Australia's own Low FODMAP Diet going strong after 20 years

Monash University

Key points 

• Monash University researchers published their first FODMAP paper in 2005

• The Low FODMAP Diet has helped millions of people globally improve their IBS

• The app has been downloaded 1.75 million times globally 

A team of Monash University researchers is celebrating 20 years of helping millions of people with irritable bowel syndrome (IBS) through its world-first Low FODMAP Diet.

Since its first research paper was published on 1 April, 2005, the tight-knit team has developed and refined the diet, and created an ecosystem of resources to enable people to follow the diet.

These include a globally successful app, a popular cookbook, a food certification program, website, social media pages and online courses for patients and health professionals.

The Monash FODMAP Diet App was kept affordable with a small one-off fee (now AUD$12.99), and 1.75 million people have downloaded it globally since its 2012 launch.

Part of the original team and now Professor of Gastroenterology in the Monash University School of Translational Medicine’s Department of Gastroenterology, Professor Peter Gibson said up to one in ten people globally lived with IBS.

Professor Gibson said the diet aimed to ease their symptoms and enable them to develop a personalised long-term eating plan to maintain good gut health. “The Low FODMAP Diet empowers people to create a diet that works for them,” he said.

“We’re not trying to cut things out completely; we’re helping to reduce the effect FODMAPS have on some people. We’ve also worked hard to ensure the accuracy of our information.”

The Low FODMAP Diet emerged after Monash University Department of Gastroenterology researchers identified a group of short-chain carbohydrates found in food that are either poorly absorbed in the small intestine or rapidly fermented by bacteria in the large intestine. 

These actions lead to the accumulation of gas and water which stretches the intestinal wall and triggers sensations of pain and discomfort in people with IBS. 

They named these carbohydrates FODMAPs, which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. Researchers then measured the FODMAP content of a wide range of foods.  

This enabled them to develop the Low FODMAP Diet, and conduct the first studies showing that it eases gastrointestinal symptoms in most people with IBS. 

Team member Associate Professor Emma Halmos, a senior research dietitian, led the pivotal feeding study as part of her PhD that showed the low FODMAP diet was effective in treating patients with IBS.

These ground-breaking findings have since been replicated by research groups all over the world which show that 50-80 per cent of people with IBS respond to a low FODMAP diet.

This study launched a major change globally in attitude and enthusiasm towards dietary management.

The Monash FODMAP App uses a traffic light system where red foods are high, amber foods are moderate and green foods are low in FODMAPS in a typical serve. 

The idea is to initially reduce intake of all FODMAPs to improve IBS symptoms, then to identify which ones trigger symptoms, and long term, to reintroduce them and personalise the diet so that only problematic FODMAPs are limited. 

Manufacturers can have their foods tested and certified as Low FODMAP, and the food database is available via the app. In 2023 the team released its first low FODMAP cookbook. 

Another team original, Associate Professor Jane Muir, who heads Translational Nutrition Science in the STM’s Department of Gastroenterology, said it was a genuine team effort.

“It’s a Monash University initiative,” she said. “It’s the Monash University Low FODMAP Diet and so it will always be part of Monash University. Everyone involved over the years is proud to have played their part in helping to put diet therapies on the map.”

Dr Jane Varney, a senior research dietitian who heads the Low FODMAP education program, said Monash realised that training dietitians and patients on how to implement the FODMAP diet was key to successfully translating the science of FODMAPs into practice. 

As a result, the team developed online courses to teach patients and dietitians how to implement a FODMAP diet for IBS. These courses have been taken by thousands of patients and dietitians from over 100 countries worldwide. 

The team has also translated the Monash FODMAP App into Spanish, Italian, German and French, with Japanese, Norwegian and Dutch translations on the way. “It’s a huge task but worth it to ensure as many people as possible can access the Low FODMAP Diet,” Dr Varney said.

What are FODMAPs?

FODMAPs are a group of sugars (short-chain carbohydrates) found naturally in many foods and food additives that are not completely digested or absorbed in our intestines and can trigger symptoms in people with IBS. When they reach the small intestine, FODMAPs move slowly, attracting water. When they pass into the large intestine, FODMAPs are fermented by gut bacteria, producing gas. The extra gas and water cause the intestinal wall to stretch and expand. As those with IBS have a highly sensitive gut, this ‘stretching’ causes of pain and discomfort

High FODMAP foods that can trigger IBS symptoms

• Excess fructose – found in honey, high fructose corn syrup and some fruits (e.g. mango)

• Lactose – found in milk and milk products

• Polyols – found in some fruits (such as pears and apples) and vegetables (such as mushrooms), sometimes added as artificial sweeteners

• Oligosaccharides (fructans and GOS) – found in wheat, rye, onions, garlic, legumes and lentils

The Monash University School of Translational Medicine Annual Public Lecture, FODMAPs 20 Years On, is on Tuesday 16 September, 6:00-8:00pm at the Alfred Innovation and Education Hub, 75 Commercial Road Melbourne. Details here

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