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Hi guys, I’m really excited to announce that I was asked to write an article about fructose malabsorption for Suggestic, a website that deals with nutrition, food intolerances and restaurant suggestions. Well, apparently I was a little enthusiastic – I didn’t want to miss anything – so I needed to split the article in two. I have already shared part one, so here goes part two:
“Last week I talked about fructose malabsorption, its link to irritable bowel syndrome (IBS) and the similarities it shares with non-coeliac gluten sensitivity (NCGS). This week, I will expand on the “fructose friendly” dietary management strategy for fructose malabsorption – the complete low FODMAP diet – that is gaining traction as the frontline dietary method for combating IBS symptoms.
IBS is generally understood as a long-term or recurrent disorder involving the function of your gastrointestinal system, usually due to imbalances of intestinal motility, function and sensation, leading to symptoms of digestive distress. It is a common occurrence in Western countries, with up to 30% of the population being affected at some point in their lives, women generally more-so than men.
What are FODMAPs?
“FODMAPs” is an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols and describes a group of readily fermentable carbohydrates that are not well absorbed in the small intestines of some people; if these carbohydrates are not broken down and/or transported through the intestinal wall and into your blood stream, they continue down into your colon, where the resident gut bacteria digest them, leading to a build-up of certain gases and short chain fatty acids, which can alter the water content of your large intestine. These products of fermentation are the causes for the wind, bloating, abdominal cramps/pain and altered bowel movements that you associate with your fructose malabsorption, lactose intolerance or IBS.
The list of FODMAPs includes:
There are hydrogen/methane breath tests that can check whether you malabsorb fructose, lactose and/or sorbitol but the other FODMAPs must be properly eliminated and then tested with a reintroduction trial (outlined below) to know whether they are causing your symptoms…”
Once again, let me know what you guys think! I sincerely hope I didn’t miss anything out – I’m planning on writing more about the links between carbohydrate malabsorption and nutrient deficiencies soon, when I have some time over the holidays.
Thank you for taking the time to read it! Have a great weekend guys – and stay tuned for the easy to make chocolate peanut butter cookie ball recipe that’s very coming soon.
Hi guys, I’m really excited to announce that I was asked to write an article about fructose malabsorption for Suggestic, a website that deals with nutrition, food intolerances and restaurant suggestions. Well, apparently I was a little enthusiastic – I didn’t want to miss anything – so I needed to split the article in two. Here goes part one:
“So you’ve gone gluten free. You had coeliac disease ruled out first – as you should – but you still felt that wheat was a big trigger for your irritable bowel syndrome (IBS). You feel better off wheat – less bloated, more energy – but you’re not quite 100 %. What could it be?
I’m sure that many of you have by now heard of the study behind the media storm that apparently refutes the existence of non-coeliac gluten sensitivity (NCGS). Gluten is a protein that is common to the grains wheat, barley and rye. Contrary to what many of those journalists would have you believe, the researchers did not say that people who identify with NCGS are imagining it; rather, that it might actually be a different component of wheat, other than gluten, or in combination with it, that is causing them to experience IBS-like symptoms, including digestive distress, bloating and others, such as fatigue.
What then could be the culprit behind your wheat-triggered IBS? The answer: it might be fructans (also known as fructooligosaccharides or FOS). Fructans coincidentally happen to be found in large enough amounts to cause symptoms in the gluten containing grains, which includes all varieties of wheat, barley and rye; and they, along with fructose, made my first year of university… let us just say, “interesting.”
Growing up, I always had a fussy gut. When I was going through the last two years of secondary school, it got a little worse but not bad enough for me to really take notice, other than joke about it with friends. It was not until I was in my first year of university that it really got going, dictating not only the parties I could go to but things as seemingly insignificant as which seat I would take in the lecture theatres and what I could wear (think room for bloating). Luckily, my mum had an eye on me and about half way through the year (after end of semester exams really took their toll on my IBS) she read an article about coeliac disease. Digestive distress, nausea, fatigue, brain fog… I ticked most of the boxes, however, I did not have active coeliac disease. My gastroenterologist (since retired) had a game plan though and the next thing I knew I was being sent off to have hydrogen/methane breath tests to check for both lactose and fructose malabsorption*.
I had heard of lactose intolerance before, but fructose malabsorption? Well, fructose malabsorption was my answer and explained why the gluten free diet that my GP had advised me to trial earlier had helped significantly – but not completely…”
Let me know what you guys think and please share – as awareness of fructose malabsorption spreads, it is more likely that people will be correctly diagnosed and the variety of food choices for us will increase, both at restaurants and in supermarkets.
Read part two here.
