk Protein Concentrate 
  • Dry milk solids
  • Reduced Lactose Whey
  • Lactose

Low-FODMAP Ingredients

  • Rennet
  • Enzymes
  • Milk fat
  • Whey protein isolate
  • Soy protein – found in some soy cheeses
  • Chives

How Spoonful Helps you Find Gut-Friendly Cheeses

Since milk and cream are normally highlighted red and yellow on the Spoonful App, we have applied special rules or exceptions that identify a cheese as low FODMAP when enzymes and rennet are present.

Spoonful Low-Lactose Cheese Rule

Feel free to scan your favorite cheese and see what the Spoonful app says. More information on how Spoonful determines the FODMAP content of a product.

Summary Notes

  1. Opt for an aged cheese whenever possible, especially if you want to enjoy a satisfying portion.
  2. Watch portions for fresh or non-aged cheese since these contain more lactose.
  3. Read the product label, and choose a cheese with 1 gram of carbohydrate/sugar or less.
  4. Avoid most cheese spreads, port cheeses, and other cheese foods since these are often excessive in lactose due to added whey and milk solids.
  5. Watch out for added high-FODMAP ingredients like garlic, cashews and onion.
  6. Watch portions – refer to the Monash App for details about low-FODMAP serving sizes.
  7. Enjoy any lactose-free dairy products! Just be careful to review the label to ensure high-FODMAP ingredients are not present.

We hope this article sheds some light on this sometimes confusing topic. Now you can say with confidence, “Can you please pass the cheese?”.

Categories
Low FODMAP

How to Choose an Everyday Low-FODMAP Bread

Shopping for bread on the low-FODMAP diet can be quite the challenge, especially during the elimination phase. Most store-bought breads are made from ingredients like wheat, barley or rye flour, each of which has a limited serving size. But don’t worry! There are lots of great low-FODMAP breads out there, and I’ll help you choose the one that’s right for you.

In this post, I’ll take you through the state of the state on lab-tested breads, then give you some label reading advice for your next grocery run. And if reading labels sounds as painstaking as we think it might, I’ll also give you a list of low-FODMAP bread products to pluck right off the shelf.

What Does the Lab Say?

The low FODMAP diet is an evolving science. In recent years, many wheat and grain-based products, including bread, have been tested low FODMAP at moderate serves. These include several varieties, such as sourdough (wheat, oat, and spelt-based), millet, corn, wheat wholemeal, multigrain, multigrain sprouted, and white wheat. Each of these varieties has a low-FODMAP serving at one slice.

Learn more by downloading the Monash FODMAP App.

A concern when interpreting the test results of bread is that ingredients and bread descriptions often vary greatly across country lines. It can be challenging to apply the same rules for low-FODMAP breads tested by Monash (an Australia-based company) to the everyday breads we see circulating on our shelves in the US. For example, many US breads contain high fructose corn syrup and fruit juice concentrates, which increases the FODMAP load.

There is also some confusion on what constitutes whole grain versus wholemeal bread and whole wheat vs whole white — as a consumer these descriptions would leave me a little confused. Based on my clinical interpretation white wheat, sourdoughs (aside from rye-based) and several naturally gluten-free breads are low FODMAP at one slice. While rye, whole-wheat, multigrain wheat, high fiber, and oat-based breads are high FODMAP.

What Types of Bread Can I Eat?

Sourdough Bread

While there is some debate on how to choose a gut-friendly sourdough, I often encourage choosing a traditional variety (i.e. made without yeast) and limiting portion to one to two slices per serving.

The best place to find a traditional sourdough bread is at your local bakery or the fresh bread section of the grocer. These fresh made sourdough breads use a starter (a blend of bacteria and wild yeasts) versus baker’s yeast, which results in a slower fermentation process. The little microbes present in the starter actually eat up the majority of the FODMAP-bearing fructans during the longer ferment time, making it easier for many IBS sufferers to digest. The addition of yeast speeds up the fermentation process, which does not allow ample time for the fructans to be digested. 

Tip: Take a look at the ingredient list, and opt for a sourdough bread made without yeast.

Here are a few low-FODMAP sourdough examples that I think are pretty delicious.

Product
The Essential Baking Company Take & Bake Sourdough Bread

Ingredients
Organic Unbleached Wheat Flour, Water, Sea Salt, Organic Barley Malt.

Product
Boudin Bakery Sourdough

Ingredients
Flour, water, salt and a little bit of the original mother dough (a magical combination formed by local varieties of wild yeast—to create a natural source of fermentation that allows Boudin sourdough to rise without using commercial yeast.).

Product
Berlin Natural Bakery Sourdough Spelt Bread

Ingredients
Whole Grain Spelt flour, Water, Sea Salt.

Basic Wheat Bread (small servings)

Feel free to enjoy one slice of your basic white wheat bread – just be sure to watch portions and frequency. Avoid the high fiber, whole grain, rustic varieties, as these are likely higher in FODMAPs.

