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145 of 150 people found the following review helpful
"The Complete Low-FODMAP Diet: A Revolutionary Plan for Managing IBS and Other Digestive Disorders" lays out the principles for a diet to control the symptoms of irritable bowel syndrome as well as help for non-responsive celiacs and those with IBD whose symptoms may be aggravated by sensitivity to FODMAPs. The book is written by Sue Shepherd, PhD, an Australian nutritionist who was instrumental in developing the low-FODMAP diet, and by Peter Gibson, MD, a gastroenterologist at Monash University in Australia, which continues to do a lot of research on IBS and the low-FODMAP diet. FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are all poorly absorbed short-chain carbohydrates. Indigestible sugars, in other words. Lactose, fructose, and polyols are poorly absorbed in many people, while fructans and galato-oligosaccharides are not absorbed by anyone. When they are not absorbed, the sugars are easily fermented by intestinal bacteria, which produces symptoms.

The first part of the book explains the principles behind the low-FODMAP diet. The second part of the book is recipes. There are about 60 pages of substance, followed by 190 pages of recipes and menus that I did not find at all useful. The good news is that the substance of the book is short and easy to digest (no pun intended, ahem). The authors begin by explaining the differences between food allergies, hypersensitivities, and intolerance. IBS symptoms are largely caused by intolerance. They briefly discuss the Rome III diagnostic criteria for IBS before getting into theories about causes and descriptions of common symptoms. Oddly, the authors are dismissive of small intestinal bacteria overgrowth (SIBO) as a cause, though there is now a large body of research on it. The attitude toward SIBO seems obtuse after a while, as the authors claim that the symptoms of IBS are caused by fermentation, by bacteria, of indigestible sugars but dismiss the idea that there are problematic bacteria there.

The meat of the book is the tables of what foods you can and cannot eat, depending on which sugars you're not tolerating. There is a comprehensive table of low, moderate, and high-FODMAP foods on pages 44-45, which is the most handy reference (note that there is an error: broccoli is a moderate fructan food, not low). It is recommended that people with IBS follow the low-FODMAP diet strictly for 2 months, then introduce some other foods one at a time to test tolerance. The authors offer advice on how to do this, examples of what you might eat for snacks, drinks, and which alcoholic beverages are acceptable, baking tips, and substitutions for wheat flour. There is advice specifically for vegans, vegetarians, diabetics, celiacs, and children. I should warn you that the diet is very restrictive in that there are very few vegetables you can eat and fruit is also limited, more in quantity but less in variety than vegetables. To give you an idea, I have 60 vegetable soups in my repertoire, and only 14 are low-FODMAP -and that isn't even considering onions and garlic, for which I substitute oils.

But the low-FODMAP diet relieves symptoms in 75% of those with IBS. It worked wonders for me, so I highly recommend trying it. I have some criticisms of this book, however. One, as I mentioned, is its indifference to finding and treating the causes of IBS. No one would want to stay on this diet forever, as it is difficult to get adequate vitamins and minerals due to the restrictions on fruits and vegetables. Unlike most medical diets, low-FODMAP restricts foods that are your primary sources of nutrition, not only filler foods like grains, sugar, and dairy products. There is no mention that fungal overgrowths can also cause IBS. There is no mention of IBS symptoms that are not confined to the GI tract, namely neurological and inflammatory symptoms. For me, it was the neurological symptoms associated with fructose malabsorption that led me to seek and find this dietary solution. Also no mention that all of this fermentation of non-absorbed saccharides increases the permeability of the intestinal wall, causing some nasty systemic symptoms that are more alarming than IBS.

