“After thoroughly researching IBS, I discovered the low-FODMAP diet,” says Leisk, referring to an eating plan that restricts certain foods and additives that are poorly absorbed by the body and may trigger IBS symptoms like gas and bloating. A native of Scotland, Leisk found less information than she might have liked in her home country — so she reached out to FODMAP Friendly, a program based in Australia that offers certification of foods that are low-FODMAP friendly. (The low-FODMAP diet was developed by researchers at Monash University in Melbourne, Australia.) She was able to learn plenty about this complex but seemingly effective diet. To Leisk’s relief, eliminating the so-called FODMAP foods — which include not just gluten and dairy but also garlic, onions, cruciferous and other vegetables, and many fruits and sugars (see below) — significantly improved her symptoms. What the change didn’t do, however, was make her life easier: Shopping for foods, parsing the information on nutrition labels, deciding what she could enjoy and what needed to be reworked became a time-consuming chore. “I was working long hours as a restaurant manager,” says Leisk, “and I found it hard to manage my diet.” Her prior research uncovered a statistic that surprised her: 20 percent of the population of the United Kingdom suffers from IBS. If they, like her, found it difficult to deal with their food issues and symptoms, if they, too, were suffering in silence, then maybe she could help. Her mom, also an IBS sufferer, began working with Leisk, cooking meals from scratch that met the low-FODMAP guidelines. That’s when a business opportunity felt natural: Why not create FODMAP-compliant meals that could be shipped to IBS sufferers all over the United Kingdom? In 2017, her business, Fodilicious, was born. RELATED: Should You Try Gut-Directed Hypnotherapy for IBS?
Recipe for a Low-FODMAP Food-Delivery Service
The origins of the business were marked by a lot of trial and error. “Trying to develop tasty foods while also eliminating so many ingredients was a real challenge,” she says, and she and her mom spent countless hours trying and rejecting recipes. The next hurdle to overcome was finding a commercial kitchen in which to create the meals, as they needed to come from an allergen-free environment. In the end, she found it easier to create her own commercial kitchen. She built a website, and at the start, she and her mom made the meals themselves (these days, all production is outsourced to commercial suppliers that meet no-allergen standards in their kitchens). Customers, Leisk says, can be confident that Fodilicious foods are low-FODMAP compliant. “We worked with the FODMAP Friendly team in Australia, shipping meals to them to be laboratory-tested and certified,” she says. Recently, Fodilicious products have been certified by Coeliac UK. Freshly made choices, such as pesto Scottish salmon with roasted potatoes, spaghetti bolognese, and chicken tikka masala, arrive in chilled packaging and can be heated and eaten within a few days, or frozen for later use. Despite the obvious challenges of starting a business from scratch, Leisk was energized rather than daunted by the uphill climb. She didn’t want to meet just one need — for gluten-free food options — but to offer products that are vegan, dairy-free, nut-free, all natural, and low calorie as well. In a final deep-breath moment before the official launch, “we conducted focus groups and tasting panels, and got enough positive feedback that we could launch with confidence,” she says.
The Basics of a Low-FODMAP Diet
FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are a group of short-chain carbohydrates that are poorly digested in the gut. The category casts a pretty wide net. Oligosaccharides include wheat and rye as well as onions, garlic, and legumes. Disaccharides are lactose, the milk sugar found in all dairy products, as well as sucrose (table sugar) and maltose. Monosaccharides include fructose, found in fruits, honey, and high fructose corn syrup, as well as glucose and galactose. Polyols, such as sorbitol and mannitol, are found in some fruits and vegetables and also used as sweeteners in processed foods. FODMAPs may trigger IBS symptoms in a couple of ways, says Shanti Lynne Eswaran, MD, a gastroenterologist at the University of Michigan who has conducted research on the diet. “Some of these foods are fermented in the gut by bacteria, creating gas that can be irritating. Some of them draw water into the small intestine, which can lead to downstream effects like bloating, pain, and changes in bowel habits.” Research appears to back up the diet’s efficacy:
In December 2016, Dr. Eswaran and colleagues published the results of a randomized, controlled trial of the low-FODMAP diet in the American Journal of Gastroenterology, which found that the diet produced greater reductions in participants’ self-reported scores for abdominal pain, bloating, consistency, frequency, and urgency than another type of recommended diet.Across the Atlantic, in a prospective study published in 2018 in Gut, the journal of the British Society of Gastroenterology, researchers showed that subjects with celiac disease and IBS who followed a low-FODMAP diet experienced a significant reduction in gastrointestinal symptoms such as pain and bloating. (These researchers recommend that anyone who is interested get help from a qualified dietitian to properly adhere to the diet, and to reintroduce FODMAP foods in a careful way.)Given that many people with IBS also suffer from emotional pain and a reduced quality of life thanks to their condition, the results of a study published in August 2019 in Nutrition in Clinical Practice are significant. Here, researchers looked at the longer-term outcomes for people with IBS on a low-FODMAP diet, concluding that the regimen helped people improve their quality of life and reduce levels of fatigue, anxiety, and depression six months out.
Because the diet isn’t a cure, nor does it address the root causes of IBS, Eswaran says, “It’s best used as a therapy and an adjunct to the medication we recommend.”
How to Do a Low-FODMAP Diet
To start, a low-FODMAP diet eliminates all foods and ingredients that are FODMAPs, usually for two to four weeks, says Eswaran. “It’s a little bit confusing to try to do this on your own, so I generally recommend the aid of a dietitian who’s been trained in this kind of elimination diet,” she says. (If you don’t have access to a dietitian, apps like the one created by Australia’s Monash University can be helpful.) After the elimination phase, you start to add some foods back in, one category at a time. “The idea is not to stay on that elimination diet forever because it’s fairly limiting and makes it difficult to have variety in your diet,” says Eswaran. The return of foods should be systematic and sequential. “You might decide to add lactose-containing foods back in for a day and see how you feel,” she says. If that works, you eliminate that again and add in a second formerly restricted food, and so on until you have information about how you’re individually affected by FODMAPs. Keeping a careful diary of your meals and related symptoms can be enormously helpful during this phase, says Eswaran. “Even items that seem healthy may contain an ingredient that’s not allowed in the elimination phase,” says Eswaran. “People do pretty well if they’re motivated and savvy.” Speaking of savvy, Leisk’s Fodilicious may still be a bit of an upstart in the food-by-mail world, but it’s expanding rapidly. Fodilicious now hires local manufacturers to cook and package the meals in facilities that are completely free of gluten, other allergens, and FODMAPs. And the company recently added a packaged snack to its offerings: Cocoa Crunch Cookie Buttons, which are also vegan and low in calories.
