181 82 996KB
English Pages 187 [118] Year 2021
The FODMAP diet How to get rid of abdominal bloating and overcome irritable bowel disorders John Olivier
Summary Summary INTRODUCTION CHAPTER 1 A lot of misinformation The digestive system and the absorption of foodGut reactions to food Allergies vs. food intolerance Food hypersensitivity Irritable Bowel Syndrome (IBS) How is it diagnosed? What are the causes? Chronic inflammatory bowel diseases CHAPTER 2 What are FODMAPs? History of the low-FODMAP diet Who is the low-FODMAP recommended for? The Benefits CHAPTER 3 How does the low-FODMAP diet work? ELIMINATION REINTRODUCTION MAINTENANCE What to eat in the elimination phase Which foods to avoid foods Safe The rules of the reintroduction phase CHAPTER 4 Some myths to
diet
dispel More fiber ... or not? Dairy matter CommonMistakes CHAPTER 5 Frequently Asked Questions All foods allowed and to be avoided Conclusions RECIPES Breakfast Appetizers and Salads First dishesSecond Desserts and Snacks
INTRODUCTION You will surely have read that the INTESTINE can be defined as our second brain,as if the word itself resembled a small head inside our belly! Irritable bowel syndrome is a functional disease affecting about 10-20% of the population and its symptoms very often include abdominal pain and alterations in bowel regularity. The causes are still quite uncertain and numerous factors have been implicated, including an alteration in the motility of the intestine, an altered communication between the brain and the "digestive tract", an increase in abdominal sensitivityand some psychological variables. In the 1990s, although symptoms were proven to arise or worsen after a meal, the prevailing belief was that food played a secondary role in IBS, but rather doctors believed IBS was caused by abnormal activity and hypersensitivity in the gastrointestinal (GI) tract, with significant contributions from psychological factors such as depression and anxiety. Unfortunately, doctors in those years received little or no training on the role of diet and nutrition in the management of gastrointestinal disorders such as IBS (Irritable Bowel Syndrome). Patients were usually told to eat smaller meals, reduce their intake of fatty foods, and eat more fiber. These recommendations were the standard of care for irritable bowel sufferers until the new century. Unfortunately, both patients and doctors have become increasingly frustrated with the inconsistent results obtained from these recommendations. The difficulty in obtaining useful dietary advice from doctors and other healthcare professionals and the growing interest in more comprehensive approaches to managing irritable bowels have led many patients to take matters into their own hands with highly restrictive do-it-yourself diets. And potentially dangerous. Several "unique" IBS diets have received attention over the years, but very few of these have been based on clear scientific rationale or have been found to be effective in high-quality
clinical research studies. Therefore, as in all pathologies not yet fully known, even irritable bowel syndromeoffers patients few effective therapeutic solutions. Food, contrary to what was previously thought, plays an essential role and most of those suffering from this syndrome describe some foods as causes of intestinal symptoms. And even today we often try to eliminate certain types of food to relieve ailments. For example, since gluten and dairy products have often been cited as the culprits of intestinal problems, including uncomfortable abdominal pain and swelling lately, many try to avoid bread, pasta and dairy products. In fact, many people tend to feel better and less swollen by doing so. The reason for this, however, is not attributable to the elimination of gluten and milk derivatives but, rather, to the elimination of FODMAPs also present in wheat and milk. Unfortunately, however, there is no one-size-fits-all solution as reactions to food change from individual to individual. However, the low-FODMAP diet certainly offers a viable therapeutic alternative for many patients, changing doctors 'views on the role of diet in managing irritable bowel syndrome and replacing initial skepticism with enthusiasm based on' evidence. In fact, there have been many testimonies of patients who have returned with considerable improvement, demonstrating that this diet is a "rescue" strategy intended exclusively for those who have failed all other therapies. In particular, the presence of FODMAPs in food was able to clarify how swelling, pain and constipation / diarrhea can occur even in the absence of pathological causes (allergies to certain foods, intolerances to certain foods or nutrients such as lactose, dysfunctions obvious organic ...) Thanks to this, today science is able to provide a completely natural highly effective solution; moreover it is possible to work at a strictly dietary level on FODMAPs even if a certain competence and needed nutritional and
gastroenterological mastery is to do it well and correctly This book was created to provide concrete help to allow readers to follow this diet and find relief from these disorders that affect the social life of those affected. The acronym is formed by the English terms Fermentable Oligosaccharides, Disaccharides, Monosaccharide’s and Polyols (oligosaccharides, disaccharides, fermentable monosaccharide’s and polyols) which indicate some simple sugars that are fermented by intestinal bacteria. The first part of this book is more theoretical and will first explain how the digestive system works, an essential point to understand the connection with nutrition and intestinal disorders. Next you will find an analysis of inflammations and chronic diseases, useful for understanding your problem more deeply. The third chapter will provide you with the foundation for understanding the logic of a low-FODMAP diet and its application process. You will be introduced step by step through the stages of the diet, understand its benefits and learn more about foods, how FODMAPs affect the digestive system. There are not many scientific studies supporting the FODMAPs diet and they have all been performed on small groups of patients and for short periods of time. However, the scientific evidence has led to the conclusion that this diet can only be recommended for patients determined to resolve the gastrointestinal symptom process that torments them, but only under the supervision of an expert dietician to avoid restrictive do-it-yourself diets that a in the long run they could cause damageto your body. Here, after an initial phase of restriction, you will carry out challenges in which you will try to reintroduce FODMAPs into your diet based on the
results obtained. This will eventually lead to a modified and personalized diet in the long term, replenishing previously eliminated foods based on your tolerance for certain foods. There is also an extensive FAQ section at the end of the book with many valuable answers to the common problems encountered by the reintroduction phase. We therefore hope that you will find in these pages some useful tips to find intestinal harmony, as well as to improve your relationship with food. If at the end of the path the results are as effective as we believe, you will surely have a more satisfying social life and you will also feel physically fitter. In fact, remember that health starts from the intestine!
CHAPTER 1 A high percentage of the population suffers from intestinal functional disorders of a chronic nature which, due to their persistence and intensity, compromise the quality of life in the social, work and emotional fields. Among these disorders, the most commonly diagnosed is Irritable Bowel Syndrome (IBS). Because it is not possible to identify a well-defined cause through medical tests, the diagnosis of IBS is based on a number of symptoms such as abdominal pain, swelling and changes in the hive. In addition, environmental and lifestyle factors associated with psychological distress and tension can also favor the onset of symptoms. In fact, one of the reasons why chronic abdominal disorders are particularly problematic is because it can take a long time to find the exact cause of the problem (years if you are not well guided), that is, to arrive at the correct diagnosis. The problems are essentially two: The same abdominal disorders can have many different causes. Understanding the right one isn't easy
A lot of misinformation People often wonder if some foods themselves cause chronic problems like bloating, pain and constipation / diarrhea. So you try to eliminate for example milkor pizza or certain vegetables, etc... And for some people this actually has a significant result. But why then do some foods that are often associated with ailments for some people don't cause problems in other people? This leads us to think that the explanation must then be sought not simply in the individual foods but in the way in which they interact with us: so we must ask ourselves if the cause of the disorders should be sought in individual allergies and intolerances.
People associate their diet with aggravation or the appearance of symptoms and modify their diet by eliminating certain foods. The attention paid to foods as possible factors of gastrointestinal disorders has therefore led to an increase in recent scientific studies, which have focused in particular on some molecules present in various categories of foods. According to studies, in fact, these molecules worsen the symptoms of IBS patients. These substances are indicated by the English acronym FODMAP which stands for“Fermentable oligo-, di-, mono-saccharides and polyols rather”, or “fermentable oligosaccharides, disaccharides and monosaccharide’s and polyols”. These are very small and active carbohydrate molecules that are poorly absorbed in the small intestine and quickly fermentable by the intestinal flora, so in people with a higher intestinal sensitivity, they create disorders attributable to IBS. Before addressing specifically what foods contain FODMAPs and how a low-FODMAP diet works, we must first understand how the gastrointestinal system is structured and how the digestive process works.
The digestive system and the absorption of food As you know, digestion includes the set of mechanical and biochemical processes in which the food introduced is transformed into nutrients capable of being assimilated. In humans, the digestive system is divided into food channels such as the mouth, pharynx, epiglottis, esophagus, and the organs involved in the process: stomach, liver, pancreas, small intestine (i.e. duodenum, jejunum and ileum) and large intestine (cecum , colon and rectum). The various parts of the digestive system have a specialization to better perform specific tasks. We can certainly say that digestion begins in the mouth: the teeth grind the food and the tongue kneads them together with an enzyme present in the saliva called ptyalin; mixed food is called a food bolus. The latter passes
from the esophagus to the stomach thanks to peristaltic contractions. In the stomach, the bolus is then mixed with the gastric juice and transformed into chyme. The last stages of the digestive process take place in the small intestine (or small intestine) and also involve the liver and pancreas; the liver produces bile and the pancreas in turn produces pancreatic juice. Under the action of digestive enzymes, the transformation of carbohydrates into glucose, of lipids into fatty acids and monoglycerides, and of proteins into amino acids takes place. The absorption of these nutrients occurs through the intestinal barrier where food, which had been transformed into simple molecules by the digestion process, enters the cells that line the digestive system. Nutrients pass into the blood and are transported to the body's cells where they will be used for energy and tissue building. Digestion then ends in the large intestine (also large intestine), an organ measuringjust under two meters and made up of three parts (cecum, colon and rectum). In the large intestine, water, vitamins and mineral salts are absorbed. Undigested materials pass into the rectum and are expelled through the anus. In this process, the intestines must also protect the body from exposure to toxic or bad things. The entire process of mixing and moving the contents around the gut is controlled by a complex of nerves in the gut wall known as the enteric nervous system or "gut brain". The ENS detects what is going in the intestine and controls its motility (i.e.,muscle activity and its coordination). The brain can affect both our perception of what is happening in the gut and the activity of the ENS. The interaction between the brain and the gut is different for each individual and can depend on factors such as mood, surrounding environment, presence or absence of distractions and past experiences, as well as the sensitivity of the gut to stimuli.