In any case, the diet is very helpful -or the principles of it are. The sample diets are too low in vegetables and absurdly high in carbohydrates. Very bad if you have an intestinal overgrowth. But I've been on the low-FODMAP diet for 4 months now, so I offer some tips: (1) They are not kidding when they say that minute amounts of onion can cause trouble. Don't eat anything that has onion or garlic powder or unidentified "spices" in it, even in the smallest amount. You don't want one onion molecule. It took me months to identify and eliminate all onion contaminants. (2) You can cook with onion and garlic oils for flavor. Fructans are not soluble in oil. The botulism scare concerning garlic oil is from uncooked oil. If you cook garlic in oil, that will kill any and all nasty organisms. I substitute ½ teaspoon garlic oil for 1 clove garlic and 2 tablespoons onion oil for 1 large onion. (3) Remember that it is the total FODMAP load for each meal or sitting that matters. Even low-FODMAP foods can cause symptoms if ingested in huge quantity. Don't eat two moderate-fructan or moderate-polyol foods together. (4) You may want to eliminate moderate-fructan and moderate-polyol foods entirely until you are symptom-free, as you may not tolerate them as well as the authors suppose. (5) You can eat the green tops of onions, leeks, and related plants. The book mentions scallion tops, but I contacted the Department of Gastroenterology at Monash University to make sure that this was true of leeks as well. They said up to 1.5 cups of leek greens could be eaten. I use leek greens in place of onions to flavor vegetable and chicken broths for soup. (6) You will find that many fruits and vegetables are not mentioned in this book. You can sometimes find fructose/glucose numbers in online nutrition databases, so you can determine for yourself if a food is suitable. But there is no resource for fructan content. Monash University has a FODMAP smartphone app that may be helpful. I don't know how often they update it. (7) Don't bother with hydrogen breath tests for fructose or lactose malabsorption. The question isn't whether you have fructose or lactose malabsorption. You probably do. Most people do. The question is whether they are causing your symptoms. (8) If you don't tolerate heavy cream or half & half, or if you want to make your own lactose-free milk, a company called Seeking Health makes lactase drops. Let them sit in your dairy product for 24 hours to break down 70% of the lactose or 48 hours to break down 96%. There is a downloadable data sheet on Seeking Health's web site. (9) The book is not clear on what spelt bread products are suitable. It's sourdough spelt bread that has been proofed overnight so that the yeast has consumed all of the fructans.
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58 of 60 people found the following review helpful
on August 14, 2013
An amazing book - detailed, but easy-to-understand. It gives all you need to implement the diet - what foods to eat at first, and what to reintroduce once you are at a healthy-feeling baseline. If you've been diagnosed with fructose malabsorption or IBS, but can't find reliable info about what you should eat, this is the most-reliable resource out there. This book is an updated version of Food Intolerance Management Plan, including the latest research results, recipe measurements in both cups and grams, and replaces some recipes that have ingredients that are difficult to find outside Australia. A family member went low-FODMAP a year ago, and has gone from feeling icky every day to feeling healthy every day. If you never feel healthy, it's nearly impossible to pinpoint your trouble-foods. This helped us get to a healthy-feeling baseline, so any problem-foods could finally be isolated. The low-FODMAP diet has been such a gift to our family!
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47 of 49 people found the following review helpful
on August 27, 2013
I would like to add to the other very thorough reviews. This book provides very practical information. I have had it for about two weeks and it's already helping! I have suffered from IBS for years and have quite a few materials on the subject. I think the most surprising thing that I learned so far is how my favorite "healthy" staples have been contributing to my symptoms. For example, some items for me are: apples, blackberries, whole wheat bread (gluten), broccoli, Greek yogurt, and agave to name a few! I can literally feel the difference. I use this book in conjunction with Patsy Cotsos's IBS: Free at Last! Both have been very informative!
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38 of 44 people found the following review helpful
on August 12, 2013
I have lived with IBS for many years. This book is both helpful and informative. It answered many of the questions that I had regarding why certain foods made me ill. The best part of the book is the categorizing of fruits, vegetables and legumes by likelihood to cause IBS issues. And also the role of gluten and wheat in stomach ailments. This is the best book that I have found on IBS.
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9 of 9 people found the following review helpful
on December 17, 2013
I have literally spent thousands trying to treat my ibs and this book finally has shown me the light at the end of the tunnel. This book is crammed full of information and can be quite daunting to read at first. I felt overwhelmed but if you pace yourself and really stick to the guidelines you will get results. This has not cured my ibs but instead has really explained the science behind why certain foods make me sick while others do not. I highly recommend this book to anyone that has a digestive disease! in order for this book to work for you, you will need to take everything into consideration, that includes getting tested for fructose mal- absorption, lactose intolerance and other tests recommended in the beginning of this book. Be your own advocate! many doctors will tell you these test are un necessary.. in the end its your health, you decide!
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19 of 22 people found the following review helpful
on November 9, 2013
The book is good, but the diet did nothing to alleviate my IBS. I guess it works for some people, but that it's really an individual thing. For me, the triggers are dairy, sleep deprivation, and stress, and fermentable polysaccharides don't make a difference. The good news is that I can eat a lot of fruits and vegetables that the Low-FODMAP diet warns against. It's worth trying the diet to find that out, but you don't need the book until you've reason to believe you're going to stay on the diet for a long time. There's a good FODMAPS app for iPhones that is easier to carry around. I'm recycling my copy of the book in the hopes it will help someone else.
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26 of 33 people found the following review helpful
on August 26, 2013
Firstly a disclaimer: this book claims to present a "revolutionary plan for managing IBS and other digestive disorders" and nothing in this review should be viewed as medical advice or a recommendation!

