FODMAP Diet: Day 20 – Lactose and Fructans
Note on my last post: I talked about FODMAPs as items that are not digested well or can ferment in the intestines. It’s important to note that it’s not the poor digestion or fermentation that is the issue. This happens in all people, but one of the theories on IBS is that sufferers are more sensitive to the side effects such as bloating from increased water in the bowels or gas production. Normal processes cause distress resulting in pain.
After over two weeks of sticking to low-lactose diet, I ramped up to the full FODMAP diet on Monday of this week. This post is all about how I handled reducing my lactose intake and my first experiences with pulling wheat out as well.
That part wasn’t that bad. Lactose-free milk is everywhere (if more expensive), there’s some lactose-free yogurt (although I’m having trouble finding the low-fat version) and I’m allowed to have reasonable amounts of hard and ripened cheeses like cheddar, mozzarella, etc.
I’m not bothering with milk alternatives – almond milk isn’t allowed on the diet, and any soy milk made from whole soybeans isn’t generally tolerated either (and I don’t know which ones are made with soybean extract).
Lactose-free milk tastes kind of like melted vanilla ice cream. A bit thicker tasting, with a shot of vanilla. It’s nice enough, but not enough to satisfy the craving for the crisp, cold taste of regular milk. Absolutely fine in cooking or cereal use though.
It’s unclear if milk ingredients in bread are enough to trigger, so I’d been focusing on milk-free breads, which is easy enough. Italian-style breads are drier but tasty and lots of whole grain don’t seem to have milk in them. So yeah, that’s been okay.
Now the full Monty.
I’ve started the rest of the diet, but it’s very involved so I’m going to discuss it in chunks over the next while. But first off:
This is where the wheat restrictions come in, as well as some vegetables like onions and additives like fructo-oligosaccharides (oligofructose) and inulin. Basically no one can digest fructans and, like any other indigestables, they can cause issues with IBS folks. Recent studies are showing that what had been called non-celiac gluten sensitivity may often be FODMAP sensitivity.
So it’s possibly not gluten that’s the issue, but the fructans. By cutting gluten from the diet an IBS sufferer also cuts most fructans, with the same result. It’s easier than trying to do a point-by-point analysis of each product to figure out if you can eat it or not.
And not all wheat. Minimal amounts of wheat, like in soy sauce or mayonnaise, aren’t enough to be an issue (usually) and wheat products like starch, thickeners, dextrose, etc. have no fructans. Basically as long as I avoid a primarily wheat, rye or barley-based food I’m okay.
This part of the diet is much harder. Wheat is a major part of our cuisine in Canada. Bread, cake, cookies, pizza crust, noodles, cereal. Gluten-free bread is expensive and mixed quality. There’s lots of recipes for homemade gluten-free breads but I’m intimidated by them and may not want to give that a go until it’s certain wheat is the issue with me.
And it’s not just bready things. Stone fruit, watermelons, artichokes, garlic, beans of all sorts, cashews, pistachios. Small amounts of broccoli, almonds and other nuts are allowed in moderation.
And no onions. None.
Well, okay, not entirely. Chives are okay, and green onions, so long as it’s only the green part.
But no yellow, red, white or purple onions. No onion powder or salt. No leeks, scallions or shallots.
Normally small amounts of FODMAPs are tolerated. Not in the case of onions. Onions are a huge source of fructans, so even tiny amounts can cause great distress. Even cooking with onions and removing them will leech out fructans into the food.
This is hard. Onions are not generally listed as a potential allergy source so do not have to be fully listed in ingredients lists. It’s often snuck in bundles with ‘spices’ or ‘flavouring’. Commercial chicken stock generally has onions. When I made gravy for a beef roast last night, I saw that my container of beef OXO had onions in it. It’s very,very common.
At lease there’s garlic-infused oil I can use for garlic flavour.
Alternative: asafoetida. This powerful Indian spice, when used in small quantities (a couple dashes per pound of meat) and allowed to cook apparently gives a flavour of garlic and onion. It’s hard to find in town. Silk Road Spice Merchant is the only I’ve found in Calgary so far. Going to have to try it.