Gut reactions to food Understanding how the human digestive system works helps to understand how food affects the digestive system and consequently the adverse reactions of the gut. As we have seen, the intestine, or rather the entire digestive system, is a very complex system that affects all other systems such as the immune system, the nervous system and more. Therefore the digestive system extends into many aspects of our health. And so taking care of the digestive system and introducing healthy food rather thanjunk food can also mean the difference between life and death. Every component of the digestive system is affected by what you eat on a daily basis. Just like with any other organ in the body, the cells of the digestive organs don't function well without proper nutrition. There are also bacteria in the gut that help maintain a healthy gut. They are called good bacteria because they promote the proper functioning of the body. Most people have between 300 and 500 different species of bacteria living in their digestive tract that help improve immune system function, fight obesity, and improve symptoms of depression, among many benefits. However, digestive system imbalances and disorders promote the production of bad bacteria and the consequences are obviously harmful. Imbalances can be caused by insufficient sleep, antibiotic therapies, and high levels of stress, the introduction of too many processed and highsugar foods. Among the signs that indicate an imbalance in the microbes present in the gut are stomach pain, sudden weight changes, constant fatigue and skin irritation. Unfortunately, most of the world's population is not eating enough nutritious food, preferring foods that contain little or no nutritional value.
This unhealthy lifestyle and related unhealthy eating habits can have a surprising number of negative effects on the body. They can explain the feeling of tiredness you may experience on a daily basis, the reason for frequent headaches, or even why you have difficulty sleeping. However, the potentially dire consequences of poor nutrition don't end there. Everyyear, studies show that what you eat can influence your risk of developing or preventing type 2 diabetes, stroke, cardiovascular, kidney, obesity and other conditions. In this book, as already mentioned, we will focus on the reactions of the intestineto food. Let's analyze them one by one.
Allergies vs. food intolerances The terms food allergy, food hypersensitivity and food intolerance are often used interchangeably and incorrectly. There are two very different types ofadverseevents food reaction: Immunological reactions. These are reactions to a protein found in food and involve the immune system. This type of reaction, often called a food allergy or food hypersensitivity, is quite rare (affecting about one in fifty people). These are reliable responses to particular foods that occur even after consuming only a small amount of food. Non-immunological reactions. These reactions do not involve the immune system and are usually referred to as food intolerances. They are very common (affecting about one in five people). Disorders can vary and depend on the amount consumed, meal times and other meals consumed on that day.
Food hypersensitivities
As mentioned, food hypersensitivities, including food allergies, are immunological reactions to a specific component of a food (called an allergen). Symptoms includehives, asthma, runny nose, and swelling in the mouth. In severe cases, these allergens are life threatening due to a reaction called anaphylaxis, in which the circulatory system collapses. Or people with food allergies may experience intestinal symptoms, but they are usually fewer than the other symptoms. The foods that usually cause these reactions are shellfish, eggs, fish, milk, tree nutsand peanuts, seeds, soy, wheat, rye, barley and oats. In the case of allergies, the body reacts to the first contact with the allergen present in that food, there is the formation of specific antibodies, called immunoglobulin’s E (IgE), which have the task of defending the organism from what the latter recognizes as a stranger. Following the reaction between the “allergenic” food and the antibody, the histamine main responsible for the characteristic symptoms of all allergic reactions such as itching or breathing difficulties is released. These symptoms can be very serious and endanger the patient, appearing within minutes of ingesting the allergen. Food intolerances are the most common trigger of bowel symptoms, but can also cause other symptoms, such as headache and fatigue. The diet low in FODMAPs is a valid ally for all people suffering from Irritable Bowel Disorders. I wrote this book to help you fully understand this eating style and thus help you understand what your ailments are due to and how to alleviate them. However, intolerance is often confused with allergy as the symptoms are similar (hives, diarrhea, vomiting ...) but differs in some characteristics: It does not involve the immune system, It can be associated with components present in food or substances contained in food, It can derive from metabolic characteristics of the person who consequently cannot introduce certain foods (eg lactase deficiency inthe case of lactose intolerance),
The severity of the pathological manifestations depends on the quantity of food eaten. Finally, unlike allergy, intolerance is not an irreversible condition, itcan only persist for a few months / periods.
Irritable Syndrome (IBS) Bowel Irritable Bowel Syndrome (IBS) is part of a group of chronic functional gastrointestinal disorders that together affect about one in five people. By functional we mean disturbances in bowel function but without the presence of identifiable physical characteristics, such as ulcers, inflammation, tissue thickening, lumps and bumps, or altered blood tests. Diagnosis of functional disorders is based on the types of symptoms and their context, such as how long and when they occur. Most people with food allergies do not have IBS. Food hypersensitivity may be at the root but symptoms are more easily triggered by foodintolerance.
How is it diagnosed? IBS sufferers can experience a wide range of symptoms, including abdominal pain,bloating, abdominal pain, heartburn, nausea, and so on. Specifically, since the diagnosis is based on symptoms, we recall that swelling is defined as the sensation of increased pressure in the abdomen, while distension is a measurable change in the circumference of the abdomen. Swelling and distention typically increase for IBS sufferers during the day and after eating. Distension and swelling can be experienced simultaneously or separately. Additionally, excessive amounts of fluid and gas in the intestines are the most common cause of distension, particularly when the distension and swelling varies in severity throughout the day. How much liquid is retained in the intestine and how much gas is produced largely depends on what food is eaten. Some of the symptoms mentioned originate in the upper part of the digestive system (esophagus and stomach) while others originate in the intestine. Other perceived symptoms include flatulence, a sense of incomplete evacuation, noisy abdomen (noises are called borborygmi), and pain in the rectum. Fatigue is also common and its intensity usually depends on that of the intestinal symptoms. Some people experience
muscle pain, while others experience an "irritable bladder" (urinary frequency and urgency). This syndrome is diagnosed in the presence of these symptoms for at least six months, often blaming them all together. It is important to point out that the doctor will investigate the symptoms you are experiencing and, in case the symptoms started after the age of fifty or if there is blood in the stool, fever, weight loss of more than five kilograms, ailments that wake you up. Night, or a strong family history of colorectal cancer will do more in-depth examinations (blood tests, colonoscopy etc) focusing on other causes, as these latter symptoms are not part of IBS.
What are the causes? IBS is a multifactorial disorder but the true cause is still unknown: several hypotheses have been advanced to explain a correlation with the symptoms. Among these, we mention: heredity and genetics, alterations in motility and visceral sensitivity, alterations in the intestinal bacterial flora (dysbiosis), intestinal infections, stress and psychological factors and components of the diet. Genetic factors. We know from a study carried out on groups of families from the United States that there is a significant association between having first degree relatives with IBS and the onset of IBS. Intestinal infections: the manifestation of IBS following episodes of bacterial gastroenteritis has been documented several times. Some of these episodes were related to the ingestion of pathogens via diet. Stress and other psychological factors. These can affect the enteric nervous system by altering the way nerve signals come from the gut, then transmitted and interpreted by the brain and spinal cord. The links between the brain and the ENS are
collectively called the brain-gutaxis; Intestinal dysbiosis: some studies have shown the presence of qualitative changes in the intestinal microbial flora in IBS patients, so these can lead to the proliferation of bacterial species that produce more gas and short-chain fatty acids and that cause an inflammatory state of the mucosa intestinal with a consequent increase in its permeability and the triggering of immune reactions and inflammation. Alterations in gastrointestinal motility: IBS presents specific changesin the motor function of the small and large intestine. In the colon, the faces proceed until evacuation, through a succession of slow waves that regulate the rate of contraction of muscle cells. Impaired motility in IBS is manifested by a change in the frequency of muscle contraction. Given the correlation of foods with IBS, it remains to wonder why not everyone has IBS. Everyone's gut has a different combination of bacteria, and some bacteria are vigorous fermenters, while others produce less gas. Furthermore, the ailments depend on the visceral sensitivity of our intestines. This is more pronounced in some people. The feeling of bloating depends on how tuned our ENS is and what degree of distension occurs before experiencing discomfort. Another question is how well our abdominal wall can move gas once it is formed and how far it can stretch. Usually, when a lot of gas is introduced into the intestine, it continues the intestinal transit until it is expelled as flatulence. In some people with IBS, however, the gas simply stays in the intestines, causing more distension. In addition, in people with IBS, intestinal distension can lead to contraction and, therefore, flattening of the diaphragm, which causes more obvious distension and greater discomfort.
Chronic inflammatory bowel disease Some people who experience IBS-like symptoms suffer from inflammatory bowel disease (IBD). Unlike IBS and other functional intestinal disorders, it is a disease in which the intestine becomes chronically inflamed. This can cause diarrhea with possible bleeding, abdominal pain, fatigue and many other symptoms. IBDs include Crohn's disease (which can affect any part of the intestine) and ulcerative colitis (which affects only the large intestine). The causes of these conditions are not known, and treatment is directed at controlling inflammation. Dietary change typically plays only a very small role in this aspect of treatment. It is hypothesized that this is an immunological reaction that can arisedue to an altered interaction between genetic factors of the individual and environmental factors. IBD sufferers whose bowel inflammation is well controlled but whose symptoms continue may also find the low-FODMAP diet a useful tool in alleviating these disorders.
CHAPTER 2 In the previous chapter we analyzed digestion and intestinal disorders, focusing in particular on the most common, namely IBS. The three most common ways to treat IBS are: diet, drugs, psychological therapies for anxiety and stress, as well as some other therapies such as probiotics. Probiotics are living and active bacteria, contained in certain foods or supplements and in sufficient numbers to exert a positive effect on the health of the intestine. Before trying any drug therapy with consequent side effects or supplements, we always recommend that you consult your doctor for a correct diagnosis. Also with regard to the dietary aspect, it is important to verify that a too restrictive and lasting diet does not create harmful psychological mechanisms for the patient. People with IBS (irritable bowel syndrome) often know that certain foods trigger symptoms and wonder what they should do and especially what they shouldn't eat. Dietary change has been shown to be the primary way to avoid the onset of disorders. Unfortunately, it is not always easy for a person to correctly recognize the offending food or foods, as it is not the content of a single food but the total FODMAP content consumed in the meal that determines whether or not symptoms occur. In fact, multiple types of FODMAPs are generally present in every meal, and since they all cause distention equally once they reach the lower small intestine and colon, their effects are cumulative. The low-FODMAP diet has been shown to work for treating both shortand short-term IBS symptoms.
