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The Complete Low-FODMAP Diet: A Revolutionary Plan for Managing IBS and Other Digestive Disorders Paperback – August 13, 2013
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“This detailed, yet easy-to-understand book is written by the two gurus of FODMAP, a scientifically proven dietary treatment that’s rapidly gaining recognition around the world. This book is the roadmap for eliminating problem foods and reintroducing items to find the customized food plan that works specifically for you. More than 80 gut-friendly, gluten-free recipes are included.”
“[Shepherd and Gibson's] book does a nice job of explaining how and why a low FODMAP diet would be beneficial to many IBS patients. Their in-depth experience with the subject permeates throughout the book, as they offer many practical suggestions for following the diet, including food lists, meal plans, recipes and tips for navigating real-life situations. What makes this book a stand-out is the stunning photography and a sense that following a low FODMAP diet can actually be luxurious! . . . If you are interested in following a low FODMAP diet for your IBS, this book should absolutely be on your bookshelf. If you like to cook, you will want to keep it in your kitchen! . . . Choosing low FODMAPs foods offers such a wonderful alternative to a bland diet, and more importantly, allows you to take in the kinds of foods that are helpful for improving digestive health. This book will definitely guide you in fitting the diet into your lifestyle in a way that feels easy and natural”
—Barbara Bolen, PhD, IBS.about.com
“IBS has been a daunting problem for patients and their physicians for years. We have seen many drugs and different dietary fads come and go. So, it is wonderful that this solution has been developed for many patients with IBS: a diet based on sound scientific and physiological mechanisms. Combined with good medical care that includes testing for small intestinal bacterial overgrowth and fructose and lactose intolerance, the low-FODMAP diet can be individualized, liberalized, and tailored to each patient. This book also provides a great deal of information as to how the diet can be truly indulged in!”
—Peter H. R. Green, MD, Professor of Clinical Medicine and Director of the Celiac Disease Center at Columbia University
“The low-FODMAP diet has revolutionized my practice and has helped so many of my patients. If you suffer from irritable bowel syndrome and choosing food is a challenge, this splendid book is a must-have survival guide. Begin your journey back to good gut health by using food as medicine. Kudos to Drs. Shepherd and Gibson!”
—Gerard E. Mullin, MD, Associate Professor of Medicine and Director of Integrative GI Nutrition Services at the Johns Hopkins University School of Medicine, and coauthor of The Inside Tract: Your Good Gut Guide to Great Digestive Health, http://thefoodmd.com
“For those with celiac disease who continue to have digestive issues, The Complete Low-FODMAP Diet is a must-read. Drs. Shepherd and Gibson do a tremendous job both in identifying the foods responsible for digestive distress and in offering a personalized approach to a balanced diet free from those triggers. With science-based information and easy-to-follow recipes, this book delivers the why and how that people are looking to know.”
—Alice Bast, President of the National Foundation for Celiac Awareness (NFCA)
“Drs. Shepherd and Gibson have truly created a complete reference guide about the low-FODMAP diet. The book offers evidence that supports the use of the low-FODMAP diet to manage digestive symptoms, especially IBS. The authors walk you through precise diets, recipes, and menus to put the diet into practice. The recipes are easy to follow and the illustrations are quite breathtaking. I strongly recommend this book for all IBS sufferers.”
—Jeffrey D. Roberts, MS Ed, BSc, Founder of IBS Self Help and Support Group
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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.
I purchased The Complete Low FODMAP Diet to help me identify common food triggers for IBS. I was amazed with the information and began the elimination diet plan immediately. I kept a detailed eating diary and followed the instructions. My condition improved as soon as I eliminated the high FODMAP foods.
The book is nicely organized, easy to understand, and includes some good recipes.
Also, I only received $8.00 of my $18.00 purchase in refunds :(
There is no table that lists what foods are low FODMAP, medium FODMAP and high FODMAP. To figure it out you have to search for other websites online or do a lot of guessing.
Page 38 says that you really should start with NO FODMAPS but in reading through the book I cannot figure out how that is possible. Are there foods with no FODMAPS? The book doesn't say anything about that again. And considering that this is a low-FODMAP diet, I struggle to understand how it can ask me to do no FODMAPS without telling me how.
The meal plans in the back contain tons of highly-processed recommendations and assume that "gluten-free" options are going to be just fine without giving further information on what to look for in the gluten-free labels. Gluten-free does not equal FODMAP free but the book won't tell you that.
Many of the recipes in the back are packed with sugar and there are no breakfast recipes in the back--not very helpful.