Thursday, 5 February 2015

Talking about the traffic light system

What do the serving size suggestions mean?

Also, discover safe servings of some red foods!




By Dr Jane Muir

We have received a number of questions regarding serving sizes of food and how much ‘green’ food you can you eat per sitting and over the day.

Remember that a low FODMAP diet is designed to lower the total intake of FODMAPs consumed. A low FODMAP diet does not completely remove all FODMAPs from the diet. This is because firstly, small quantities of FODMAPs are well tolerated (even in sensitive individuals), and secondly, because FODMAPs are present so widely in foods that it is impossible to completely remove them from the diet. Therefore, a low FODMAP diet will change ones FODMAP intake from high to lower, which is enough to reduce the symptoms of Irritable Bowel Syndrome (IBS) in most people.


In designing the low FODMAP diet, the team at Monash University has come up with cut-off values for which foods are classified as either green, orange or red.  These cut-off values are the basis for the traffic-light system used in the Monash University Low FODMAP diet app. The traffic light rating is given for each food based on a typical serving size of that food per sitting (ie. per meal). To access this information in the app about serving sizes you just need to click on the food item with the traffic light.  

Each food (at the serving sizes specified) are assigned a different colour to represent the FODMAP content it contains:

- green means low dose, orange means moderate dose and red means high dose.  

When you commence the low FODMAP diet, start by avoiding the red foods, limiting the orange, and eating mainly the green foods – at the serving sizes specified.   
You can eat a number of different foods with a green rating in the one sitting (per meal).  You may also be able to eat more than the standard serving size specified, but you need to read the information supplied with each food.

Here are some examples. Serving size suggestions of green foods.


Example- Broccoli.  The overall rating for broccoli is green.  By clicking on this food you will get the serving size information.  Broccoli has a green rating for ¼- ½ cup only (this is raw uncooked weight).  Please read the additional information about this vegetable (we get lots of questions about broccoli!).  It states that you must avoid larger servings (1 cup) as this will contain high amounts of oligos (fructans and GOS) and polyols- sorbitol.

Example- Baby spinach:  The overall rating for baby spinach is green. By clicking on this food you see the serving sizes.  Baby spinach has a green rating for ½-1 cup (this is raw uncooked weight).  Also note that you could eat more than the standard serves of ½ - 1 cup of baby spinach!  Advice is given that larger quantities can be consumed but limit quantities to less than 150 grams (about 5 oz.) per serve/sitting. 


Please remember to use the app to get more information about serving size suggestions.  Remember also that you can eat a number of green servings of food per meal.  So if you are hungry, include another serve of a green rated food.

Always remember that everyone’s FODMAPs tolerance varies. There is no one-size-fits-all rule. A Dietitian who is experienced in this area can help to assess your individual tolerance level. See below links to find your local Dietitian association listings.








Discover safe servings of some red foods!

Example- almond: The overall rating for almonds is red.  By clicking on this food you will get serving size information.  Almonds have a red rating for a typical serve of 20 nuts.  However, a ½ serve of almond (10 nuts) has a green rating.  

Example- oat: The overall rating for oats is orange. By clicking on this food you will get serving size information.  Oats have an orange rating for a typical serve of ½ a cup. This serve of food is likely to be tolerated but should be limited and not eaten on a regular basis.

           


22 comments:

  1. I have been following the low FODMAP diet and using the Monash Low FODMAP diet guide app on my phone for a couple of years now. I just realized that I had no diarrhea and did not take any immodium this week. Thank you so much. My life was so miserable before I learned about FODMAPs. You've improved my life so much.

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  2. The overall rating for oats is orange. By clicking on this food you will get serving size information. Oats have an orange rating for a typical serve of ½ a cup. This serve of food is likely to be tolerated but should be limited and not eaten on a regular basis.

    HSSC Date Sheet 2015 BISE Gujranwala Board

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  3. If I have understood this blog entry correctly, I can safely eat 10 almonds and 10 hazelnuts in one sitting but not 20 almonds and zero hazelnuts. This is surprising. For foods that are on the spectrum depending on serving sizes, can you explain how ingesting small servings of multiple foods is different from a large serving of a particular food. Surely, the amount of FODMAPs in the multiple small servings would add up to be as much, or more, than the amount of FODMAPs in the large serving.

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    1. Hi Sof,

      FODMAPs are found in most CHO containing foods. The amount in each food item varies even if it is in the same food group (such as nuts) - but also the type of FODMAP also varies, so green food serves can be combined without affecting symptoms.