But let's see in detail what FODMAPs are.
What are FODMAPs? Certain components of food cause distension of the intestine by absorbing more fluid and rapidly generating gas when fermented by intestinal bacteria. The solution is to determine which carbohydrates are primarily responsible for gas production in the gut and to limit them. But what are the offending carbohydrates for these ailments? In the previous chapter, these sugars were assigned the acronym FODMAP, which means: Fermentable: rapidly broken down by bacteria in the intestine; Oligosaccharides: fructans and galacto-oligosaccharides (GOS); Disaccharides: lactose Monosaccharide’s: fructose Polyols: sorbitol, mannitol, maltitol, xylitol, polydextroseisomalt and They are therefore carbohydrates that in predisposed subjects create intestinal disorders Bowel recognized as Irritable Syndrome (IBS). These molecules are difficult to absorb and / or digest in the small intestine, for various reasons (slow transport mechanisms, reduced activity or lack of some enzymes, etc.), and this causes them to ferment in the bacterial flora with consequent production of gas. FODMAPs are also osmotic ally active, which means they can draw water into yourgut and thus cause diarrhea. FODMAPs have some characteristics in common: As we have mentioned, they have a slow absorption so they remain inthe intestine without being absorbed; They are very small molecules that cause fluid imbalance,
drawing a lotof water into the gastrointestinal tract and causing muscle contractures. If the molecules are not absorbed by the small intestine, they continue the journey to the large intestine. The bacteria that live there see these molecules for use as fuel and quickly break them down, producing hydrogen, carbon dioxide and methane gas. The fermentation speed differs depending on the molecular chain: oligosaccharides and short-chain simple sugars are fermented very quickly compared to polysaccharides. How many times have you thought that a food was the cause of your gastrointestinal symptoms and yet other times you have consumed it without problems? Most patients often report that they do not understand why the food that once caused the symptoms, resulting in bloating and diarrhea, at other times causedno problems. This really depends on the way FODMAPs behave inside our body. As we have seen previously, FODMAPs cause intestinal irritation problems, andcause symptoms related to several factors such as: Group of FODMAPs consumed; Consumed quantity; Other foods consumed concurrently; Other foods consumed in the previous hours; Specificcharacteristics of the individual; In the case of allergies, the symptoms are triggered when you come into contact with the allergenic substance, even in small quantities and regardless of the factors we have seen in the case of the irritated colon. Let's go through the FODMAPs one by one now. Lactose. It is a disaccharide that is broken down into its two particles of glucose and galactose thanks to the lactase enzyme. This enzyme is present in the border of the intestinal villi but, in the event of a deficiency of this
enzyme, the undivided lactose is fermented by the bacterial flora resulting in the production of short-chain fatty acids and gases such as hydrogen, methane and carbon dioxide. Symptoms are abdominal cramps, bloating, flatulence and diarrhea. Lactose is present in milk, fresh cheeses, ice cream and foods with lactose additives such as cooked ham. Fructose. It is a monosaccharide considered among the triggers of IBS. It is present in honey, fruit and corn syrup. In food it is found both free and bound to glucose to form sucrose, the common cooking sugar. The intestine lacks an enzyme involved in the digestion and transport of fructose. Its absorption is more efficient in the presence of glucose. So fructose malabsorption is more common when it is taken alone rather than together with glucose. In fact, fructose alone causes a greater presence of water in the intestine with a consequent increase in the fluidity and transit of intestinal contents. As with lactose, fermentation also takes place for fructose. The fructans are small fructose polymers present as a deposit forms in grains, in ertain fruits and many vegetables: onion, garlic, artichokes. Our intestine does not have the enzymes for the digestion of these compounds which therefore become substrates for fermentation processes by the ileus and colon bacteria. In particular, fructans with a low degree of polymerization are poorly tolerated by the intestine. Polymerization is the transformation of simple molecules into a large complex molecule, called a polymer, with very different chemical and physical properties from the initial molecules. Fructans are found mostly in wheat, so the major sources are bread, pasta, crackers,biscuits and breakfast cereals. In addition, they are also present in many vegetables such as garlic, leeks, onion, artichokes, asparagus, and chicory roots. In general, all FODMAPs contribute to IBS symptoms, but their quantity depends on the diet to which one is most exposed in various parts of the
world. In Western Europe, for example, fructose and fructans are the most present. The galactans are polymers of lactose very abundant in legumes, such as lentils and beans in other major foods in vegetarian and vegan diets, such as cabbage and brussel sprouts. The polyols are sugars, among which the sorbitol, maltitol and xylitol, poorly absorbed in the small intestine and subjected to fermentation often dependent on the amount consumed. They are present in fruits such as apples, apricots, cherries, pears, peaches, plums, plums, watermelon, avocado; in vegetables such as cauliflower and mushrooms; in sweeteners such as sorbitol, mannitol, xylitol, isomalt and are found in many "sugarfree" foods (eg chewing gum, sugar-free candies, low-fat fruit yogurts, low-calorie desserts, low-calorie biscuits). To conclude this analysis it should be noted that a certain number of tests on individual FODMAPs, especially tests carried out with lactose, fructose and sorbitol, have caused symptoms such as swelling, pain, nausea and altered intestinal transit in many people, but especially in individuals with IBS. . In particular, the most common test applied by doctors to those who experience these difficult to interpret symptoms is the breath test or "breathe test" hydrogen and methane. It is a non-invasive diagnostic test that is carried out by blowing on a tube after ingesting a lactulose, a synthetic sugar, to evaluate any malabsorption or failure to digest the sugars.
Historical notes on the diet low in FODMAP As you have understood, over the years there has emerged numerous evidences that the ingestion of certain short-chain carbohydrates, such as lactose, fructose and sorbitol, fructans and galacto oligosaccharides, induces the typical symptoms of irritable bowel syndrome. For a long time, patients have been advised to avoid these foods in situations of excessive flatulence and bloating. However, the foods were listed without any connection of common components and as mere guesses. As a result, dietary recommendations related to such foods were haphazard and without structure. Subsequently, scientific and technological advances have led researchers to recognize the components of certain foods as responsible for the disorders and were thus induced to test diets low in FODMAPs (now also defined in Italy as a low-FODMAP diet). It was originally developed by a team of researchers at Monash University in Melbourne, Australia. The two researchers who created this diet were Peter Gibson and Sue Shepherd. Notably, after creating a successful form of fructose malabsorption diet in 1999 in her private diet practice, Sue Shepherd became a member of the research team that developed the low-FODMAP diet. Her doctoral research and other studies inwhich she has been involved have shown that FODMAPs can trigger IBS symptoms and, in turn, limiting dietary FODMAPs is proven to be effective. The research was first published in 2005. Since then, scientific data on the effectiveness of the method has accumulated, prompting more and more gastroenterologists and nutritionists / dieticians around the world to use theirapproach. The acronym to describe these short-chain carbohydrates was created as a collective term was needed to encompass them all with the idea of broadspectrum sugars.
Who is the low-FODMAP diet recommended for? First of all, it should be noted that this type of diet is based on temporary restriction and the subsequent gradual reintroduction of foods (especially vegetables) rich in fermentable short-chain carbohydrates. The aim, after seeing a reduction in ailments in the diet, is to determine which foods, in what quantities and with what frequency of consumption, are able to trigger the symptoms. Experts agree that it is useful in the treatment of sore colon, Crohn's disease, ulcerative colitis and other diseases that affect the colon in a chronic or recurrent way. However, remember that the goal of this diet is not to cure but to relieve the symptoms you are suffering from. It serves to buffer the situation acutely. So it doesn't help you lose weight, this is a side effect of reducing bloating and abdominal pain. So then this diet is not suitable for everyone, as the list of foods to be eliminated, at first and to be reintroduced in a limited way at a later time, does not always generate the same effects, with the same intensity in all people. . In addition, it is a very restrictive and monotonous diet and could in the long run lead to nutritional deficiencies. For this reason, it is generally followed for about a month, a time in which, usually, the patient has significant improvements in symptoms, in particular for pain and abdominal swelling. Unlike other dietary approaches that eliminate only a part of the food, in the diet low in FODMAPs, the simultaneous restriction of all foods that can create problems in those subjects suffering from irritable bowel applies. The patient is therefore deprived of the conviction of being intolerant to that particular food since it is not intolerance but malabsorption. Therefore, eliminated foods should not be banned forever but these can, with due care, and this is also very subjective, be reintroduced in the right quantities.
Finally, let's clarify another point: many are convinced that the lowFodmap is a low-gluten diet for those who suffer from a not exactly defined “intolerance” to this protein, without however being affected by celiac disease with certainty. Hypersensitivity to fodmaps and celiac disease are two different things, although the symptoms and reactions to certain foods can be similar. While it is true that wheat, barley and rye are avoided in the FODMAPs diet, the motivation does not depend on the fact that these cereals contain gluten, but fructans (oligosaccharides) that reach the intestine undigested and once fermented by bacteria cause the symptoms of irritable bowel syndrome in predisposed individuals. In fact, in the FODMAPs diet, oats and derivatives are allowed while their gluten content is prohibited in the case of celiac disease, for which the therapeutic treatment always requires the supervision of specialists.