It is important to remember that the low-FODMAP diet is NOT a wheat-free diet; however, I often encourage my clients to limit wheat intake when first getting started. Why? Because it’s easy to over consume wheat in one sitting, and many of the low-FODMAP servings sizes are often less than what is recommended on the label.  It may be a good idea to limit yourself to no more than one or two servings of wheat per day and pay extra attention to portion sizes.

What about potato bread, corn bread, and oat bread? Oat and oatmeal-based breads are made from wheat flour and oats and have been tested high FODMAP.  Potato bread is made from wheat flour and potatoes — this is an untested bread and probably best to avoid or test tolerance at one slice when symptoms are well managed. Corn bread is low FODMAP per Monash; however, the majority of corn breads are made with a combination of corn, wheat flour, and often whole corn kernels. Due to great variance in recipes, I would approach this bread type with caution.

Here is an example of a wheat bread that is low FODMAP at 1 slice.

Product
Sara Lee Classic White Wheat Bread

Ingredients
Enriched Wheat Flour [Flour, Malted Barley Flour, Reduced Iron, Niacin, thiamin Mononitrate (Vitamin B1), Riboflavin (Vitamin B2), Folic Acid], Water, Sugar, Yeast, Calcium Sulfate, Soybean Oil, Salt, Wheat Gluten, Preservatives (Calcium Propionate, Sorbic Acid), Enrichment (Calcium Sulfate, Vitamin E Acetate, Vitamin A Palmitate, Vitamin D3), Monoglycerides, Datem, Soy, Lecithin, Ferrous Sulfate, Citric Acid, Grain Vinegar, Potassium Iodate, Monocalcium Phospohate.

Gluten-Free Bread

While gluten-free bread does offer more low-FODMAP varieties than wheat bread, oftentimes you can find high-FODMAP ingredients like extracts or other FODMAP-heavy flours like rye or bean. Watch out for the tricky high FODMAP ingredients (see list below) as they are often added to gluten-free bread to boost flavor and fiber.

Here are a few examples of gluten-free low-FODMAP breads.

Product
Udi’s Gluten Free Delicious Soft White Sandwich Bread

Ingredients
Water, Tapioca Starch, Brown Rice Flour, Canola Oil, Potato Starch, Dried Egg White (egg White, Calcium Sulfate), Dried Cane Syrup, Tapioca Maltodextrin, Tapioca Syrup, Modified Food Starch, Yeast, Gum (xanthan Gum, Sodium Alginate, Guar Gum), Salt, Locust Bean Gum, Cultured Brown Rice, Brown Rice And Enzymes.

Product
Franz Gluten Free Mountain White Bread

Ingredients
Water, Brown Rice Flour, Tapioca Starch, Tapioca Syrup, Whole Grain Sorghum Flour, Xanthan Gum, Contains 2% or Less of Each of the Following: Whole Eggs, Whole grain Amaranth Seed, Extra Virgin Olive Oil, Salt, Cultured Rice Flour, Yeast, Enzymes

Bread Ingredient Cheatsheet

Below are some common ingredients you’ll run into on both high and low-FODMAP bread labels. The Spoonful App takes care of a lot of this for you, but it always helps to know the nitty gritty.

Low vs High-FODMAP Ingredients

Low FODMAPHigh FODMAP
-Tapioca starch or tapioca flour
-Brown rice flour
-White rice flour
-Rice starch
-Potato starch or potato flour 
-Teff (flour)
-Cornmeal, corn flour, milled -corn, or masa harina
-Cornstarch
-Maize flour
-Millet (flour)
-Oats (flour)
-Quinoa (flour)
-Buckwheat (flour)
-Green banana flour
-Arrowroot (flour)
-Sorghum (flour)
-Psyllium husk powder
-Sugar 
-Maple syrup
-Yeast
-Seeds: chia, flax, pumpkin, sesame, sunflower
-Xanthan gum
-Apple cider vinegar
-Vinegar
-Soy protein
-Pea Starch*
-Chicory root
-Inulin
-Prune juice or prune juice concentrates
-Fruit juice or fruit juice concentrates
-Apple juice or fruit juice concentrate
-Pear juice or pear juice concentrate
-Soy flour
-Amaranth flour
-Bean-based flours such as navy bean and fava pea flour
-Rye (flour)
-Kamut (flour)
-Pumpernickel
-Spelt (unless spelt sourdough bread)
-Barley (flour)
-Coconut flour
-Chestnut flour
-Einkorn (flour)
-Emmer (flour)
-Lupin flour
-Freekah
-Triticale
-Wheat germ
-Pea fiber**
*While not tested by Monash, the definition of pea starch implies that it is low FODMAP. This is often added to some breads in very small quantities to improve texture of the bread.**This has not been tested by Monash and likely high FODMAP

Ingredients to Approach with Caution

Honey: there is a small low FODMAP serving size. If this is located low on the ingredient list it is likely low FODMAP and acceptable on the low FODMAP diet.

Agave: there is a small low FODMAP serving size. If this is located low on the ingredient list it is likely low FODMAP and acceptable on the low FODMAP diet.

