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Understanding FODMAPs Series: Part 2 – Disaccharides in Focus

Published on Monday, November 18, 2024
by Caitie G

Low-FODMAP

IBS

Disaccharides: The Double Sugars in the FODMAP World

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, a subset of carbohydrates generally poorly absorbed in the intestines. Representing the ‘D’ of the FODMAP family, disaccharides are a two-sugar unit more commonly referred to as lactose and sucrose. A significant portion of children and adults already experience lactose intolerance and may require the use of the over-the-counter enzyme Lactaid to better tolerate and absorb dairy products. Sucrose is a disaccharide composed of glucose and fructose, both of which are generally well-tolerated in individuals but if consumed in high amounts, can contribute to digestive discomfort in folks already dealing with Irritable Bowel Disease (IBD) symptoms.

Lactose Intolerance and the FODMAP Elimination Diet

According to Johns Hopkins Wellness and Prevention, following a Low FODMAP diet is a time commitment with three main steps: eliminate high FODMAP foods, slowly reintroduce one food item at a time and monitor tolerance and gastrointestinal (GI) symptoms for one week, identify which foods can be re-added or which foods need to be eliminated fully. This process can take anywhere from 2-6 weeks but should not extend past 6 weeks without guidance from a Physician or Registered Dietitian (RD). The Cleveland Clinic emphasizes the importance of carrying out this diet under the supervision of a medical professional, as nutrient deficiencies and unintentional weight loss may happen.

Lactose elimination can be very tough for some people, especially lacto-vegetarians who really rely on dairy as a main protein source. However, we are seeing a substantial increase in dairy-free/lactose-free products hitting the market. While lactose-containing enzymes are available, they should be taken in caution when conducting the FODMAP elimination phase as many of these enzymes contain mannitol, which is a type of polyol, the ‘P’ in FODMAP.

Consider these swaps when you are ready to eliminate lactose-containing products:

Sucrose Sensitivity: Less Common but Possible

Sucrose intolerance, caused by a deficiency of the enzyme sucrase, can cause similar GI symptoms to those experiencing IBD. Sucrose is most often found in generic table sugar but can be hidden in items such as sodas, maple syrup, and molasses. While tolerance varies, people tend to feel bloating, abdominal pain and have abnormal bowel movements only when high amounts of sucrose are consumed.

The University of Wisconsin School of Medicine and Public Health does reassure upcoming FODMAP-followers not to worry about the lack of sucrose in the diet; no nutrient deficiencies should result if followed appropriately. Avoiding sucrose can be tricky, as sugar is a common ingredient in many foods. Even when choosing a dairy-free milk option, as mentioned above, it must be unsweetened in order to be Low FODMAP compliant. The best method to ensure you follow a low-sucrose diet is to avoid any foods with sugar listed as one of the first four ingredients on the nutrition label. Similarly, some fruits and vegetables are higher and lower in sucrose; see below for an overview (while some of these fruits are approved in other components of the Low FODMAP diet, they do still contain sucrose and should not be consumed in high amounts):

Following the Low FODMAP diet can be incredibly overwhelming. Keeping organized will be the key to success. If you are looking for more information and guidance, several apps are available. The Spoonful App is helpful at grocery stores, offering a barcode scanning feature to analyze foods on the spot. Additionally, the Monash University FODMAP Diet app provides easy-to-digest FODMAP information and is constantly being updated.