The benefits Reduction of intestinal symptoms and treatment against other inflammatory diseases Individuals who experience chronic irritable bowel syndrome have found disablingside effects for social life, such as bloating, stomach pain, reflux, need frequent useof the bathroom, can ruin dinners and parties, causing the subject to stay indoors. In this regard, the evidence was proven that over 75% of people benefited from the diet low in FODMAPs. In these people there were marked improvements with significant reduction in swelling and better digestion related to greater visceral relaxation and less distension of the stomach. In addition, after the reintroduction phase, this diet often allows you to raise the tolerance threshold towards trigger foods. In addition, in a study of 52 patients with Crohn's disease and 20 patients with ulcerative colitis who followed this low-FODMAP diet for a set
period of time, very effective results were reported. Progressively more enjoyable life By relieving IBS from your eating routine, you can live without fear of embarrassing symptoms of discomfort. It is about a better quality of life and physical well-being that you will feel in yourself! A low-FODMAP diet improves histamine levels A 2017 study found that the low-FODMAP diet improves immune system activation markers, more specifically histamine. Histamine is a signaling molecule in the gut - which is important for alerting the immune system when there is a problem material being introduced into the body. In particular, patients with an irritated colon or inflammatory disease the bowel usually has an overactive intestinal immune system. Therefore, the low-FODMAP diet temporarily eliminates gut bacteria and this could be taken in by the immune system resulting in improved symptoms. However, remember that a healthy lifestyle is the main treatment for IBS. It is essential to avoid stressful situations or learn to manage it, avoid eating fast or nervously, and practice periodic physical activity. These are the principles of a complete treatment for its full benefit. It is also important to avoid tight clothing in the abdominal area, eat a healthy diet without alcohol, coffee, industrial foods, ultra-processed or too rich in hard-to-digest wholegrains.
CHAPTER 3 How Does the Low-FODMAP Diet Work? Unlike many other diets, it is important to point out that the restrictions on the low-FODMAP diet are temporary and can last for as little as a few weeks. Some foods that contain FODMAPs such as fructans are actually beneficial for our gut bacteria. Hence, totally eliminating FODMAPs for months can cause more problems than it solves. Instead, start by cutting out foods rich in FODMAPs and follow the diet as best you can for a short time (2-8 weeks) and then consult a nutritionist or doctor to evaluate the effects it has had on irritable bowel symptoms. Do not continue the diet for months and months without checking the evolution. It is important to check with a professional about 8 weeks after starting the diet to make sure it is working and that it is nutritionally adequate. After the initial period of a stricter low-FODMAP diet, your nutritionist will beable to help you identify which are the most problematic FODMAPs for your body. You will be able to reintroduce FODMAPs into your diet slowly and will only need to moderate the intake of those that your gut is most sensitive to. Therefore, it is important to avoid starting this diet on your own without any professional guidance. While this book is full of information on lowFODMAP diet, irritable bowel syndrome, and recipes you can use, it's not a one-size-fits-all solution to all bowel problems. So, let's see what the phases of this diet are. There are essentially three:
ELIMINATION This phase of the diet can last from 3 to 8 weeks and depends on how the body reacts to the rigorous removal of FODMAP-rich foods from the diet. These foods should therefore be replaced with low-FODMAPs alternatives. Remember that the more carefully you stick to the program, without overstretching, the faster you will get results. You will likely notice improvements from the first week, but it is important to regain lasting intestinal well-being before moving on to the next step, namely identifying problem foods. The first phase therefore involves completely eliminating from your diet all foods with a high content of FODMAPs and limiting those with a medium content, because it is the combined effect of the FODMAPs that causes the symptoms. Remember that alcohol and caffeine should also be avoided during this time. While they are not rich in FODMAPs, they both tend to irritate the intestines and cause flare-ups of irritated colon symptoms. Before this phase of exclusion, we reiterate that it is advisable to perform breath tests to analyze the presence of a malabsorption of fructose and lactose. The resultscould make the diet less restrictive if tests confirm that the fructose and / or lactosecontained in the FODMAPs are well tolerated. Additionally, we recommend that you prepare your food at home during the days of the Elimination Phase, so that you have 100% control over the composition of everything you eat and limit the likelihood of consuming FODMAPs carbohydrates. In these weeks it is essential to minimize the consumption of prepared industrial products but if you plan to consume some, check the labels carefully and avoid the presence of FODMAPs ingredients such as those in
the following list: Wheat, rye, barley, kamut and spelt. Chicory root extract or other prebiotics such as inulin. Fructooligosaccharides / FOS. Fructose, crystalline fructose, high fructose corn syrup. Sorbitol, mannitol,isomalt, xylitol, maltitol Polydextrose, hydrogenated starch hydrolyzate. Molasses. Concentrated fruit juice. On the other hand, at times, there are some ingredients that may put you in doubt as to whether you can consume them during the Elimination Phase. The following list contains other ingredients permitted view of the absence or low carbohydrateFODMAPs: Starch or corn starch Modified starch Starch resistant wheat starch Maltodextrin Carrageenan Guar Gum Xanthan
RETURNED After the elimination phase, you can then reintroduce food gradually high in FODMAPs that were previously eliminated from the diet. It is expected to reintroduce one food at a time every 3-5 days. Patient symptoms should be monitored to see which of these highFODMAP foods triggers an IBS flare-up. This step is important in recognizing the types of high FODMAPs you can tolerate and in what amounts.
You can also reintroduce alcohol and caffeine at this stage. Most people take 6 to 8 weeks to complete the reintroduction phase.
MAINTENANCE In this phase, the patient returns to eating as normal as possible and eliminates or limits only the foods that cause irritation to the colon. At this point, in fact, you should have identified the foods responsible for the ailments and you have the freedom to customize the diet so that you can maintain it for the long term. Now it is important to plan a balanced and nutritious diet to follow, also according to your lifestyle. Over time, you may also try again to consume other foods that belong to a group that had previously caused symptoms.
What to Eat in the Elimination Phase As we explained in the previous chapter, FODMAP stands for oligosaccharides, disaccharides, fermentable monosaccharides and polyols. Therefore, to adhere to the rules of this diet and reap the benefits, all you need to do is identify these types of foods and avoid them for a period. Fermentable sugars are easily broken down and fermented quickly by bacteria in the large intestine. These short-chain carbohydrates are not necessarily harmful per se, not least because they provide nourishment to the necessary bacteria that are present in the intestine. The problem arises when bacteria feed on carbohydrates and convert them to gas.
Which foods to avoid Fruits - Apples, apricots, blackberries, grapefruits, nectarines, peaches, pears, plums, pomegranates and watermelon. Cereals - Barley, couscous, spelled, rye, semolina and wheat.
Foods that contain lactose: milk, custard, ice cream, margarine, soft cheese (cottage cheese and cottage cheese), yogurt (regular and Greek). Dairy Substitutes: Oat milk (however, 1/8 of a serving is considered low inFODMAPs) and soy milk. Legumes - Beans, peas, chickpeas, lentils, chickpeas, lentils, soy and peas. Sweeteners - Table sugar, agave, high fructose corn syrup, isomalt, maltitol, mannitol and molasses. Vegetables - Artichokes, asparagus, beets, Brussels sprouts, cauliflower, celery, garlic, leeks, mushrooms, onions, shallots and snow peas.
Safe food Fruits - Avocado (limited to 1/8 of the total), banana, blueberry, melon, grapes , honeydew melon, kiwi, lemon, lime, olives, orange, papaya, plantain, pineapple, raspberry and strawberry. Sweeteners - cane sugar, maple syrup and powdered sugar Dairy products and alternatives: almond milk, coconut milk (limited to 1/2 cup servings), hemp milk, rice milk, some cheeses such as brie, camembert, mozzarella, parmesan and lactose-free products such as lactose-free milk, ice cream and yogurt, creamy cheeses (such as Philadelphia or robiola) (2 tablespoons); goat cheeses (30 g); aged cheeses (28 g), cheddar, edam, emmental, feta, fontina, gorgonzola, gruyere, pecorino. Vegetables - Arugula, bamboo shoots, peppers, broccoli (limited), carrots, cabbage,corn (limited to half a cob), eggplant, fennel, green beans, lettuce, parsley, potatoes, spinach, squash, tomato, turnip and zucchini.
Cereals: rice, oats, gluten-free products and quinoa.Nuts, almonds (limit of 10), hazelnuts (limit of 10), Seeds: cumin, pumpkin, sesame and sunflower. Meats: Beef, chicken, eggs, fish, lamb, pork and turkey. Seafood - Crab, Lobster, Salmon, Tuna and Shrimp
The rules of the reintroduction phase There are rules in the reintroduction phase: start with small amounts and then gradually increase to avoid negative effects. The first group to be tested for example are polyols. Most people choose to try an avocado or apricots (which contain sorbitol). The recommended amount is 1⁄2 avocado or 2 fresh apricots - if symptoms occur stop and wait until you are symptom-free before trying again or trying a new food. After the avocado / apricot, try some mushrooms and, if tolerated, try cauliflower. You can for example the following order of reintroduction:
FODMAP GROUP POLYOLS 1st week (sorbitol)
FOOD TO BE INTRODUCED 1⁄4 of ripe avocado, or 1 yellow peach or 8 blackberries 2 medium fresh apricots or 4 halvesof dried apricots (contains sorbitol)
2nd week (manitolo)
1⁄2 cup of mushrooms (contains manitol) 1⁄2 cup of cauliflower or 5-6 button mushrooms
LACTOSE (3rd week)
1⁄2 to 1 cup of milk or 200 g of yogurt
FRUCTOSE (4th week)
1⁄2 2 mangoes or 1 tablespoon of honey
FRUTTANI (except onion) 5th week 6th week FRUTTANI (onion only)
2 slices of white bread or 1 clove of garlic 50g cooked onion
GALACTOOLIGOSACCARIDI (7th week)
1⁄2 cup of lentils , beans or chickpeas
beans,
However, the order in which the FODMAPs are reinserted is not important, but itis crucial to ensure that the foods used for the test contain only one type of FODMAP. To give an example: yellow peach is excellent for testing one's sensitivity to sorbitol, while nectarine (nectarine) and white peach are not because they also contain fructans. As you will notice from the table, we will dedicate a whole week to the onion: since this food plays a very important role in the cuisine of all cultures, it is essential to determine your personal level of tolerance. Key points in reintroducing food Try only one FODMAP type at a time. Test one FODMAP group per week. Whenever possible, choose a food that mainly contains one type of FODMAP. Choose the amount corresponding to what you usually consume. Start with a smaller portion first if in doubt, then increase if it hasn't caused you symptoms. Eat the food belonging to that FODMAP group at least twice during the test week, unless the adverse reaction occurs on the first attempt; in that case stop. If no symptoms occur, increase the range of foods that contain the FODMAP you are testing and evaluate the response, or keep the same amount and type of food you tested and move on to the next challenge by trying the next FODMAP group. If you experience symptoms Avoid the suspicious food and wait for the symptoms to pass, then reduce the dose by half and try again, or try another food within the same FODMAP group to confirm that it is one of the offending ones, or if you assume this type of FODMAP is a problem for you limit it, the dose of FODMAP is crucial: if symptoms occur, try half the amount and repeat, but wait until the symptoms are gone before doing so.
