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Patients come into my office everyday for stomach issues (gas, bloating, constipation, etc) and believe that gluten must be the sole culprit. Yes, gluten certainly can wreak havoc on the body, but another factor could be an intolerance to one or more types of FODMAPs. FODMAPs are short chain carbohydrates found in virtually all gluten containing food products and can cause the same undesirable gastrointestinal side effects as gluten. FODMAP stands for “fermentable oligosaccharides disaccharides monosaccharides and polyols" and include fructans (wheat, pastries, pasta), galactans (chickpeas, lentils, beans, soy), lactose (all dairy products), fructose (honey, apples, pears), and polyols (sugar alcohols such as sorbitol and stone fruits such as as avocado). Foods range in their amount of FODMAPs, some having very low amounts that are unlikely to cause stomach issues, to foods that have very high amounts which are most likely to cause problems. FODMAP containing foods may only cause side effects when eaten in large amounts (i.e. the American diet) so just because your favorite food is on the high FODMAP list does not necessarily mean it needs to be completely eliminated from your diet. Figure out if you have sensitivity to FODMAPs by cutting out FODMAP containing foods for a few weeks and then slowly re-introducing them back into your diet one at a time, and/or pay attention to how you feel after eating FODMAP rich foods. Below is a list of FODMAP containing foods - from low amounts of FODMAPs to high amounts. SK   1. Get your dressing on the side.Most dressings are high in fat, sugar, and salt for very little servings sizes (think size of a ping pong ball). Get more bang for your buck with dressings that are great in flavor and have a better nutritional profile such as hummus, hot sauce, soy sauce, or balsamic vinegar. Always ask for dressing to be on the side, you are more likely to use less of it. 2. More vegetables.Vegetables fill you up due to their high fiber and high water content. The body cannot digest fiber and so it takes longer for high fiber foods to pass through your system, thus keeping you fuller longer while at the same time causing your body to absorb fewer calories. Fiber also keeps your cholesterol in check by binding to cholesterol and literally expelling it from your body with each trip to the bathroom. 3. Ask for the bread or bun to be non-toasted.Toasted means buttered, in most cases. The majority of restaurants will default to toasting your bread while also adding butter, resulting in more calories and fat added to your meal without you even realizing it. 4. Go open face on your sandwich.You will not miss the top piece of bread from your sandwich. Most breads from restaurants are low in fiber, high in empty carbs and won’t do anything to help you stay full. Instead, pile on the protein and vegetables, these will fill you up more than an empty calorie extra piece of bread will. 5. Poach the eggs.Poached means eggs are cooked in water without anything else added to them. Rest assured your poached eggs will not have vegetable oils added them. 6. If you go omelet, ask how it's made.Make sure to ask how the omelets are made. Restaurants may other inflammatories such as milk that may be problematic for you. And of course always add vegetables! 7. Get that Sushi with brown rice or quinoa.Opt for brown rice or quinoa with sushi (preferably quinoa which contains all of the essential amino acids making it a complete protein while also being high in fiber). It can be misleading as to how much rice you are taking in - one roll of sushi and the rice could be ¼-1/2 cup of rice (aka sugar). And definitely stay away from tempura which is code for fried.
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