      Yes, the FODMAPs can add up but you may not have a problem with some FODMAPs. For example not everyone malabsorbs lactose, fructose or polyols- your dietitians will be able to help you sort out which are the particular FODMAPs that you have to monitor. The dietitian can set your filters to correspond to this.

      There is no strict system & we do not have a recommended max consumption or frequency for any FODMAPs as it differs from individual to individual. The traffic light system should guide you to a well tolerated serve per meal so it is not necessary to add up serves over the day.

      Hope that makes sense.
      Kindly, Emily
      The Monash low FODMAP team.

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    2. Much appreciated. Thank you Emily.

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    3. hello and what about eggs or meat ?? save are 2 eggs in app. but in the description - text is " eggs dont contain carbohydrates. Please is safe in one sitting eat 5 eggs ??

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    4. hello and what about eggs or meat ?? save are 2 eggs in app. but in the description - text is " eggs dont contain carbohydrates. Please is safe in one sitting eat 5 eggs ??

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    5. Hi Peter, yes eggs are a naturally low FODMAP food, so you could theoretically eat 5 in one sitting if you wanted to, however current dietary guidelines recommend 2-3 serves of meat/meat alternatives each day for an average adult - one serve is 2 large eggs. Best wishes, Monash FODMAP

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  4. So if a food that is 'green' doesn't give an upper limit can we eat it freely? Such as say cucumber, carrots and lettuce? Also is apple cider vinegar low fodmap?

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  5. Hi
    I am finding the App very helpful, thank you. One question - if there is no additional note about a green item in terms of avoiding larger than the serving size stated, does that mean it is ok to eat in any quantity? E.g. parsnips and carrots. Had a reaction today and as everything I've had is low fodmap, just trying to work out why.

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  6. A lot of the things i read talk about quantity of FODMAP foods per sitting. How often is a sitting? (I am a grazer who eats a lot of small meals)

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  7. Hi.

    What if it doesn't say anything in the note. Such as e.g. cottage cheese?

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  8. Hi! I tried to see an answer to this but didn't find so here it goes:

    Is it enough for the bowel system to eat reds and oranges the safe amount? So the good bacteria gets its "food"? Does like 10 almonds give enough of the fodmaps it has so the bacteria is happy but also I'm happy and not having diarrhea? Or is it so that you'd have to eat closer to 20 so the bacteria gets its food? TIA!

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    1. Hi there, its a hard to say exacly how much prebiotic rich food is needed to keep our gut bacteria happy. The following foods include small/moderate amounts of the prebiotics, fructans and GOS: pomegranate, currants, beetroot, butternut pumpkin, oats, burghal, canned lentils, canned chickpeas and almonds. Including green serves of these foods will promote the growth of good bacteria in your gut. Important too is doing the rechallenge phase of the diet and long-term, relaxing the diet as much as your individual sensitivities will allow. Thanks, Jane

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  9. Can you please tell me why peanut butter in the US has a limit but other peanut butters do not.

    The peanut butter i eat ingredients are: peanuts, salt, palm oil and sugar. Though there are others that don't even add sugar I believe or oil. Are those the ones that don't have a limit?

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    1. Hi Erica, it is likely that the US peanut butter we tested was sweetened with high fructose corn syrup, as many US brands are made in this way. If your peanut butter is simply peanuts, oil and salt and/or regular sugar, then it likely has a similar FODMAP content to the Australian peanut butter tested - which is low in FODMAPs.

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  10. Great. That makes sense and makes me much happier. I have eaten > 2 tbsp and seemed ok but also have reacted on days where i have eaten peanut butter and wanted to make sure I was interpreting reactions properly.

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  11. Hi, the peanut butter sold at Aldi lists its ingredients as peanuts (90%), sugar, vegetable fat, salt. Manufacturered in Argentina. Is there any way of knowing which sugars and fats have been added? Also, is the amount found in peanut butter enough to be a problem, even if it a FODMAP?

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    1. Hi Kylie,

      Thank you for your question. When sugar is listed in packaging then this refers to sucrose which is low in FODMAPs. Where a fructose sugar is used this is usually listed on the ingredients list. Also the vegetable oil/fats will be low in FODMAPs. There are some people who may experience bowel symptoms with fatty foods and the vegetable fats in this peanut butter could then aggravate symptoms. However if that is not you then this peanut butter should be well tolerated. We recommend that a maximum or 2 tablespoons be used as more than this could become problematic for some people.

      Thanks,
      Shirley

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  12. What about serving sizes for children? For example should a two year old have half or a quarter of the upper limit of an adult? (Eg. 2.5 or 5 almonds?)

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    1. Hi Cheri,

      Thank you for your comment, no you do not need to halve the serving sizes for children.

      All the best,
      Monash FODMAP.

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