Consider trying again in the future as the sensitivity may change over time.
CHAPTER 4 Some myths to dispel In the age of the internet, of shared information and easy access and availability, the greatest difficulty is to decide whether the information is truthful or not, if it is based on evidence, or if it is myths or simply the someone's opinion. Surely the way to be sure about the basis of the information is to rely on articles published in famous journals and on scientific studies. The intention in writing this book is precisely to access these sources and present you with the most important and up-to-date scientific results. Below we propose some myths related to food and IBS, debunked by the most up-to-date scientific evidence.
More fiber ... or not? It often happens to read blogs or to find patients who have changed different specialists, trying various dietary therapies based on large amounts of fiber but without success. The latest research shows just the opposite, in fact only 9% of people who follow a diet based on fiber improve the symptoms of IBS. Fiber is undoubtedly an important element in our diet, precisely because it acts both on the transit and in the metabolism of intestinal bacteria. These bacteria feed on fiber to produce substances that are beneficial to the body such as short-chain fatty acids, nourishment for the cells of the intestinal wall and much more.
Therefore, introducing fiber is essential in all types of diets. However, for those suffering from irritated colon and in sensitive individuals it is precisely the fiber that can cause the typical symptoms as in the case of FODMAPs. For people suffering from irritable bowel syndrome, scientific studies have shown that excessive consumption of fiber does not improve typical gastrointestinal symptoms, such as bloating, pain, diarrhea or constipation. The general recommendation is to use fiber-based supplements only if necessary and, if necessary, the fiber should be non-fermentable (i.e. without FODMAPs). For example, the fiber to use, if you are sensitive to FODMAPs, are supplements containing methylcellulose, but it is also possible to remedy with alternatives to foods rich in dietary fiber that do not contain FODMAPs, such as brown rice, rice or corn bran, polenta or oatmeal, oat bran, potatoes with skin, allowed fruits and vegetables, etc. Remember that the recommended daily dose of fiber is 25-30g in adults, after which the symptoms may worsen and you will also have made a large unnecessary expense of supplements.
Dairy issue There is a very controversial issue about the consumption of milk and its derivatives for those suffering from irritated colon. As mentioned earlier, lactose intolerance is caused by reduced levels of the enzymelactase, which has the function of digesting lactose. However, the ability to produce lactase is different for each individual, so there is no single approach that works for everyone and with the same effectiveness. Furthermore, it is important to point out that dairy products are very nutritionally complete foods and therefore their total elimination does not seem to make much sense in a balanced diet.
On the other hand, studies have shown that each of us has a limit of absorption andtolerance, so that, except in extreme cases, a certain amount of lactose can be tolerated and this depends on the person, on the food introduced (the amount of lactose varies in cottage cheese or mature cheese). FODMAPs give problems if taken cumulatively: for example, lactose is bad when taken after a pizza with onion, a salad with artichokes and apple and all accompanied by drinks with a high fructose content. In conclusion, before eliminating milk and dairy products from our diet, it would be a good idea to undergo the breath test to make sure we are intolerant and possibly, it is important to be aware that all dairy products do not contain the same amounts of lactose. Coffee, soy and vinegar We are all aware of the stimulating capacity of caffeine, which we are used to consuming just when we need energy, but few know (and are therefore surprised) that coffee contains FODMAPs. In fact, coffee contains galactans which, accumulated in several cups a day, give the same quantity of a plate of beans! As for soy, attention should be paid to products made from whole soy beans, wherethe amount of galactans is significant. Different is the speech of the soy protein, whose products will not contain galactans, as the carbohydrate part is discarded. Finally, vinegar contains an excess of fructose depending on the type. For example,apple cider vinegar contains a lot of free fructose, so it should be taken in moderation. Other types of vinegar contain HCFS (high fructose corn syrup), so product labels should be read very carefully.
Common Mistakes You've been on the low-FODMAP diet for a while, your bowel symptoms
have improved, and apart from a few snags, you're pretty strict. However, it happens, especially in the evening or after lunch, to sometimes feel a bit of swelling which you cannot explain. If you started the low-FODMAP diet only after a diagnosis of irritable bowel syndrome (as we recommend), if you are not overly stressed and do not consume excess alcohol, caffeine or smoking, you may still run into these mistakes common. 1- Ignore Recommended Amounts As we have already mentioned, portions are an essential element in this type ofdiet. For example, a food that is considered to be low in FODMAPs in small portions (such as spinach and fennel) is high in FODMAPs in larger doses. It is therefore not enough to know that spinach is low FODMAP, because more than 150gr. contain high amounts of oligofructans. 2- Beware and Too Much Fiber Resistant Starch Rice (and to a lesser extent other grains) cooked and left to cool contain large amounts of resistant starch, which is fermented by our gut bacteria, causing bloating. Due to its high fermentation, it should be limited if you suffer from irritable bowel. So watch out for not ripe bananas, potatoes and grains (especially rice) that should not be allowed to cool too much. Similarly, as we have mentioned, if you suffer from ailments, it is necessary to review the doses of fiber (soluble and insoluble) taken. In fact, together with fructose, lactose and polyols, fibers are also considered among the most difficult carbohydrates to digest. 3- Accumulation Effect When it comes to FODMAPs, the so-called "accumulation effect" matters a lot. It is one of the reasons why we often feel more bloated in the
evening: the effect of the FODMAPs ingested throughout the day builds up and causes us to feel more bloated. What do you have to do in these cases? First of all, we must understand that not all foods classified as low FODMAP are the same: we have already had the opportunity to explain that some foods should be limited more than others. By now you know that FODMAPs are carbohydrates, therefore almost all foods that contain carbohydrates (not only cereals, but also fresh fruit, nuts, dairy products and vegetables), even those low in FODMAPs, are fermented in our intestine. In fact, intestinal bacteria feed on carbohydrates. This is why, on the contrary, proteins (eggs, meat, fish) and pure fats (oil or ghee), not containing carbohydrates (and therefore FODMAPs), are potentially not fermentable. It goes without saying that if you have a carbohydrate-only meal (cereals, fresh and dried fruit, vegetables), even if low FODMAPs, it will have a significant FODMAPS load compared to that of a meal that also includes proteins and fats. This is to let you know that if you have mostly consumed carbohydrates during the day, you may feel more bloated. 4- Beware of the labels Have you purchased “free from” products, but have intestinal disorders reappeared? FODMAPs are not allergens, so they are not bold on the label or written on the front of a package. Incidentally, some are not even individually labeled in the ingredients - have you ever seen the word "flavorings?" 5- Not Getting Enough Movement In addition to managing stress, remember that diet is only one way to relieve intestinal ailments. You've by chance focused all your attention on the low-FODMAP diet and now you're wondering "why are my IBS symptoms still so out of control?" How far do you really move? Even if you hit the gym 3-4 times a week, you still need those 30 minutes of walking on rest days to make sure your
gut can benefit. 6- Do you think gluten-free products always meanlow-FODMAP The diet is not a gluten-free diet but rather a diet that excludes high amounts of wheat. However, not all gluten-free products are low in FODMAPs. Why? Take gluten-free bread for example. Some brands make gluten-free bread with honey (high FODMAP), agave (high FODMAP), inulin (high FODMAP), bamboo fiber (not yet tested), molasses (high FODMAP), and other ingredients. 7Staying too long in the elimination phase of the FODMAP diet A healthyand varied diet is essential to keep the gut healthy, therefore experts in the field of digestive health suggest that it is important NOT to stay on the low diet for long. By FODMAP. If you stay on a diet, you may be missing out on healthy foods and food groups that protect your health and keep your intestinal flora balanced. Some FODMAPs are prebiotics and probiotics in nature (good for our gut). Prebiotics can promote the growth of good bacteria in the gut and limiting prebiotic fibers in the long term is not recommended. By maintaining the low-FODMAP diet over the long term you can also compromiseyour intake of fiber, calcium and B vitamins
CHAPTER 5 Frequently Asked Questions After analyzing what it consists of, what are the phases of the lowFODMAPs diet, in this section we will give guidelines by answering the frequently asked questionsthat may arise? At this point, you will have already understood that this is not a life-long diet, but it is about following the elimination phase of foods high in FODMAPs only for the time necessary to relieve symptoms, for a period that usually goes from 3 to 8 weeks in order not to compromise the bacterial flora. It is then recommended to reintroduce tolerated foods in appropriate quantities. It is possible for many people to return to their usual diet, with the sole precaution of avoiding large quantities of a few foods that are high in FODMAPs. Also remember that this diet is a big change for you in terms of nutrition and shopping habits. Therefore, it is important to become actively aware of the foods you are eating and especially aware of the ingredients written on the labels to know exactly which ingredients you are putting into your body. Keep in mind that information regarding FODMAPs on food labels can be difficult to find and therefore you should do more careful research so that you can get the most out of this diet. A good idea is to start keeping a food diary, certainly not to count calories but to list the ingredients you ate in a day. In addition to this, I suggest that you also log a few sentences about how you felt right after each lowFODMAP meal you ate and any symptoms over the next two days. Doing this every day will help you better keep track of which foods you
can tolerate and which foods, even some low-FODMAPs foods you need to cut out of your diet for now. Finally, try to record other factors that may be contributing to bowel symptoms. If you are very stressed in your life or if you are in your period, write it down so you don't mis-attribute all your symptoms to the foods you are eating. Now let's see what the doubts are and frequently asked questions regarding this diet: How much fruit is allowed and at what times of the day? You can eat fruit during meals or between meals, as you like. For each meal or snack, limit yourself to only one portion of fruit allowed. Paying attention to the quantities and letting 2 or 3 hours pass between each intake, you should not experience any discomfort.
