Hot Tips! IBS and Spicy Foods
Fajitas! and Chiles! and Salsas! Oh My! …
I’m excited to share this article I’ve co-authored with Kate Scarlata that reviews the 3-phase low FODMAP plan, and addresses concerns many people with IBS have about eating spicy foods. If you’ve been wondering about chile /chilli pepper heat, if the capsaicin they contain is a FODMAP, how some people are able to test their tolerances, and a few more tips to consider, we have answers to your burning questions.
Hot Tips For IBS Patients: The Low FODMAP Diet And Spicy Foods
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in the world. 1 in 7 people are affected by IBS globally. Following a low FODMAP Diet has been found to offer relief for 70 – 75 % of those dealing with IBS. FODMAPs are fermentable carbohydrates (sugars) that are found naturally in foods. In patients with IBS, consuming these carbohydrates can result in symptoms during digestion.
Many patients with IBS who are considering the Low FODMAP Diet* have concerns that they may be embarking on a bland food regimen to obtain symptom relief, and that spicy foods such as chile (chilli) peppers will trigger symptom flare-ups. While many types of chiles have a low FODMAP serving size, they have been found to contain the compound capsaicin. This is a natural compound that gives chiles their spicy quality. To clarify, capsaicin is not a FODMAP. Individual tolerance levels for capsaicin vary and should be taken into consideration with preparing meals with chiles.
“Many studies have shown that spicy food is associated with IBS symptoms in some people, and potentially more so in women with IBS,” says Kate Scarlata (MPH, RDN and New York Times Best Selling Author specializing in gut health and nutrition). “Capsaicin, found in hot peppers, may be the primary culprit. The science is a bit mixed in this area, however, it appears that capsaicin can increase GI transit and contribute to IBS-associated pain. Interestingly, capsaicin induced pain appears to occur more commonly in individuals who don’t eat it often. It’s possible that regularly eating spicy foods actually desensitizes receptors in the gut associated with IBS pain. As with most food related issues in IBS, it is not one size fits all. People living with IBS should listen to their body and adjust diet triggers as needed. GI dietitians are best suited to help guide patients in detecting diet triggers for IBS symptoms. The least restrictive diet to help manage symptoms is the goal to allow and foster a healthy relationship with food.”
The Low FODMAP Diet is comprised of three phases: Elimination, Reintroduction and Personal Maintenance. Patients are advised to complete these phases under the supervision of their GI and a FODMAP trained dietitian, and to allow two to six weeks to complete phase one to assess their progress. The diet does not mean “No” FODMAP. It is a food plan based on serving sizes per meal in which foods that have tested to contain low levels of FODMAPs are encouraged for patients to consume, particularly during the beginning phase of the plan. High FODMAP foods such as wheat-containing products and some chile peppers also have lesser, low FODMAP portions.
Food swaps are also implemented. For example, white bulbs of onion have tested to be high FODMAP and can be substituted with low FODMAP green parts of scallions, chives and green parts of leeks.
Phase 1 – Elimination: in which patients consume low FODMAP portions of foods. Jalapeno peppers were tested by Monash University, who maintain one of the largest FODMAP-tested food databases in the world. They found that fresh, raw jalapeno peppers are high FODMAP at 1 medium size pepper per meal, however, 1 tiny jalapeno is considered to have a low FODMAP rating and is compliant in the beginning Elimination Phase of the diet.
Phase 2 – Reintroduction: once the patient’s symptoms are under control, they methodically reintroduce moderate FODMAP levels of foods. These are called Food Challenges, with 3-day breaks between challenges. Patients test their tolerance to higher FODMAP consumption by eating low FODMAP foods while introducing each subgroup (fructan, fructose, GOS, lactose, sorbitol, mannitol) separately, at moderate FODMAP levels to determine which trigger symptom flare-ups and those that do not. Patients can track their symptoms through a food journal to ensure the process is completed successfully.
Jalapenos contain fructose and have a moderate FODMAP rating at 1 small pepper (slightly larger than tiny) per sitting. If symptoms are not triggered at this first serve size, patients may proceed to trial a higher FODMAP serve size of 1 medium size jalapeno. If the challenge results in symptoms, patients then stop and try again later, in smaller amounts.
Phase 3 – Personal Maintenance: involves expanding the patients diet to maintain calm symptoms, while continuing to add small amounts of trigger foods. Patients identify their personal tolerances and develop a long-term, less restrictive dietary approach.
With regard to chile peppers, patients may choose to trial individual tolerance of Serranos, cayenne powder, chipotle powder, and other spicy foods as they establish their personal balance.
Serrano chiles, cayenne powder and chipotle powder have Low FODMAP portion sizes. Fresh Poblano peppers, fresh mild green chiles (Hatch, Colorado Green, Anaheim, Chiles Verde Del Norte) and canned mild plain green chiles have tested to contain low FODMAP levels.
The Low FODMAP Diet is not a lifetime food regimen. Millions of people following the diet find that in the Reintroduction and Personal Maintenance Phases they are able to tolerate varying portions of high FODMAP foods and previous triggers. Personal sensitivities can change over time, opening countless possibilities in enjoying spicy, robust dishes such as fajitas, spicy tofu bowls and jalapeno poppers, while maintaining calm digestion.
It is important for patients to be medically diagnosed with IBS by their gastroenterologist and work with a registered dietitian and healthcare professional when starting the Low FODMAP Diet to tailor the plan to their particular sensitivities.
*The Low FODMAP Diet was developed by researchers from Monash University of Australia – inventors of this scientifically proven food plan for improving the symptoms of IBS and world leaders in FODMAP research. A team on the management of IBS conducted by the American College of Gastroenterology suggested that a low FODMAP diet can be used for overall symptom improvement in IBS.
Credits:
Amy Laura, co-founder FODify IT! IBS survivor and digestive health author of Calm Tummy Happy Heart – the first low FODMAP cookbook from the United States with recipes Monash FODMAP Certified, American Southwest inspired. All ingredients, including chiles and chile powders, have been measured, assessed and certified to be appropriate for the beginning Elimination Phase of the Low FODMAP Diet.
https://www.amazon.com/Calm-Tummy-Happy-Heart-University/dp/B0BM3DJGP6
Kate Scarlata, co-author of Mind Your Gut — The Science-Based, Whole-Body Guide To Living Well With IBS. MPH, RDN, LDN FOR A DIGESTIVE PEACE OF MIND LLC MEDWAY, MA 02053 https://www.katescarlata.com/
Mind Your Gut: https://www.amazon.com/Mind-Your-Gut-Science-based-Whole-body/dp/030683233X/
Department of Gastroenterology, Monash University, Melbourne, Australia. For more information about FODMAPs and the low FODMAP diet, visit: https://monashfodmap.com