I am a firm believer that when it comes to diet, moderation is key, and no food is per se a “bad” food. We all need a treat once in a while, and for many people, that means a “sweet treat”. I have to admit, this time of year especially, with the holidays humming and the weather turning chilly, I find myself wanting to bake some special treat, or warm up with an occasional cup of hot chocolate. Perhaps because it reminds me of when, as a teenager, I was skiing in the Alps during the Christmas break, and, after hours in the freezing temperatures, my friends and I would warm our hands (and our tummies) around a cup of hot chocolate (see my recipe for Italian Hot Chocolate below).
Although there are many low FODMAP dessert choices out there, the issue for people with IBS is eating too much at one sitting. This may make you consume too much fructose at once and lead to unpleasant symptoms. Before I give you my tips to enjoy sweets without incurring into tummy trouble, it is useful to understand how fructose is absorbed.
Fructose is a single-sugar unit (a monosaccharide, the “M” in the acronym FODMAP) which can be absorbed in two different ways: the first is by diffusion, which means the fructose molecule crosses the intestinal wall on its own; the second is by “piggybacking” with glucose on a transporter molecule. The first method is a slow and inefficient process, which may leave unabsorbed molecules in the small intestine. The second method is the most efficient but works well only when there are equal amounts of glucose and fructose to be transported, as the two molecules are paired up in the transport system. If there is more fructose than glucose, the excess fructose is not taken up and remains in the small intestine. As it is a small molecule, fructose has a high osmotic capacity, which means it draws water, leading to diarrhea. When it then travels the large intestine, it is fermented by the gut bacteria, resulting in gas production and bloating.
Most of the fructose in our diet is found in fruit and in sweeteners (together with glucose). As both absorption methods may lead to unabsorbed fructose molecules lingering in the small intestine, how well fructose is absorbed depends both on the dose consumed and the fructose to glucose ratio. There are two keys to ensuring you don’t get symptoms from fructose: one is to choose fruits and sweeteners with a balance of glucose and fructose and avoid or limit those that contain more fructose than glucose; the second is to avoid eating too much sugar at one sitting, as too large of a fructose load will overwhelm the system.
3 Tips to Satisfy your Sweet Tooth on a Low FODMAP Diet
1. Choose fruits and sugars with a good balance of fructose and glucose:
Sucrose (aka table sugar, also known as beet/brown/cane/castor/confectioner’s/granulated/icing/organic/refined sugar; raw sugar crystals, can juice crystals, cane syrup, evaporated milled cane juice, simple/sugar syrup)
100% Maple Syrup
Corn Syrup (is it mostly glucose)
Rice malt syrup
Stevia, powdered or liquid (not a sugar, but a non-nutritive natural sweetener)
*These are “suitable” in appropriate portions – See the Monash University Low FODMAP Diet App. Fruit: It is recommended to consume no more than one portion of fruit per meal or snack. You can have more than one portion of fruit in one day, just be sure to separate them by at least 2-3 hours.
2. Avoid fruits and sugar with excess fructose (unless you have re-challenged them and found you can tolerate them)
Note: there are other “high FODMAP” fruits not listed here as they are high in sorbitol (not fructose).
Note: Most high-fructose corns syrup (HFCS) has a similar fructose/glucose ratio to sucrose (about 55% fructose and 45% glucose). However, the fructose amount may vary from 42 to 90%. As it is not possible to know from the label which kind of HFCS it is, it is best to avoid it.
*These are high in Fructans (not fructose), a type of oligosaccharides (the “O” in FODMAP). Fructans are chains of fructose molecules that travel to the large intestine undigested and are fermented by our gut bacteria.
Artificial Sweeteners (aspartame, sucralose, and saccharine) are low in FODMAPs but, as some preliminary studies are showing that they may be harmful to our gut bacteria, many dietitians (myself included) are starting to recommend avoiding them altogether.
3. Avoid large loads of fructose in one sitting
This is where it is easy to get confused by the plethora of “low FODMAP desserts” appearing every day on blogging sites. Sure, these desserts may be made with gluten-free flours, low-lactose dairy products, and other low FODMAP ingredients, but a dessert is only low FODMAP at a portion size that limits the fructose content (most likely from the sugar) to a certain threshold.
Beware of desserts that end up having high amounts of sugar per serving (such as some cakes, brownies, or desserts with frosting or cream fillings). A good rule of thumb is to limit the amount of sugar to about 2-3 teaspoons (10-15 grams) per sitting. This is not unreasonable given that, FODMAPs aside, the American Heart Association recommends limiting the daily intake of added sugars to no more than 6 teaspoons (25 grams) for women and 9 teaspoons (36 grams) for men.
Going back to my initial “everything in moderation” message, if you follow a healthy diet without excess added sugars, come the holidays, you may enjoy a dessert without guilt. Still, if you want to avoid symptoms, make sure the piece is small, or, if you really want to indulge for once, keep your overall FODMAP level low during the rest of the day. Your tummy will thank you, and you will be able to really enjoy the time you spend with your friends a family!
Italian Hot Chocolate
1 teaspoon cornstarch
1/3 cup water
2/3 cup lactose-free milk (whole or 2%) or almond milk
1 ½ oz (42 g) 72% dark chocolate, finely chopped
2 teaspoons sugar
1. In a small saucepan, dissolve the cornstarch in the water; add the milk and bring to a boil
2. Lower the heat, and add the chocolate and sugar. Simmer for 1-2 minutes, stirring constantly, until the chocolate thickens.
3. Pour into two 4-oz cups (preferably heated with hot water). Enjoy!
2 servings (1 serving is equivalent to 10 grams of sugar, and under the low-FODMAP serving size for dark chocolate).
Note: this is so rich that you can make it into 4 servings and drink it, as it is popular now in Italian cafés, in espresso cups.