What types of meat and fish are recommended? And what about fats? All meats and all types of fish are allowed, as they do not contain sugar, and therefore no FODMAPs. Be careful though that we don't have garlic or onion sauces. Fats and oils do not contain FODMAPs or animal-based protein foods, as well as eggs. However, plant-based protein foods such as legumes contain FODMAPs and you may need to limit your intake of these foods.
If I am a vegetarian, what vegetable fibers can I consume? What if I'm vegan?Following the FODMAP approach without introducing meat is quite complicatedsince legumes, which are a fundamental part of vegetarian diets, contain GOS (galactosyl-oligosaccharides) and fructans. It is therefore necessary to eliminate them or limit their quantity, depending on the type of legume. You can easily consume about 1⁄4 cup or 45 g of canned lentils or chickpeas, well rinsed, because they contain less FODMAPs than dry ones.
You can also eat: tofu and tempeh, quinoa, eggs, dried fruit (except pistachios and cashews) and, to a limited extent, seeds (such as sunflower seeds), aged cheeses (such as Parmesan) and lactose-free milk. If I have diabetes, is the FODMAP diet right for me? Yes sure. On the other hand, many of the rules of this diet correspond to those recommended for people with diabetes. For example, it is required to regularly eat lighter meals that are well distributed over the course of twenty-four hours, and to limit the consumption of prepackaged foods. In the menus offered from the first to the third week, the division of sugars during the day and in the same way the division between sugars, proteins and lipids at each meal, have also been designed for those suffering from diabetes. I am celiac. Is the FODMAP approach right for me? There may be people who not only suffer from irritable bowel, but are also glutenintolerant or have celiac disease; in that case, gluten is an additional problem. The point that unites the gluten-free diet and the low FODMAP diet is that bothavoid foods containing wheat, barley, rye. Obviously you can consume gluten-free pasta, however you have to pay attention to other gluten-free products (biscuits, crackers, tortellini, ravioli, etc.) which often contain ingredients belonging to FODMAPs and in the low FODMAP diet we try to maintain a consumption of foods with low in FODMAPs. The main difference is that gluten is a protein while irritable bowel symptoms are due to certain carbohydrates. When you consume food with gluten and it causes a disturbance, it does not mean that the cause is gluten. It means, that the food consumed also had a high FODMAP component which triggered the reaction. For example, wheat has oligo-fructans and GOS, and these are the causes of IBS symptoms, not the gluten in wheat. Although irritable bowel and celiac disease have some symptoms in
common, the former mainly involves the large intestine or colon. When food with high FODMAP content passes through the colon of a subject predisposed to irritation, this becomes "irritable" resulting in the ailments we know. Fortunately, it does not cause damage to the intestine. Celiac disease, on the other hand, is an autoimmune disease, which mainly affects the small intestine. When a person who is celiac ingests food containing gluten, it causes an attack by the immune system which leads to damage to the small intestine. In conclusion, we can say that the gluten-free diet is absolutely necessary for celiacs, while the low FODMAP diet is for those who suffer from irritable bowel. Gluten-free products can be consumed by IBS sufferers only when the ingredients are low FODMAP. For example, if you suffer from IBS but not celiac disease, you can consume oat flakes without any problem, but not apples, honey or legumes, which do not contain gluten. Can the FODMAP approach help me lose weight? The low-FODMAP diet is not intended to help you lose weight, but if you suffer from excess gas it can help you get your "flat stomach" again thanks to the disappearance of bloating. It is possible that by consuming fewer prepackaged foods you will lose weight, but it is not insured. If I exclude a lot of fiber, will I end up suffering from constipation? When you change your eating habits, there is always a risk of constipation, but if you follow the guidelines and recipes proposed here you will get enough fiber to not suffer from it. Also, don't forget to drink enough water and exercise to facilitateintestinal transit. How do you read the labels so as not to make mistakes? It is important to read the labels carefully to make sure the product has a low FODMAP content. As already explained above, the FODMAP approach is based on tolerable quantities, and not on the presence or absence of a given food. As ingredients appear on labels in order of importance and weight, check the position relative to FODMAPs or a food
rich in FODMAPs in the list. If, for example, you find "fructose" at the top of the ingredient list of a gluten-free bread, you shouldn't buy it. On the other hand, if it is in 10th position, it almost certainly means that this bread does not contain much fructose, and therefore you can take it. Can cooking change the final FODMAP content in food? No. The amount of FODMAP generally does not change after cooking. Is it really necessary to avoid onion and garlic? Onion is one of the main culprits of IBS symptoms as it is rich in fructans and is an essential part of cooking. It is therefore necessary to completely ban it during the elimination phase, even in minimal quantities. Its "similars" such as leeks, shallots and the white part of spring onions should also be avoided. It is also necessary to exclude everything that could contain them: for example, broths, soups and ready-made sauces. As for the use of onion, leek, shallot and the like, unfortunately there is no definitive solution, since they must not only be eliminated as ingredients, but we must also make sure that they are not present in the products we usually buy, as for example in spice mixtures, broths, sauces, marinades and so on. When you use onion for cooking, a large portion of the FODMAPs go into your preparation. It is therefore not enough to remove the onion after cooking. To rediscover the flavor of the onion, you can use the green part of the spring onions and the chives, added at the end of cooking.. The garlic also contains fructans, but if you really want to add it, we suggest you season for a minute the oil by browning a whole clove. This way you can use the flavored oil, but without the garlic. How can I adapt my recipes? To follow the low-FODMAP diet, you need to make some major changes in the kitchen, but the alternative can be just as tasty. First of all, it is
necessary to replace garlic and onion with aromatic herbs and spices to flavor savory dishes, with the advantage of being able to reduce the amount of salt and therefore reduce the cardiovascular risk. In addition to following the aforementioned instructions regarding onion and garlic, you can also add a little asafoetida to your dishes, an Indian spice with an onion-like flavor and, if desired, young onion sprouts also give a lot of flavor. However, it is better to check your tolerance. Another alternative we suggest is to replace the onion with small amounts of fennel, which is also aromatic. How can I eat at the restaurant? During the elimination phase it is preferable not to eat in a restaurant. Later, you will be familiar enough with the FODMAP approach to choose the right dishes at the restaurant - just bring a reminder of the foods allowed and the foods to avoid. Many restaurants now offer gluten-free menus, you just need to explain to the waiter that you want a gluten-free meal, plus no garlic or onion. Here is a selection of courses with low FODMAP content in the different cuisines of the world. ITALIAN: Gluten-free pasta carbonara or with pesto (without garlic) Grilled meat, chicken or fish with polenta and grilled or boiled vegetablesGluten-free pizza with tomato sauce and lowFODMAP ingredients Tuna salad, ham. CHINESE: Fried rice and rice noodle dishes, without garlic or onion JAPANESE: Sushi and sashimi, avoiding ingredients with a high FODMAPcontent (for example: avocado, asparagus). Avoid tempura that contains wheat.
MEXICAN: Chips, nachos and corn tortillas Tacos ofox or chicken Tamales (steamed corn) Avoid beans and guacamole because of avocado Be that as it may, even if a little deviation from your diet happens and you experience symptoms, you can always always get back on the right path. What if the FODMAP approach doesn't work for me? This approach usually works in 75% of cases. For the remaining 25%, the results are modest or nil. Sometimes this may be due to an incorrect observation of the diet (see paragraph on common mistakes), but it is also possible that foods other than FODMAPs are responsible. Keeping a food diary can be invaluable in helping to find out which foods are the offending ones. We also advise people who suffer from IBS but have not achieved satisfactory results with the FODMAP approach to work on their anxiety by adopting good relaxation practices. Is a "FODMAP list" really enough? However, knowing which foods contain more or less FODMAPs is not enough to give those suffering from "irritable bowels" a definitive solution. As explained, DIY gives few results that are often unbalanced from a nutritional point of view and that is why the patient turns to specialists and dieticians to obtain a personalized and balanced diet. There are many aspects to take into consideration on the condition of the person, on his past and current medical history: over the years a method that subjects the patient to tests / questionnaires on which the experts are able to tailor the diet has proved to be satisfactory. How can I balance my glucose and fructose intake? If you need to avoid excess fructose, consuming glucose at the same time as fructose could reduce the severity of your symptoms. You should be
aware, however, that this strategy is not recommended. How much glucose you need to consume in conjunction with fructose depends on the amount of food you are eating and what other foods you have recently consumed at the same time. The best way is to make trial and error to determine the amount of glucose needed to avoid suffering from irritable bowel symptoms when eating a food that has an excess of fructose. However, this strategy is unlikely to help when consuming excess fructose foods and other FODMAPS at the same time.
All foods allowed and to avoid
TO AVOID LIMIT
ALLOWE D
WatermelonPeach figs Cherries Mango Plum More ApricotsPears Apples
Coconut Pomegranate Avocado
Pineapple Mandarins Strawberries Blueberries Lemons Oranges Kiwi Bananas Raspberries Lemons
Asparagus Cauliflower Artichokes Garlic Onion Mushrooms
Sweet potatoesBeet Red Celery Corn canned Cabbage Broccoli
Tomatoes Spinach Potatoes Carrots Pumpkin Cucumbers Lettuce Zucchini
Barley
Rice
Farro and derivativesRye Grain Kamut
maize
Oats
corn Flakes Amaranth
Never Millet Quinoa
Buckwheat milk Yogurt
Cottage cheese
Yogurt / lactosefreemilk Hard cheese Mozzarella Feta
Conclusions First of all I want to thank you for reading this book. It is not easy and it really takes courage on your part to take this first step to take back the reins of your life and your daily routine. By reading these pages you will certainly have realized that the lowFODMAP diet is not a "forever" diet. In fact, if you follow the guidelines correctly, you may be able to go back to eating your favorite foods in a matter of weeks! This book is intended to help you familiarize yourself with and address all three stages of the diet correctly and how to start re-integrating the higherFODMAP ingredients back into your diet so you can be sure you are relieving gut symptoms. As mentioned earlier in the book, your digestive health shouldn't be controlling your standard of living. Nor should it control the quality of your life. You should be able to live your life to the fullest without worrying about irritable bowel symptoms. You should be able to live every day without suffering from incapacitating symptoms that devour your energy and good mood, without suffering from daily aches and discomforts. The low-FODMAP diet can put you on the right path to take control of your digestive health and break free from the shackles of IBS. I sincerely hope you have gained valuable insight into how this diet can work for you and how you can adopt it into your life with as little effort as possible. Next, all you need to do is get to work. It can be difficult, especially in the beginning when eliminating the foods you know and love from your diet, but I know you can do it! Have the same confidence in yourself. The perks are definitely something worth trying if it means getting better.
