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Athletes and Gastrointestinal Distress: Do FODMAPs in the Diet Trigger Symptoms?

Sports nutrition is a passion of mine and often enough I hear from athletes and physically active people who suffer from gastrointestinal (GI) distress. New research is starting to link FODMAPs in the diet to symptoms of GI distress in athletes. Here is what the science has to say.

GI distress is a common problem among athletes with 30-70% of endurance athletes reporting the occurrence of GI distress (1). The symptoms of GI distress are variable; however, many individuals report bloating, constipation, heartburn, indigestion, and even gastroenteritis (inflammation of the stomach and intestines). Aside from physiological and psychological triggers, dietary factors are a contributor to symptoms of GI distress. For example, a recent case study published by Dana Lis and colleagues attributed a high intake of FODMAPs (Fermentable Oligosaccharides Disaccharides and Polyols) to symptoms of GI distress in a 31-year old runner who presented with a history of persistent GI symptoms during and after a run (2). A thorough medical history and diet assessment revealed this runner consumed a high amount of FODMAPs each day (51 g), but had no history of celiac disease or other GI conditions. Furthermore, this runner previously tried a gluten-free diet and this proved ineffective. Consumption of a low FODMAP diet for 6 days led to improvements in daily GI symptoms (2).

What are FODMAPs?

The term FODMAP is an acronym to classify groups of carbohydrates (sugars and fibers) that are found in common foods and beverages. Collectively, these carbohydrates are poorly absorbed in the small intestine and end up in the large intestine where they are fermented to produce gas, and can cause other unpleasant symptoms such as abdominal pain, bloating, constipation and even diarrhea. Individuals who suffer from digestive disorders such as Irritable Bowel Syndrome (IBS) are also very sensitive to FODMAPs and display similar symptoms to those with GI distress. The list of foods that are high in FODMAPs is unfortunately, well long (see the list). Thankfully, nutrition research is expanding in this area and scientists are continuing to learn more and more about dietary approaches to help those who can’t tolerate FODMAPs in their diet. Working with both a physician and a registered dietitian (RD) can help rule out foods that are specific FODMAP triggers and create a customized plan to help you get the nutrition you need to be healthy and reach your health and fitness goals. New products in the market that are “FODMAP friendly” are also available to consumers to help meet their nutritional needs.

List of High FODMAP Foods

Dried fruits

Asparagus

Milk

Wheat

Isomalt

High fructose corn syrup

Nectarines

Artichokes

Ice cream

Barley

Mannitol

Agave

Persimmon

Sugar snap peas

Yogurt

Rye

Sorbitol

Honey

Watermelon

Cauliflower

Custard

Maltitol

Rum

Apples

Mushrooms

Buttermilk

Xylitol

Pistachios

Figs

Garlic

Milk powder

Cashews

Boysenberries

Onions

Evaporated milk

Soybeans

Mango

Split peas

Pears

Kidney beans

Cherries

Black beans

Apples

Baked beans

Blackberries

Peaches

*This is not a comprehensive list of all High FODMAP foods. *

Implications for Athletes

Athletes who suffer from GI distress often fail to resolve symptoms through commonly recommended dietary approaches (1). With evolving research in the area of FODMAPs, a connection seems to exist between athletes who are high FODMAP consumers and symptoms of GI distress. Case studies provide anecdotal evidence on this topic, but research in the form of clinical trials are needed to better understand if following a low FODMAP diet is truly effective for athletes who suffer from GI distress.

Stay tuned and watch my blog space as I continue to research in the area of FODMAPs and athletes who suffer from GI distress.

References

  1. Lis D, Ahuja K, Stellingwerff T, Kitic CM, Fell J. Food avoidance in athletes: FODMAP foods on the list. Appl. Physiol. Nutr. Metab. 2016;41:1002-1004.

  2. Lis D, Ahuja K, Stellingwerff T, Kitic CM, Fell J. Case Study: Utilizing a Low FODMAP Diet to Combat Exercise-Induced Gastrointestinal Symptoms. International Journal of Sport Nutrition and Exercise. [Epub ahead of print].


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