Fare Well - FODMAP Challenge 2017

Fare Well - FODMAP Challenge 2017

Katherine, ever the fighter, challenges her gut to another round of FODMAP challenge. Low-FODMAP, high-FODMAP, no difference, she's testing it all!

When one has food issues, challenging foods is a constant labor, as the body changes over time and environment casts a different read on outcomes.

Last summer, my partner in FODMAPping crime, Mollie of Fit Fab FODMAP, and I took on a seemingly endless FODMAP challenge. While I had a lot of successes, over time, I started to question whether some foods I previously thought were safe for me had become unsafe, and vice versa. It was hard to know whether I was sensitive to the food item or whether it was another medical issue with overlapping symptoms.

To find out for sure whether a food item was troublesome, I knew I had to go back to the challenge board. Under the care of my gastroenterologist and her registered dietician, I set about a new plan. This challenge is designed a little differently, with more progressions of portion size and more resting between tests. And boy, do these changes make it easier for me to psych myself into each phase!


FODMAP Challenge How To

  • Enlist the help of a FODMAP-knowledgable registered dietician to customize a challenge for you. Below is my personalized challenge created for me by Gabriela Garnder, RDN, LD, CNSC, of Memorial Hermann in Houston, Texas. Need help finding a FODMAP Registered Dietician, look to the registry by Kate Scarlata, RD.
  • Challenge one high-FODMAP category at a time, setting yourself up for immediate success with an easy or much-missed group. I will challenge Fructans first as I love to travel, and it is difficult to eat while on the road without encountering onions or garlic. I will challenge Lactose last as that category really gave me lots of bad reactions beyond my gut (migraines, etc.) during last summer's challenge. And Polyols are so dead to me that I won't mention them beyond this sentence.
  • Within each FODMAP category, challenge several items, one at a time at first and then in combo if necessary to really test the body's ability to handle a "normal" day of eating several meals.
  • The order of the food item introduction within a category is really important, so start with those items that contain very low amounts of the high-FODMAP. In the Galactan challenge, I will test lentils before chickpeas, starting with the ¼ cup amount that is already considered low-FODMAP according to the Monash University FODMAP app.
  • Progressively increase the amount of FODMAP slowly. I will start with ¼ cup of milk and then progress by ¼ cups until I reach 1 full cup of milk so this time we will learn for certain what my cut-off-point really is.
  • If a reaction occurs, the challenge for that FODMAP category is to be stopped immediately and resting is to resume. This is the part that I struggle with the most. I am comfortable continuing on with mild reactions, because, in reality, I can live with those on occasion and would rather know that if I get a mild bloat with beets it's fine to eat them on the few times a year that I go out for a Greek salad. If I get a strong pain with an item, then of course, game over! But you might feel differently.
  • There is a rest period of seven days or until symptoms subside between every FODMAP category.
  • A strict low-FODMAP elimination diet is to be maintained at all times during the entire challenge, even on rest weeks.
  • Always test a new food with a safe food. This is a rule I have implemented for myself over years of food challenges. I will eat cashews with a rice cake in order to, in my mind, give my stomach something easy to digest while it processes how to break down this new cashew food.
  • Do not challenge foods that you already know with 100% certainly are not good for you. Again, the goal is to set yourself up for success! Here, I will not challenge wheat. I already had an endoscopy and blood work performed to confirm that I am gluten-intolerant. I also will not challenge foods that are really high in histamine, as they have been troublesome for me with migraines.
  • Challenge at your pace, when all the stars are in alignment and everything is right in your gut world. For me, when I am stressed, traveling, or having some other medical issues, those are the worst times for me to challenge. I will get conflicting results and not be able to determine whether a failed food item is due to these external factors or to my GI system. Better to challenge when the time is right, at my pace.

  • Want to read more about how to challenge FODMAP foods? There is a great article on A Little Bit Yummy which is reviewed by a registered dietician, a good amount of information is provided in IBS Free at Last! (Book Fare review coming soon), and a small section with good sources of food item options and sizes is in The Complete Low-FODMAP Diet.


    What's the Plan, Man?

    Here, I will keep you, dear reader, informed of my progress, reporting my successes, symptoms (G-rated), and any funny moments.