Have a great night!
I’m not a huge fan of flying. I’m not scared of it but I don’t find it enjoyable, either; long hours (15 hours between Melbourne and LAX) in cramped seating, recirculated air, mostly unsuitable foods and the bathrooms, if you can call them that, all add up to me not having a good time. I stress about connections until we make them and about whether our luggage will make it when we do.
We have had enough mishaps with changed departure gates, delayed planes and missing luggage (LAX is a disorganised hellhole) that Ev and I have become very adept at travelling light. The last time we went home to Australia, we got everything we needed for two weeks, including things for other people, in two carry on bags… and by “carry on” I mean the real carry on bags, not the giant suitcases that American based airlines let people take on and try in vain to cram into the overhead compartments, taking up space meant for everyone. Yes, that annoys me. If I’ve been responsible and packed my belongings into a small suitcase intended for overhead bins, perhaps with valuables in there, I am not impressed when I am told it HAS to be checked, because a 3/4 full plane has already run out of overhead storage. But I digress.
Some people truly do enjoy flying but for the rest of us, here’s how I manage eating with FM and dealing with potential symptoms while flying. It’s pretty appropriate timing, because Ev and I are going to spend the next week in Cabo, Mexico! We’ve been waiting for this holiday since we got back from Cabo last summer. As much as I prefer road trips and exploring different towns, not staying in the one place for too long, sometimes it’s nice to just go and veg out somewhere that is completely relaxing and not have to worry (so much) about the food. As I have said previously, for me, Mexico/Mexican food seems to be a safe bet if I eat plainly and avoid tropical fruits.
The other posts in the travel series can be found here.
I’m sure I’ll be posting photos of tropical paradise on my Instagram account, if you’d like to follow along.
Step 1: Plan ahead, Stress less
Most people don’t need to be told that stress can increase their IBS symptoms; I know I don’t. It’s not all in our heads, though. Research also demonstrates that the two coexist (see here and here), as the autonomic nervous system and certain hormones, which are triggered during times of stress, also act upon the gut.
To avoid stress related IBS and ensure as smooth a travel/flight experience as possible, plan ahead. Some things to consider are:
Step 2: Make some safe food flash cards
If you don’t speak the language, flash cards listing the ingredients you can and cannot consume in the language spoken by the airline/at the airport will help prevent a lot of confusion, if you decide to brave the food.
In fact, even if you do speak the local language, flash cards might still be a good idea as the idea of fructose malabsorption is still so novel that the apparently random list of ingredients that you cannot consume might overwhelm the staff and create an unwanted fuss.
Make sure the lists are clear and concise as to what you can and absolutely cannot consume.
Step 3: Eat plain before the plane
Each time I fly, I will eat plainly in the preceding week, for a few reasons:
Step 4: Pack your own food
This will not always be possible, due to customs regulations and such but if you are able, I highly recommend taking FODMAP friendly snack foods to tide you over during flights and layovers while you’re away.
Some ideas include:
Examples of what I might pack:
Step 5: Be prepared for the worst
Sometimes, despite our best efforts, shit happens. Literally. While it’s not ideal, you can lessen its impact on your travel by planning for it. If you have an FM-ergency kit, your life will be a lot easier. (See what I did there? You can use it). Keep this in your carry on, you may need it on your flight as well as at your destination.
I hope these guidelines help you fly and travel successfully, as they have me. If you think of anything that I should add, please let me know.
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I’ve just signed up with Bloglovin’, an online platform from which you can follow any blog you like – regardless of who or what hosts it – and it collates them into one easy-to-read feed for you. It’s essentially like the old Google Reader, which I used to use, until it was cancelled; definitely handy to use and it helps to de-clutter your email inbox, if you choose not to follow the same blog in two locations.
Feel free to head over there, sign up (for free, with Facebook or email) and follow me – and any other blogs you like. This way, you’ll never miss a post. Unlike if you just follow the Facebook page, as Facebook is now on a vendetta to make you pay for it to publicise your posts with your followers. Which would be fine if this was a business… but it’s not. So, if you only follow Not From A Packet Mix on Facebook and have been wondering why you’re not getting my weekly posts in your news feed, I would recommend either following by email or Bloglovin’, as well.
Road trips are possibly my favourite way to travel; you get to see so much more of the landscape than if you fly everywhere and I find that cities tend to look the same after a while. To be able to drive down the west coast of the USA and see lush greenery and snow-capped mountains turning first into farm land and then into a more arid landscape complete with mesas is pretty awesome. Also, California is full of eucalyptus trees, which reminds us of home and smell amazing, as well.