What works for one might not work for another but the book is said to feature the first and only scientifically proven diet of its kind, backed by clinical trials noting that up to three-quarters of affected adults who reduced their intake of FODMAPs -- a set of difficult-to-digest carbohydrates found in wheat, milk, beans, soy and certain fruits, vegetables, nuts and sweeteners -- also saw improvement in their IBS symptoms. Consult with your healthcare provider if in doubt, but perhaps those who suffer from IBS will know what has (or has not) worked for them to date and will be willing to give it a try. At least you are only modifying your food input, rather than mixing bottles of chemicals together and hoping for success.
Right, the boring legals out of the way, what do you get? Before you even can get in the kitchen there is a lot of reading ahead of you - nothing seems to be left to chance. From a look at how food can interact and cause problems with your digestion and common illnesses, one gets introduced to the concept behind a low-FODMAP diet and how you can introduce it to your lifestyle without too much upheaval. Special focus is also given to vegetarians, vegans and those suffering from other illnesses such as diabetes and celiac disease. After a quick look at suggested menu plans and methods for "keeping on track" it is straight down to the recipes. Throughout the book the text seems to be fairly clear, understandable and focussed. Many dietary books could learn from this approach.
The recipes themselves are split into typical chapters that you'd find in other recipe books (appetisers and light meals, salads, soups, stews and curries and so on). You are not exactly deluged with each recipe class but there seems to be a sufficiently broad selection to get you going and give some variety within your diet and, of course, as you become more au fait with things and if you find that the dietary programme works for you, you can then tailor make other recipes with the knowledge already gleaned. Mind you, even if you don't have a specific health problem that this diet can (purportedly) help with, many of the recipes are rather good generally. The first one, "Feta, Pumpkin & Chive Fritters" jumped out of the page for being pleasantly different and when served up with a salad it could be a great lunch in its own right. Excellent food photography helps really draw you in and you if you had just opened this book up in the middle, you would be forgiven for just thinking you've a great general recipe book in your hand. It doesn't feel like it is trying to be "special" or "different". There are many recipes that this diet-sceptic reviewer is looking forward to try.
Individually each recipe is clearly written with a brief explanation or various hints and tips. No jargon or broad assumptions here so both "beginner" and "accomplished cook" alike will find that these recipes just work. It would have been nice to have had an estimation of preparation and cooking times (one of our usual niggles) but maybe you can't have everything. At least the measures are in dual metric and U.S. imperial, an all-too-common oversight in many books it seems. For those who need to track such stuff, there is also a detailed per serving nutritional information breakdown.
So, as explained at the start, no opinion can be given as to the efficacy of the dietary programme, but it certainly is a more approachable, more manageable and relatively "low maintenance" approach. If the "theoretical" side works for you, then you will have no problems with the cooking side. By looking at the list of recipes alone you would not have thought that they were "special dietary dishes" - maybe you can find something that the entire family can enjoy and what your body will allow you to enjoy.
In any case, the book is reasonably priced and should you not get on with the diet in any case, you still have a great source of recipes for the rest of your family (and maybe some of the recipes also cooperate with your body too!).
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6 of 6 people found the following review helpful
VINE VOICEon May 25, 2014
There is some very good information in The Complete Low-FDMAP Diet. I enjoyed the first few chapters and the charts that listed good and bad food. However some of them were confusing and I would have liked to see them placed together instead of in different parts of the book. I have not tried any of the recipes but some looked interesting. Since I cannot eat soy and most of the flour mixes contained soy flour I could not use them. Soy is such a big problem for people today that I did wish the author had suggested a substitute for it's use.
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8 of 9 people found the following review helpful
TOP 1000 REVIEWERVINE VOICEon September 2, 2014
This is what you need if you have a celiac or gluten-intolerance diagnosis, you're very diligent about following the diet, and you still have, um, let's call it, "unpredictable" digestion.

Personally, I've had complications from celiac--specifically microscopic colitis; years ago, when immodium started to get scarce, I finally noticed and went to a gastroenterologist and, at his advice, followed the Finer Protocol. (Three months of a ton of Pepto.) I got better, but not completely better.

In desperation, because you can no longer buy immodium anywhere, I went lactose free--and then I found this, because of a blogger friend of mine, who actually edited this book. This is the final key. I'm symptom free, for possibly the first time in twenty years.

I feel like I'm not sick anymore--it's changed my identity. I'm a former professional athlete, and I haven't felt like this in decades. I feel like I could climb mountains, again, literally.

If you're following the gluten-free diet, you're pretty sure you don't have complications like microscopic colitis or lactose intolerance, and you're still occasionally getting sick--this is the magic bullet. It is the cure for fructose intolerance IBS.
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5 of 5 people found the following review helpful
on October 29, 2014
I am gluten free and understand the fodmap principle, which the book explains very clealy.The diet requires careful label reading at the grocery store. Few of us realize that onion and garlic, said to be major offenders, are in many spice mixes and condiments. I was surprised to see onion listed as an ingredient in national brands of mayo and ketchup. Staying on the elimination diet for two months requires a dedication similar to a weight-loss plan. Some of the recipes are inventive, but a lot of them seem to lack flavor and trying to cook without onions and garlic is challenging. How do you make a good spaghetti sauce without them? Most of the recipes for baked goods call for specialty flours and I know from sad experience that they are expensive and may be used rarely. I think the book should de-emphasize sucrose, granulated sugar, high doses of which can cause digestive symptoms. And some sources disagree about which foods should be avoided. For instance, one source indicated that arugula and avocado are high fodmap foods while another source says they are okay in moderate amounts. One source says to strictly avoid beans and lentils, while another says that canned beans and lentils are safe if thoroughly rinsed. I also think more research is needed, but if the diet helps some people over their misery, then it is worth trying and if you finally discover which foods actually bother you -- which can be tricky -- you can return to your regular eating pattern sans those foods. Much easier than a gluten-free diet, which is for a lifetime.
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