Secondly, this book has a large variety of recipes that you will have many options for meals and snacks that taste so delicious that you will forget you are on a diet. Each recipe has a description, a list of what you'll need, and instructions on how to prepare the meal, and some low-FODMAP shopping tips, so you always get the best ingredients for your gut. All of the meals in this book will also help you maintain good nutrition while on a diet. Good luck with your low-FODMAP journey, and feel free to leave an Amazon review, telling me more about how this diet has helped you!
RECIPES Changing your diet is never easy, even when you are highly motivated, as habits always act as a major obstacle to change. In particular, when starting a low-FODMAP diet, there is the added challenge of having to cope with the lists of allowed and not recommended foods. Unlike other trendy diets, the aim is to find a concrete solution to better manage thesymptoms. At first it may seem very technical and complicated, because many foods must be avoided and this implies a certain rigor in the choice of foods to buy and in the meals to prepare. However, with the right pairing, it is possible not only to decrease IBS-related symptoms, but also to enjoy food again. Here are the low-FODMAP recipes we have chosen for you… they're so yummy you'll be looking forward to trying them! For the sake of clarity, in the following recipes, the nutritional values are intended to correspond to the average values per portion.
Breakfast
Banana bread Servings: 2 people Difficulty: Simple Preparation time: 1h
Calories Fats Proteins Carbohydrates Fibers Sugars
170 6g 2g 28 g 2g 7g
Ingredients: 70 g hazelnuts 300 g brown rice flour 65 g corn starch (cornstarch ) 2 teaspoons of bicarbonate ¼ teaspoon of salt ½ teaspoon of cinnamon 4 tablespoons extra virgin olive oil 85 ml maple syrup 3 bananas 1 tablespoon lemon juice
Preparation: 1- Preheat the oven to 180 ° C after lightly greasing a square pan of 23 cm on the side. 2- Prepare the egg substitute. It is prepared with: 2 tablespoons of flax seeds and 170 ml of water. You have to grind the seeds, put them in a bowl, add water and wait 5 minutes. 3- Grind half of the hazelnuts well and chop and the other half. Put the first in a bowl. Add the rice flour,cornstarch, baking soda, salt and
cinnamon. 4- Mix well. 5- In another bowl, put the oil and maple syrup. Pourin the egg substitute, mashed bananas and lemon juice. Mix well and then incorporate the two preparations in the other bowl, mixing until a homogeneous mixture is obtained. 6- Add the finely ground hazelnuts. 7- Pour the mixture into the pan and bake. 8- Cook forabout 45 minutes. 9- Check the cooking with the help of a toothpickuntil, when extracted, it is dry and clean. 10- Remove from the oven and let it cool for at least30 minutes before removing the bread from the pan. 11- Let it cool for at least another 30 minutes before serving.
Mini crêpes with Matcha Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates
240 16 g 5g 20 g
Ingredients 1⁄2 cup / 50 gr potato starch. 1⁄2 cup / 50 gr rice flour. 1 teaspoon matcha powder (green tea originating from China and used as a spice or dye) 2 egg 1 cup / 200ml almond milk Preparation: 1- In a large bowl add the flour, potato starch andmatcha and mix. 2- Include the eggs and beat until all blended. 3- Gradually pour in the vegetable milk while beating.4- Leave to rest for at least 15 minutes. 5- Pour some batter into a hot non-stick dish with aspoon. 6-
Cook over medium heat for 2-4 minutes and
flip. 7-Cook for another time and place on a plate.
Sweet omelet with almonds andstrawberries Servings: 2 people Difficulty: Simple Preparation time: 20 minutes
Calories Fats Proteins Carbohydrates Sugars
186 4g 8g 11 g 7g
Ingredients: 250 grams of strawberries 2 spoons of coconut sugar, divided 1 teaspoon of vanilla extract 6 eggs 1⁄4 - cup 40 grams of almond flour 1 tablespoon of coconut oil 1⁄4 - cup 60 grams of cottage cheese, optional A handful of almonds, shredded 1 teaspoon of poppy seeds Preparation: 1. Cut some strawberries and put them in a bowl. 2. Cut the rest of the strawberries in the center and sprinkle 1 tablespoon of coconut sugar over the strawberries. Set the split strawberriesaside until finished. 3. Add the vanilla, eggs, 2 tablespoons ofcoconut sugar and almond flour to a bowl. 4. Beat vigorously until the eggs are softenough.
5. Soften the coconut oil in a round pan or differentgriddle over medium heat. 6. With circular movements around the liquefied oil cover the bottom and then incorporate the mixturewith the egg into the pan. 7. Add the chopped strawberries and then thericotta and half of the almonds. 8. Still using the hob, reduce the heat to low and cook for about five minutes or until the omelet is compact. 9. Continue for another 5 - 8 minutes. 10. Remove from the grill, cover with the rest ofthe almonds, strawberries and poppy seeds and serve immediately.
Green Tea Smoothie Servings: 2 Difficulty: Simple Prep Time: 5 minutes
Calories Fat Protein Carbohydrates Fiber Sodium
240 4g 8g 42 g 7g 8 mg
Ingredients 2 Ripe Bananas 1 teaspoon matcha (green tea powder), or more totaste 4 teaspoons of maple syrup 8 tablespoons of lactose-free yogurt50 cl of lactose-free or almond milk
Preparation 1. Crush the banana on a saucer, 2. Add the matcha and put it in the glass of the blender orkitchen mixer. 3. Add the maple syrup, yogurt and milk. 4. Blend for 1 or 2 minutes at high speed to obtain ahomogeneous mixture. 5. To serve.
Appetizers and salads
Tomato and feta cheese salad Servings: 2 people Difficulty: Simple Preparation time: 10 minutes Calories Fats Proteins Carbohydrates Fiber Sodium
170 14 g 5g 7g 2g 420 mg
Ingredients 2 cucumbers 10 g dill, or other aromatic herbs (mint, coriander,etc.) 12 radishes Salt Pepper 2 tablespoons of vinaigrette sauce
Preparation 1. Cut the cucumbers into sticks, drain well, 2. Sprinkle them with salt and let them drainfor about 15 minutes. 3. Rinse and dry well. 4. Meanwhile, chop the dill and put it in a bowl. 5. Slice the radishes and add them. 6. Add the cucumbers too. 7. Season with a pinch of salt, a little pepper and thevinaigrette sauce.
8. Mix and serve.
Watercress and orange salad Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
85 7.5 g 1g 4.5 g 1g 18 mg
Ingredients 1 orange 2 spoons of extra virgin olive oil 1 tablespoon of vinegar 1 teaspoon of mustard Salt Pep per 1 bunch of watercress 1⁄2 teaspoon of pink pepper (optional)
Preparation 1. Wash and dry the oranges and then grate the peel. 2. Put the grated peel in a bowl. 3. Add the oil, vinegar and mustard. 4. Beat everything with a fork. 5. Add a pinch of salt and pepper. 6. Wash and dry the cress and place it on plates. 7. Peel the oranges, divide the wedges and arrangethem on plates. 8. Pour the sauce over it, garnish with pink
pepper(optional) and serve.
Mixed salad and strawberries Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
80 7.5 g 2g 2.5 g 1g 22.5 mg
Ingredients 100 g of mixed salad 80 g of strawberries 18 g of mozzarella 2 tablespoons of vinaigrette sauce 1/2 teaspoon of balsamic vinegar Salt pepper
Preparation 1. Put the mixed salad in a salad bowl after washingand drying it. 2. Add the strawberries to the salad after washingand drying them. 3. Cut the mozzarella into small pieces and add it. 4. Pour the vinaigrette sauce into the salad bowl with the balsamic vinegar and a pinch of salt andpepper. 5. Mix well and serve.
Roasted peppers and tomatoes Servings: 2 people Difficulty: Simple Preparation time: 15 minutes Calories Fat Protein Carbohydrates Fiber Sodium
132 12 g 1.5 g 6.5 g 1g 170 mg
Ingredients 2 red or yellow peppers 3 tomatoes dried tomatoes ( in oil), chopped 2 chopped anchovy fillets 1.5 teaspoons of capers 12 tablespoons of pine nuts (optional) 6 black olives 3 tablespoons of extra virgin olive oil 1/2 tablespoon of balsamic vinegar 1/2 tablespoon of juice lemon 1/2 tablespoon of parsley base 1 tablespoon of chives, chopped Salt pepper
Preparation 1. Cut the peppers into quarters and clean them wellfrom seeds and filaments. 2. Place them on the hot barbecue grill with their skin turned towards the grill. after about 5 minutes, turn the peppers and cook them for another 2-3 minutes 3.
. Alternatively, place the whole peppers in a
pan and bake for 30 minutes at 220 ° C. 4.
After cooking, place the peppers in a bowl, cover them and let them cool for about ten minutes to remove the skin.
5. Then cut them into strips and place them on a serving dish. 6.
Add the sliced tomatoes. Drain the dried tomatoes and anchovies, chop them and incorporate together with the capers, pine nuts (optional) and olives.
7. In a cup, mix the oil, balsamic vinegar, lemon juice, parsley base, chives, a pinch of salt and pepper. 8. Beat with a fork and pour over the sauce. To serve.
First courses
Pasta carbonara Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
215 6.5 g 7.5 g 29.5 g 1.5 g 125 mg
Ingredients 160 g of gluten-free penne60 g bacon, diced 1 egg Salt Pepper 15 g butter 1 tablespoon of grated Parmesan
Preparation 1. Cook the pasta in boiling salted water. 2. Brown the bacon in a non-stick pan. Oncecooked, place it on absorbent paper to remove some of the fat. 3. Break the eggs into a bowl, with a pinch of saltand pepper, and beat them well with a fork. 4. Drain the pasta and pour it into the bowl. Stirquickly to cook the eggs in contact with the pasta.