In my opinion, road trips are also the easiest type of holiday to take while on a low FODMAP diet, as you can really be in control of your food if you plan ahead and pack an Eski (cooler) with sufficient supplies.
I will outline below how I manage my meals on a road trip:
Step 1: Make an itinerary and food list
I am a list maker, so is my sister. It’s something we’ve always done, as we’re OCD control freaks who can’t bear to be disorganised. Plus, it’s fun. Luckily for me, Ev is the same… although he hates packing his own bag. But he’s not the one with FM, so that’s not such a big deal.
Being a list maker means that I like to plan each leg of the road trip with hours and distances and town names. This is good, as it will help you with step 2. Another way to make step 2 easier (well, the act of eating at the restaurants that you’ve researched) is to call ahead or go armed with a list of foods that you CAN EAT (make sure it’s labelled clearly, so you don’t get a plate of onions sauteed with apples on whole wheat toast) to make both your life and those of the wait staff and cooks much easier.
Step 2: Research local restaurants and eateries
Before you go out to dinner, you would find online menus or call the restaurant you’re thinking about going to and see if they can provide a meal for you; travelling is no different. The key to a relaxed holiday (and gut!) is planning. I know lots of people who like to wing it – I have never been one of them – but a “we’ll find something, don’t worry” attitude is more likely to lead you to either an irritated or hungry gut later on if you are following a FODMAP friendly diet.
Either before you leave home, or each day of your trip (if you have internet connectivity), scout out a few potential cafes and restaurants and note their locations with regards to your itinerary. What town will you be driving through at lunch time? Does the town you plan to spend the night at have a restaurant or supermarket that you can source meals from?
Step 3: Pack emergency foods
If you’re driving down a deserted highway and you can’t find anywhere to eat, things can get ugly; this is true even if you don’t have a food intolerance. I tend to become very irritable when I’m hungry (more like a 6 year old than a 26 year old) and I’m sure I’m not pleasant to be around when I’m like that. In fact, even when we’re not road tripping, Ev will tell me to eat something if I’m beginning to get grumpy.
I think packing an emergency food supply is a good thing to do for road trips, regardless of FM. Things to consider when packing a food kit include:
Examples of what I might pack:
Step 4: Be prepared for the worst
Even the most diligent planning can’t prevent a slip up here or there. A waiter might not take your request seriously, or simply misunderstand you; or you might sneak a food in and hope that your FM has gone on holiday elsewhere. Go prepared with a kit containing methods you know will help to alleviate your symptoms.
My emergency FM kit would include some or all of the following but yours may be different:
This sounds like a lot and if it overwhelms you, I’m sorry. Just please remember that you can still enjoy a road trip while on the low FODMAP diet with some extra planning; just like road tripping with kids or dogs… but we still do that!
If you have any other tips that I have forgotten, please let me know in the comments section below. Happy holidaying!
I whipped up these little beauties after being inspired by the super-soft and fluffy zucchini quinoa muffins I made from Patsy Catsos’ cookbook, Flavour Without FODMAPs Cookbook – Love the Foods that Love You Back and before going on a road trip from Seattle to San Francisco and back.
If you’ve read the “My FM Journey” page, you will know that I was diagnosed with FM back in 2006, so I’ve had 8 years to perfect my methods of travelling on a fructose friendly diet. Granted, I can now have some onion and garlic, which makes life a lot easier than it used to be but you can travel while eating low your version of the low FODMAP diet – it just takes a little bit of extra planning.
These muffins lasted a week in an airtight container within an Eski (cooler) and remained fluffy the entire time. If I’d had some, I would have added in Feta cheese to give the flavour a bit of bite but they are still delicious without it and sometimes I wonder whether good Feta isn’t too expensive to waste in muffins and Parmesan cheese would also do. Either way, these muffins are a delicious savoury treat, perfect for a snack or to serve with soup.
Pumpkin and Chive Muffins
Peel, dice and bake pumpkin at 180 C/350 F for 30 minutes, or until completely cooked, then puree it with your immersion blender or similar. If pumpkins are out of season, tinned puree will also do. Leave the oven at 180 C after the pumpkin has cooked.
Meanwhile, combine the flours, pepitas, baking powder, salt and spices in a bowl and set aside.
Blend the eggs, butter and pumpkin puree until smooth. Add in the dry ingredients and stir to combine before adding in the minced chives and/or any other flavour variation you’d like.
Divide the mixture between a 12 hole muffin tray and bake at 180 C for 18 to 20 minutes, or until a centre muffin tests clean with a skewer.
Enjoy with a bowl of hot soup, or take as a snack to keep you going throughout your work/school day.