    Challenge

    FODMAP Category - Food Item

    Date

    Symptoms / Results / Notes

    FRUCTANS Day 1

    1 clove garlic, cooked

    March 29

    A-OK. OMG, the smell is killing me, though. I think I have become a vampire since giving up garlic years ago.

    FRUCTANS Day 2

    1/2 cup beets, steamed (pictured above)

    March 30

    Mild bloat 2 hours later without pain.

    FRUCTANS Day 3

    1/4 cup onions, cooked

    March 31

    Mild bloat 2 hours later without pain.

    FRUCTANS Day 4

    1 clove garlic AND 1/4 cup onions, cooked

    April 1

    Bloat with mild reflux; stopping the Fructans challenge due to these symptoms. I am really happy to know that I can safely consume either garlic or onion, ALONE and that beets are back in the game.

    FRUCTANS Day 5

    1/2 cup beets, steamed, for lunch AND 1 clove garlic AND 1/4 cup onions, cooked, for dinner

    SKIP

    SKIP

    Rest for 7 days


    April 1 - 8


    GALACTANS Day 1

    2 Tbsp plain cashews

    April 8

    A little, very mild potty trouble with no pain. Rested for 1 month due to travel and other medical issues that might be interfering with challenging.

    GALACTANS Day 2

    1/4 cup canned, rinsed lentils

    May 9

    Mild bloating with moderate potty issues within 2 hrs. Within 5 hrs, mild stomach ache. Going to cease challenging Galactans.

    GALACTANS Day 4

    1/2 cup canned, rinsed lentils

    SKIP

    SKIP

    GALACTANS Day 5

    1/4 cup canned, rinsed beans or chickpeas


    SKIP


    SKIP

    GALACTANS Day 6

    1/2 cup canned, rinsed beans or chickpeas


    June 1 and June 11


    A-OK with plain pinto beans.

    Rest for 7 days



    May 9 - May 31

    FRUCTOSE Day 1

    4 - 6 medium asparagus spears, steamed


    June 16

    Mild bloating with mild stomach ache within 2 hours; no biggie.

    FRUCTOSE Day 2

    1/4 cup sugar snap peas, steamed

    FRUCTOSE Day 3

    1/2 cup sugar snap peas, steamed

    FRUCTOSE Day 4

    1/2 cup sugar snap peas, steamed AND 4 - 6 medium asparagus spears, steamed

    FRUCTOSE Day 5

    A food baked with honey

    Rest for 7 days


    LACTOSE Day 1

    1 Tbsp goat cheese

    June 1

    Mild potty issues following day. Joints tender.

    LACTOSE Day 2

    1/4 cup ice cream made without HFCS

    June 2

    Mild potty issues following day. Joints tender and a slight headache. Need to retest lactose in a few weeks to be certain it is not changes in my medical protocol, etc., causing these non-GI pains.

    LACTOSE Day 3

    1/2 cup ice cream made without HFCS

    LACTOSE Day 4

    A food baked with milk

    LACTOSE Day 5

    1/4 cup milk

    LACTOSE Day 6

    1/2 cup milk

    LACTOSE Day 7

    3/4 cup milk

    LACTOSE Day 8

    1 cup milk


May 9, 2017: So, my other, non-GI medical providers and I are embarking on some new feats together. I have given this transition a couple of weeks to settle, and I am game to start back on the FODMAP challenge. I have had some mild potty symptoms during this time off, so I am going to deem those due the medical transition, as I was totally strict about low-FODMAPs only during these past few weeks. Therefore, I am going to assume any new symptoms will be entirely due to the FODMAPs.

June 2, 2017: Sometimes things are not so clear-cut. I started back on my standard Rheumatoid Arthritis protocol on May 24, and hope that it is going to settle back in within the next month or two. In the meantime, I am cautiously testing FODMAPs, but reserving the right to retest should I sense non-GI issues (see lactose), as one can never know if my joints being tender and my headaches are due to RA or to GI.

June 11, 2017: I have been off-and-on testing beans, and I think they are OK in small quantities with lots of other foods. I even had them with a little onion and survived! My suspicion is that I tolerate fresh or dried beans better than canned, which would make sense with my migraine sensitivity. I have also had a little meat cooked with slight amounts of garlic and or onion and been A-OK!

August 14, 2017:My docs have changed some of my medications for non-GI-related issues, so I have taken a few months off of testing FODMAPs again. Sigh. I will finish this challenge sooner or later. I WILL!

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