Coconut sugar: there is a small low FODMAP serving size. If this is located low on the ingredient list it is likely low FODMAP and acceptable on the low FODMAP diet. 

Molasses: there is a small low FODMAP serving size. If this is located low on the ingredient list it is likely low FODMAP and acceptable on the low FODMAP diet. 

Malted Barley is sometimes added in very small portions to some breads, this is likely low FODMAP if located low on the ingredient list.

Almond flour or almond meal: this is likely low FODMAP if consumed in small portions and if located towards the end of the ingredient list. There is a low FODMAP serving size for almond flour.

Cassava flour: while not specifically tested, cassava is low FODMAP in small servings. This flour is likely low FODMAP if consumed in small portions or if located towards the end of the ingredient list.

Milk solids or dry milk solids: if sugar content is 1 gram or less this is unlikely providing excessive lactose. However, may approach with caution if sugar content is greater than 1 grams or listed towards the top of the ingredient list.

Raisin Bread: raisins are low FODMAP at one tablespoon. Limiting yourself to one slice of a low FODMAP raisin bread is likely falling within a low-FODMAP serving size.

Wheat flour: as mentioned above wheat flour used in bread making may be considered low FODMAP in small portions on severa wheat based foods, however wheat flour is  high FODMAP per Monash app. Opting for a gluten-free flour mix (made without high FODMAP ingredients) would be a better option when baking at home. 

Apple fiber: this has not been tested by Monash, however it does appear in a few certified low FODMAP breads.

Example of a Low, Moderate and High-FODMAP Bread

Source: Spoonful App

Low-FODMAP Certified Breads

If you want to be sure that the bread you’re choosing is 100% low FODMAP, I recommend reaching for something that has been certified by Monash or FODMAP Friendly. Here is a list of gut-friendly breads.

US Products

  • Schar Gluten Free Baguette
  • Schar Gluten Free Ciabatta Rolls
  • Schar Gluten Free Deli Style Seeded
  • Schar Gluten Free Deli Style Sourdough
  • Schar Gluten Free Multigrain Ciabatta Rolls
  • COBS Bread Low FOD Loaf

International Products

  • Baker’s Delight Wholegrain lowFOD Block Loaf
  • La Boulangrie Alternative Inewa 100% Spelt Sourdough
  • La Boulangrie Alternative Inewa 100% Spelt & Buckwheat
  • Brumby’s Bakery Quinoa and Linseed Low FODMAP Loaf
  • Ernst Bocker Gluten-Free Oat Bread
  • Ernst Bocker Gluten-Free Breakfast Rolls
  • Pure Life Bakery Organic Sprouted Khorasan
  • Pure Life Bakery Organic Sprouted Spelt
  • Pure Life Bakery Organic Sprouted  Sunflower Sourdough
  • Naturis Organic Bread Spelt Sourdough Wholemeal
  • Naturis Organic Bread Spelt Sourdough Wholemeal Chi & Sunflower Seeds
  • Good Mills Innovation GmBH Ancient Wheat 2am Wheat Rustic Country Loaf
  • Schar Gluten Free Wholesome White Loaf
  • Schar Gluten Free Wholesome Vitality Loaf
  • Schar Gluten Free Wholesome Vitality White Loaf
  • Schar Gluten Free Wholesome Seeded Loaf
  • Schar Gluten Free White Ciabatta Rolls
  • Schar Gluten Free Brown Ciabatta Rolls
  • Schar Gluten Free Seeded Ciabatta Rolls
  • Schar Gluten Free Panini Rolls
  • Schar Gluten Free Grissini
  • Alpine Breads Hemp Rising
  • Alpine Breads Sour Rye
  • Alpine Breads Tuscany Sourdough
  • Alpine Spelt & Barley sourdough
  • Alpine Spelt & Sprouted Grains
  • Alpine Breads Spelt Hot X Buns

Not Certified, but Likely Low-FODMAP Breads

  • Udi’s Gluten Free White Sandwich Bread
  • Franz Gluten Free Great Seed, 9 Grain, and Mountain White Bread
  • Canyon Bakehouse Gluten Free Country White Bread
  • Live G Free Gluten Free Whole Grain Bread
  • Trader Joe’s Gluten Free White Sandwich Bread

Bake Your Own

If you have some down, you can try making your own low-FODMAP bread. Here are a few amazing recipes to try.

And wouldn’t you know it? There is also a dedicated line of low-FODMAP baking producfts from Lo-Fo Pantry. Each of these has been certified by the FODMAP Friendly Food Program.

Takeaways

If choosing a wheat-based bread, opt for white wheat breads since they are likely lower in FODMAPs than high-fiber, whole wheat varieties. Remember to practice moderation and limit wheat consumption to avoid overfilling the FODMAP bucket with fructans.

Watch out for paleo, low carbohydrate, and keto-friendly breads as they often contain functional fibers such as chicory root fiber and inulin, fruit juices/purees, coconut flour, bean based flours, and cassava and almond flour in large portions

Check out the Monash App and FODMAP Friendly for a variety of certified low-FODMAP breads. More and more companies are having their products tested and this list continues to expand.