The FODMAP gentle diet is a simplified version of its more complicated cousin, the low FODMAP diet. On the low FODMAP diet, you temporarily cut out a boatload of foods that contain moderate and high amounts of FODMAPs while mainly eating foods that are low in FODMAPs. Conversely, on the FODMAP gentle diet, you only cut out a small list of foods that are particularly high in FODMAPs.
Both the FODMAP gentle and the low FODMAP diet are elimination diets. Elimination diets are meant to be short-term “experiments” designed to help you figure out which foods trigger digestive symptoms.
Neither the low FODMAP diet nor the FODMAP gentle diet should be followed forever. Long term dietary restrictions that cut out lots of foods can disrupt your microbiome, negatively impact your nutrient intake, and put you at risk of disordered eating.
Regardless of which version of the diet you follow, you’ll still need to do your homework to identify which FODMAPs you tolerate:
- Keep a log of your bowel symptoms for about 2 weeks before you start the diet. This establishes a symptom baseline that you can refer to when evaluating whether or not FODMAP reduction improved your symptoms.
- Continue to carefully log your symptoms during the elimination and reintroduction phases of the diet.
- Use substitutes for any foods you’re eliminating and modify recipes accordingly.
- Complete the reintroduction phase by following a protocol to test how your body responds when you reintroduce very high FODMAPs.
- Personalize your final diet by progressively adding back FODMAPs that you tolerated well and limiting FODMAPs that triggered symptoms.
Foods to avoid on the FODMAP gentle diet
During the elimination phase of the diet, which lasts about 3-4 weeks, a relatively small list of very high FODMAP foods are avoided (see chart below). For those of you using the Monash FODMAP app, Monash University suggests avoiding even the green light serving size of the restricted foods in the “foods to avoid” list below.
Reintroducing FODMAPs on the FODMAP gentle diet
Once you feel your symptoms have improved enough during the elimination phase of the FODMAP gentle diet, you then move onto the reintroduction phase.
This phase involves reintroducing the eliminated foods in a systematic, step-by-step manner to see if they trigger symptoms. You continue to avoid the foods you restricted during the elimination phase. Even if you tolerate a particular FODMAP group, you don’t reintegrate it into your diet until you’ve completed challenging all the FODMAP groups.
The reintroduction protocol (or schedule) for the FODMAP gentle diet is essentially this:
- Day 1: eat 1/3 your usual portion size of the challenge food.
- Day 2: eat 2/3 your usual portion size.
- Day 3: eat a full portion size.
- Day 4, 5 and 6: washout days during which you resume the FODMAP gentle diet without challenging any FODMAPs. This allows your gut to settle a bit before starting the next challenge.
Now what if you don’t usually eat the challenge food recommended and therefore don’t have a “usual portion size”? Refer to the chart below for recommended portion sizes.
Learn more about the reintroduction phase of the low FODMAP diet by checking out my blog post on reintroducing FODMAPs.
Pros & cons of the FODMAP gentle diet
There are a lot of similarities between the two diets, so what’s the upside to the FODMAP gentle diet? Because the FODMAP gentle diet has fewer restrictions…
- It’s easier to implement than the traditional low FODMAP diet.
- You don’t absolutely need the Monash FODMAP app.
- Your recipes need fewer substitutions.
- You don’t have to make as much drastic change to your day to day dietary pattern.
- It’s easier to eat out and travel.
- It’s easier to follow when you’re cooking for and eating with your family.
One drawback to the FODMAP gentle diet is that the outcome may not be clear. Because you will still be consuming foods with moderate and (some) high FODMAP content, a lack of symptom improvement may be due to insufficient FODMAP restriction. If you have a really sensitive gut, the FODMAP gentle diet may not eliminate enough FODMAPs to improve your symptoms.
Another drawback is the lack of research on the FODMAP gentle diet. The closest “evidence” that it might work is research that finds the NICE diet helps improve IBS symptoms. I find this extrapolation a little weak because the NICE diet has numerous other dietary interventions that may explain why some people feel better when following it.
So if the FODMAP gentle diet isn’t evidence-based, why use it?
The low FODMAP diet was developed by researchers at Monash University who continue to do extensive research and work on the low FODMAP diet. Research has found that the low FODMAP diet improves IBS symptoms for many people who try it. So while research hasn’t been done on the FODMAP gentle diet, it is endorsed by the FODMAP experts at Monash.
There are some populations for whom a highly restricted diet like the low FODMAP diet is not the best idea:
- People who are malnourished or at high risk of becoming malnourished. A person who is malnourished likely already has a restricted diet so adding further restrictions exacerbates the malnutrition.
- People who have experienced an eating disorder in the past. Restrictive diets can lead to disordered eating, and even trigger relapse in people who’ve had an eating disorder.
- People who already have other dietary restrictions for health issues like severe food allergies, kidney failure requiring dialysis, or a history of bariatric surgery. Again, adding more restrictions to an already restricted diet is a recipe for worsening health.
For these groups, taking a gentler approach to the diet may help improve symptoms while reducing the risk of harm that highly restricted eating can cause.
If you feel you fall into one of the groups listed above, I suggest working with a Monash FODMAP trained dietitian who can assess your dietary needs and symptoms, make individualized recommendations, and support you in implementing interventions.
Some other groups of people who may prefer the FODMAP gentle approach over the low FODMAP diet:
- People who find the low FODMAP diet too complicated or are unlikely to follow it.
- People who consume a high FODMAP diet and experience only mild symptoms.
- People without a lot of control over their diet – (eg. people who travel or dine out often for work; people who live in remote communities where grocery stores have limited variety).
Bottom line
The FODMAP gentle diet is an easier alternative to the low FODMAP diet in that you avoid far fewer foods. This gives you greater flexibility in your diet, which makes life a bit easier and reduces the risk of poor nutrition, disordered eating, and microbiome disruption. Although the FODMAP gentle diet may not be sufficiently restrictive to improve symptoms for some people, it is sometimes recommended for people who need a gentler approach.
xo Andrea, RD