5. Add the bacon, butter and Parmesan grated. 6. Finally serve.
Spaghetti with citrus pesto Servings: 2 people Difficulty: Simple Preparation time: 15 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
265 11.5 g 6.5 g 34.5 g 2.5 g 245 mg
Ingredients 5 basil leaves ½ orange 23 g of almonds 25 g of capers 4 anchovy fillets (optional) ½ tablespoon of lemon juice ½ tablespoon of maple syrup 2 tablespoons of extra virgin olive oil 160 g of gluten-free spaghetti Salt
Preparation 1. Wash and dry the basil leaves or, if they are not dirty, gently clean them with a damp cloth and dab them between 2 sheets of absorbent paper. 2. Peel the orange, remove the white filaments and put it in the blender together with the almonds, capers, anchovies (optional), basil, lemon juice and maple syrup.
3.
4. 5. 6.
7.
Blend until you get a homogeneous mixture. Finally slowly add the oil and continue to blend until creamy. Put the pesto in a bowl and cover with a drizzle ofoil to prevent oxidation. Close tightly with a lid or cling film. Keep refrigerated until consumed. While cooking the spaghetti, transfer the citrus pesto to a bowl and add 4 or 5 tablespoons of the pasta cooking water. Drain the spaghetti and put them back in the cooking pot. Season with the pesto, mix well and serve.
Thai-style rice and meat noodles Servings: 2 people Difficulty: Simple Preparation time: 15 minutes
Calories Fat Protein Carbohydrates Fiber Sodium
183 6.5 g 13 g 18 g 1.25 g 260 mg
Ingredients 1.5 tablespoons of lime juice 1 tbsp fish sauce 1 tbsp olive oil 1 tbsp sugar 1/2 chilli 200 g sirloin steak 60 g rice noodles 115 g broccoli ½ carrot, grated 45 g soybeans 1 tbsp mint, finely chopped salt
Preparation Marinate the meat 1. Pour the lime juice, fish sauce, oil, sugar and chilli into a bowl. 2. Mix everything well. 3. Take 2 tablespoons of this marinade and put them in a bowl and set the rest aside. 4. Arrange the meat and turn it over to sprinkle it
well with the marinade. 5. Cover and leave to rest in the refrigerator for an hour. 6. Cook the spaghetti and broccoli 7. Cook the spaghetti al dente in a pot of boiling salted water. Drain them and pour them into a bowl. 8. Cook the broccoli al dente in a pot of boiling salted water. Drain them and put them in the saladbowl. 9. Add the carrot, bean sprouts and mint, season with the reserved marinade and mix. 10. Cook the meat on the barbecue or in a pan and cutinto thin slices. Then arrange them in the salad bowl.
Seconds
Turkey burger with cheese Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
185 7g 15 g 15 g 2.5 g 250 mg
Ingredients • ½ stalk of celery, coarsely chopped (35 g) • 225 g of turkey or ground chicken • 1⁄2 tablespoon of oregano • 1 teaspoon of mustard • Salt • Pepper • 20 g of gorgonzola • 4 slices of gluten-free bread (180 g) • 1 teaspoon of olive oil • 1 teaspoon of ketchup (optional) • 1 teaspoon of mustard (optional)
Preparation 1. Put the first four ingredients in a bowl. Add saltand pepper as required. 2. Mix first with a fork and then with your hands. 3. Create 4 burgers. 4. Divide the cheese and place it in the center of the hamburger. 5. Overlap the other 2 burgers by pressing on
theedges to close the cheese well inside. 6. Cook in a previously oiled pan or grill. 7. After about 5 minutes, turn the burgers and cook for another 5 minutes, until the meat iscompletely cooked. 8. Insert each hamburger between 2 slices ofgluten-free bread. 9. Serve with mustard andketchup to taste, adding a lettuce leaf and tomato wedge if you like.
Chicken caesar salad Servings: 2 people Difficulty: Simple Preparation time: 20 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
185 10 g 20 g 2g 1,5 g 165 mg
Ingredients 300 g of chicken breast 3 tablespoons of flavored oil garlic 2 chopped anchovy fillets 1 yolk 1 teaspoon mustard 1 teaspoon Tabasco sauce 1 tablespoon vinegar 20 g bacon, diced 1/2 romaine lettuce Salt Pepper 2 tablespoons grated Parmesan
Preparation 1. You can cook the chicken on the barbecue or onthe grill of a preheated oven. 2. Sprinkle the chicken with a little oil, salt andpepper and cook for about ten minutes, turning it halfway through cooking. 3. When it is well cooked and golden, place it
ona cutting board and cover with aluminum foil. 4. Pour a tablespoon of garlic flavored oil intoa saucepan over low heat. 5. Add the anchovies, stirring with a spoon for a minute until they are dissolved. 6. Put the egg yolks in a bowl, along with the mustard, Tabasco sauce and vinegar. Stir vigorously with a fork and then slowly pour in the garlic flavored oil, whisking until emulsion. 7. Add the oil with the anchovies and season withsalt and pepper. 8. Heat the bacon in a non-stick pan. Once browned, place it on absorbent paper to removesome fat. 9. Wash and dry the lettuce and put it in a saladbowl after having cut it up. 10. Incorporate the bacon, season with the sauceand mix well. 11. Cut thin slices of chicken and place them on the salad. Sprinkle with Parmesan and serve.
Chicken Piccata Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fiber Sodium
150 6.5 g 17 g 5g 0.5 g 130 mg
Ingredients 300 g of chicken breast 2 tablespoons of cornstarch (cornstarch) 28 g of butter 1/2 tablespoon of olive oil 2 tablespoons of lemon juice 3 tablespoons of hypoallergenic vegetable broth 1 tablespoon of capers ½ tablespoon of chopped parsley Salt Pepper
Preparation 1. Cut the chicken breasts in two and open them toobtain the escalopes. Beat them with a meat grinder. 2. Sprinkle it with salt and pepper and then flourin the cornstarch. 3. Place the oil and half of the butter in a skillet over medium-high heat.
4. When the oil and butter are hot, add the scallops, one at a time, and cook for 3 minutes on the side. 5. Remove them when they are ready and place them on a warm plate in the oven, covered withaluminum foil. Repeat with the other escalopes. 6. Lower the heat to medium-low and add the lemon juice, vegetable broth and capers to thepan. 7. Bring to a boil, scraping the bottom well with aspoon to recover the accumulated meat juices. Season with salt and pepper. 8. Return the escalopes to the pan, cover and cook for 3 minutes over low heat. Remove them and place them on a tray. 9. Add the remaining butter to the pan and mix vigorously with a spoon to dissolve the juices andmake a sauce to pour over the escalopes. Sprinklewith the chopped parsley and serve.
Poached eggs and ham Servings: 2 people Difficulty: Simple Preparation time: 15 minutes Calories Fat Protein Carbohydrates Fiber Sodium
198 11 g 11 g 12.5 g 1.5 g 505 mg
Ingredients 200 g of potatoes 3 eggs 6 cl of cream cooking 5 g dill, chopped Salt Pepper 1/2 tablespoon olive oil 1/2 tablespoon white vinegar 1/2 orange 15 g butter 2 tablespoons white wine 1 tablespoon Cointreau, or Grand Marnier (optional) 130 g smoked ham, cut into 4 slices 1/2 teaspoon of chives, chopped
Preparation Prepare the potato mash 1. Bring to the boil the potatoes whole, without peeling, until very tender (about 20 minutes). 2. Drain them, peel them while still
hot, put them in a bowl and mash them well. 3. In a bowl, beat 2 eggs and then add them to the potatoes. Add the cooking cream, dill, a pinch of salt and pepper. 4. Mix well and then let it cool until it is compact enough to form two flatbreads. 5. Heat the oil over medium-high heat in a heavybottomed skillet. Then put the flatbreads and cook for 3-4 minutes on the side, until golden brown. 6. Put them on a plate and keep them warm in the oven. Prepare the poached eggs 7. Fill a shallow, large saucepan with water. Add the vinegar and bring to a gentle boilover low heat. 8. Drop one egg at a time into the water. The egg is ready after about 3 minutes, when the egg white has completely congealed assuming its white color (the yolk must instead be soft inside). Keep the eggs warm on a plate in the oven.
Assemble the final dish the flatbreads 9. Place On individual plates (possibly hot), put aslice of ham on top and the egg on top.
Sweets and Snacks
Homemade popcorn Servings: 2 people Difficulty: Simple Preparation time: 5 minutes
Calories Fat Protein Carbohydrates Fiber Sodium
110 2g 3g 19 g 4.5 g 0 mg
Ingredients • 1 teaspoon of extra virgin olive oil • Salt • 50 g of corn kernels for popcorn
• 2 teaspoons of oregano Preparation 1. Pour the oil with a pinch of salt into a bowl suitable for the microwave. 2. Add the corn kernels and mix. 3. Close the bowl with a microwave-safe lid. 4. Microwave on high for about 3-4 minutes, until the time between popping corn is reduced to 1-2 seconds. 5. Remove the bowl from the microwave and sprinkle with oregano and serve.
Kiwi and oranges augratin Servings: 2 people Difficulty: Simple Preparation time: 10 minutes
Calories Fats Proteins Carbohydrates Fibers Sodium
67.5 1.5 g 1g 12 g 1.25 g 0 mg
Ingredients 1 kiwi 1 orange 1 egg yolk 1 tablespoon red wine 1.5 tablespoons of sugar 0.5 tablespoons of powdered sugar
Preparation 1. 2. 3. 4.
Preheat the oven grill. Peel and slice the kiwis and oranges. Arrange the slices on four ovenproof saucers. Heat the egg yolks in a double boiler, adding the wine, a spoonful of cold water and the sugar. 5. Place the container inside the pot with the hot water. Cook over very low heat, stirring constantly and with a whisk, until a thick cream is obtained (about 5 minutes). Spread the cream over the fruit slices in the four saucers. 6. Place the saucers in the oven and cook au
gratin until a crust forms (about 2-3 minutes). 7. Sprinkle with icing sugar and serve immediately.
Other eBooks :
Lose weight on the ketogenic diet Fat Burning Ketogenic Diet The magical power of fasting