Embracing the Mediterranean Diet for IBS: Flavorful Low FODMAP Choices

Optimizing the Mediterranean Diet for IBS: Taming Digestive Discomfort with Flavorful Choices

The Low FODMAP diet has been long recommended as an effective treatment for symptom relief from Irritable Bowel Syndrome (IBS). The Mediterranean Diet, characterized by its emphasis on fibrous fruits, vegetables, lean proteins, and olive oil, is associated with reduced inflammation, potentially contributing to a lower risk of cardiovascular disease, diabetes, and certain cancers. Could the Mediterranean diet also help our guts lessen the symptoms of IBS?

IBS is considered a functional gastrointestinal disorder with inflammatory markers increased in the guts of people who have IBS. Furthermore, research has shown that individuals living in the Mediterranean have significantly fewer inflammatory diseases than those living in Western societies consuming a more inflammatory/western diet. 

Preliminary research suggests that following a Mediterranean Diet (MD) may reduce levels of inflammation within the gut, restore healthy gut microbiota, and improve nutrition status among individuals with IBS. However, there are limited clinical trials in humans examining the effect of following a Mediterranean diet to treat IBS.

Another study examining the effects of the Mediterranean Diet (MD) on individuals with Irritable Bowel Syndrome (IBS) revealed that lower compliance with the MD was observed due to the heightened severity of IBS symptoms. Consequently, researchers were unable to conclude that adhering solely to the MD reduced the severity of IBS symptoms. This underscores the significance of carefully integrating the MD into IBS management strategies, especially considering the potential impact of higher-FODMAP foods.

Let's explore six strategic approaches for individuals with IBS to seamlessly blend the Mediterranean Diet with the Low FODMAP diet, effectively managing IBS symptoms while enjoying the benefits of Mediterranean-style eating.

Heart-Healthy Fats: A Foundation of Mediterranean Cuisine

Try Olive oil! Why? Olive oil is high in monounsaturated fats like oleic acid and is a great source of anti-inflammatory polyphenols. Some oils are infused with garlic and onions, which are also okay to use while on a Low FODMAP diet because fructans are not fat-soluble. This is a great way to incorporate flavors you may love without the consequences! I recommend choosing cold-pressed or expeller-pressed oils.

*Nuts, olives, and avocados are also excellent sources of heart-healthy fats with a lovely Mediterranean flair. Add these to salads and side dishes for extra flavor. They are even great as a snack or part of a charcuterie board for appetizers! 

Incorporating Low FODMAP Vegetables

Vegetables are a great source of fiber and micronutrients such as polyphenols, vitamins, and minerals that our guts need to keep them strong and reduce inflammation.

Examples: eggplant (1/2 cup), arugula (1/2 cup), bok choy (1/2 cup), carrots (1/2 cup), cucumber (1/2 cup), green beans (1/2 cup), green bell pepper (1/2 cup), green peas (1/2 cup), leaf lettuce (2 cups shredded), winter squash (1/2 cup), summer squash (1/2 cup), spinach (2 cups, raw), zucchini (1/2 cup).

*For a Mediterranean vibe, try roasting some summer squash and zucchini with salt, pepper, lemon juice, olive oil, and paprika. It's a terrific side dish along with any main course!

Low FODMAP Fruits: A Sweet Addition

Like vegetables, fruits also provide our bodies with a great source of fiber and micronutrients like polyphenols, vitamins, and minerals. They are chock full of antioxidants that help to reduce inflammation. 

Examples: banana (1/2), blueberries (1/2 cup), cranberries (1/2 cup), grapes (1/2 cup), orange (1 small), pineapple (1/2 cup), strawberries (1/2 cup), tomatoes (½ cup). Make sure to adhere to portion sizes!

*Tomatoes are part of traditional Mediterranean meals- try to stick to ½ cup servings per meal. 

Plant-Based and Vegetarian Delights

Consuming whole-food plant proteins can be a beneficial source of protein and help reduce saturated fat intake and cholesterol intake, which can also help reduce inflammation.

Examples: canned chickpeas (1/4 cup serving) and canned lentils (1/2 cup serving). Try to limit highly processed meatless options. These are full of additive ingredients that could cause inflammation. Check out this recipe for a Low FODMAP veggie burger made with butter beans and seeds by Stefani Weiss at Gluten Free Stories!

*Falafel is a great plant-based meat alternative chock full of herbs. It tastes so yummy with fresh lemon juice. Just be mindful that chickpeas are considered Low FODMAP with ¼ cup serving, so be aware of how much falafel you eat. Generally, 2-3 medium-sized pieces are considered okay. 

Fatty Fish: Omega-3 Powerhouses

Fatty fish is an excellent source of omega-3 fatty acids, monounsaturated fats that help reduce inflammation. Luckily, many fish that are highest in omega-3 fatty acids are also the lowest in mercury. Try to choose wild-caught vs. farm-raised to obtain the highest nutrient quality.

Examples: 3 oz portion of salmon, tuna, or sardines (these are great with fresh Mediterranean flavors like lemon, dill, and olives)

The Probiotic Power of Yogurt

Yogurt with live cultures is a great way to replenish gut-healthy bacteria. In people with IBS, the good gut bacteria tend to be lower than the unhealthy bacteria. Adding yogurt is a great way to get protein and that bacteria back in.

Examples: Try to choose yogurts without added sugars and be weary of sugar alcohols (sorbitol, mannitol, xylitol), as these are high FODMAP. My favorite brand of yogurt is the Stonyfield Plain Probiotic Yogurt. If you need to sweeten your yogurt, add a portion of Low FODMAP fruit or one tablespoon of pure maple syrup. Yogurt can be a substitute for condiments like sour cream and mayonnaise.

*A fun, flavorful twist with yogurt- make your own Tzatziki sauce- 1 cup plain Greek yogurt, ½ cup grated cucumber, 3 T. lemon juice, salt, pepper (to taste), 1 tbsp olive oil, 2 tsp of minced garlic, 1 tsp dill.

Savoring Wellness: The Fusion of Mediterranean and Low FODMAP Diets

By harmonizing the principles of the Mediterranean Diet with the Low FODMAP approach, individuals with IBS can embark on a culinary delight and digestive relief journey. By strategically incorporating heart-healthy fats, Low FODMAP fruits and vegetables, plant-based proteins, fatty fish, and probiotic-rich yogurt, managing IBS symptoms becomes achievable and delicious. 

Embracing the Mediterranean Diet for IBS empowers individuals to take control of their digestive health while savoring the vibrant flavors and nutritional benefits of this renowned culinary tradition. With these six strategic approaches, the path to digestive comfort and flavorful choices becomes clear, offering a holistic wellness approach for those navigating Irritable Bowel Syndrome.

1. _{Chen, E., Mahurkar-Joshi, S., Liu, C., Jaffe, N., Labus, J. S., Dong, T. S., Gupta, A. R., Patel, S., Mayer, E. A., & Chang, L. (2023). The association between a Mediterranean diet and symptoms of irritable bowel syndrome. Clinical Gastroenterology and Hepatology.}
2. _{Kasti, A. N., Petsis, K., Lambrinou, S., Katsas, K., Nikolaki, M. D., Papanikolaou, I. S., Hatziagelaki, E., & Triantafyllou, K. (2022). A combination of Mediterranean and Low-FODMAP diets for managing IBS symptoms? Ask your gut! Microorganisms, 10(4), 751.}