|Example of a monosaccharide on the left, and disaccharide on the left, which is 2 monosaccharides linked together by an oxygen.|
Larger carbohydrate chains that are made up of 3-10 simple sugars (i.e. monosaccharides), are known as oligosaccharides, and are abundant in various foods including asparagus, onion, artichoke, legumes, wheat, and garlic. Last but not least, there are polyols, which are sugar alcohols, or common sugar-free substitutes, including xylitol and sorbitol, while they are also found in real food sources such as grapes, mushrooms, avocado, apricots, and many others.
Why it Matters
Overall, the main takeaway from these differing types of carbohydrates found in food, is that the bodies small intestine has a hard time digesting them. In fact, this is even true for those that are completely healthy. Therefore, when the food that enters the small intestine is unable to be broken down, it remains so when it enters into the large intestine, where it then feeds gut bacteria. Though having happy gut bacteria is important to obtaining a balanced GI tract, over-feeding them causes the microbes to become over-active, fermenting everything that they can get their “hands” on. In turn, this causes one to have a variety of symptoms that can range from minor discomfort in one’s abdomen, to inhumane, debilitating pain throughout one’s entire body. Not only does undigested food in the small intestine cause overgrowth (i.e. SIBO), but it also hinders the large intestine from its key job (water absorption), which is why bloating, bowel issues (constipation and, or, diarrhea), gas, cramps, indigestion, and belching, are all common symptoms of FODMAP intolerance as well. Enterocyte cells, as mentioned in my previous, leaky gut post here, are one of the major factors in the health status of one’s gut, and are also responsible for digesting many FODMAPs. Therefore, if they become damaged or dysfunctional, not only does allergies and other inflammatory health conditions come as a result, but also the chance of FODMAP intolerance and overgrowth. Common triggers of GI damage include gluten, medications (antibiotics, NSAIDs, birth control, etc…), alcohol, legumes, and other items prominent in the SAD (standard American diet), all of which lead to a a leaky gut, which, as mentioned above, subsequently adds to the likely hood of one becoming noticeably FODMAP intolerant. FODMAP intolerance can also occur when the expression of Glucose Transport Protein 5 present in the GI tract, becomes dysfunctional, due to it being one of the main fructose transporters in the body. This cant occur through ingestion of polyols and sugar alochols, due to their direct effect on the function of GLUT5. As Dr. Sarah Ballantyne mentions in her post, what type of FODMAP one adversely reacts to, can sometimes be brought back to what insufficiency is occuring in the body, with fructose and polyols being related to GLUT5 deficiency, and fructan containing foods, being from a lack of certain digestive enzymes.
How to Heal
If intolerance to FODMAPs is caused by a damaged gut, then it is quite obvious that one of the only ways to fully reverse this is to first begin to heal one’s gut. For starters, it is important to eliminate, or at least decrease (depending on the extent of one’s intolerance), the amount of dietary sources of fermentable carbohydrates in one’s dietary intake, as well as other foods, medications, and substances that have a negative impact on gut health. This can take anywhere from a few weeks, to months, or even years, depending on the degree of one’s health condition. It is also key to get one’s gut flora balanced, of which can be done through supplemental probiotics, or probiotic foods. However, one must be careful while introducing more bacteria to the gut when experiencing FODMAP intolerance, as it may make their symptoms progressively worse. Truly, it depends on the person, and what is the underlying cause of their gut imbalance. Below is a brief list of foods high in FODMAPs, however, if you are looking for more information on both gut healing and the information discussed today, I encourage you to purchase Dr. Sarah Ballantyne’s, “The Paleo Approach,” or visit the various resources provided at the end of this post.