Including liver cleansing low fodmap vegetables in the elimination phase is essential for anyone on a low-fodmap diet for fatty liver and SIBO.
The low-fodmap SIBO diet can feel quite restricting and is often high in saturated fats and animal protein, including red meat, which increases the risk of developing fatty liver. Many people on the low fodmap diet have a higher intake of fats due to them not being fermentable, but this can be problematic for those with low stomach acid, fatty liver, or a sluggish gallbladder.
There is new research suggesting that patients with IBS are more likely to develop fatty liver with shared risk factors, including:
- leaky gut
- immune system activation causing inflammation
- small intestinal bacterial overgrowth
- bile acid metabolism
Anyone with IBS, abnormal liver function tests or elevated liver enzymes should be investigated for fatty liver. Many people with IBS and SIBO have a sluggish gallbladder and liver as an underlying cause of SIBO that needs to be addressed.
Results from this meta-analysis on foods likely to cause fatty liver recommends a high to moderate intake of nuts, legumes, fish, eggs, whole grains, and vegetables with a low intake of red meat and soft drinks for people with fatty liver.
High fructose corn syrup is used to sweeten soft drinks and is problematic for fatty liver and IBS. The excess fructose in high fructose corn syrup may cause gastrointestinal symptoms such as loose stools due to the osmotic effect of fructose on the gut.
Omega 3 fats in fish have been shown to reduce lipid accumulation in the liver. At the same time, dairy foods such as cheese increased the likelihood of fatty liver likely due to cheese containing more saturated fatty acids that increase liver fat. Fruits and vegetables, including low fodmap vegetables, are rich in fiber, antioxidants, and polyphenols that help prevent the development of fatty liver.
For this reason, I love to focus on incorporating low fodmap vegetables into the diet for IBS and fatty liver. Low fodmap foods can help reduce IBS symptoms such as abdominal pain and bloating.
During the elimination phase of a low-fodmap diet, high-fodmap foods containing fermentable sugars and fermentable oligosaccharides are avoided to get IBS symptoms under control. When you come off the fodmap diet, pay attention to the types of carbohydrates that cause uncomfortable symptoms.
The following list of low fodmap vegetables is excellent for supporting the body with nutrient-dense, low-calorie, and liver-cleansing vegetables which can be lacking when following the low fodmap diet or SIBO diet. Vegetables are excellent foods for a low fodmap cleanse or diet.
Many people following the low fodmap diet or SIBO diet often have a high-fat diet since fats are not fermentable like vegetables.
But if a fatty liver, a sluggish gallbladder, and poor bile flow are one of the underlying causes of your SIBO symptoms, a high-fat diet is not exactly beneficial either.
Fats will place an extra burden on the gallbladder and liver, which need liver-cleansing vegetables to function optimally. The increased intake of pro-inflammatory saturated fats can also be problematic if inflammation is present alongside SIBO.
Eating low fodmap vegetables is highly beneficial for anyone suffering from SIBO or IBS symptoms associated with a sluggish gallbladder. When following a fodmap diet for fatty liver, it is crucial to include lots of low fodmap vegetables and fruits.
This liver cleansing low fodmap vegetable list will help provide the liver and body with antioxidants, vitamins, minerals, and healthy carbohydrates without causing excessive bloating. IBS symptoms are often associated with high-fodmap vegetables such as onion, garlic, and asparagus.
Low FODMAP Vegetable List to Include on a FODMAP Diet for Fatty Liver
The following list of vegetables is low fodmap in the following serving size listed
- Alfalfa sprouts (2 cups)
- Bok choy (1 cup)
- Carrot (1 medium carrot)
- Chives (eat freely)
- Eggplant (1 cup)
- Kale (eat freely)
- Silverbeet ( 1 1/2)
- Rocket ( 2 cups)
- Romaine Lettuce (2 cups)
- Spinach (1 1/2)
- Spring onion (green tops) (1 1/2 cups)
- Radish (4 radishes)
- Green Beans (15 green beans)
- Bean Sprouts (3/4)
- Oyster mushrooms (1 cup)
- Rhubarb (1 cup)
- Okra (71/2 pods)
- White Potato (eat freely)
- Parsnip (eat freely)
Medium fodmap vegetables that are low fodmap in the following portion size
- Red Pepper (1/3 cup)
- Raw Tomatoes (1/2 cup)
- Broccoli (3/4 cup)
- Canned Beetroot (1/2 cup)
- Red cabbage and regular cabbage (3/4 cup)
- Celery (1/3 cup)
- Sweet Potato (1/2 cup)
- Cucumber (1/2 cup)
You can also enjoy fresh parsley, cilantro, turmeric, and ginger as herbs to spice up the low fodmap diet. This low fodmap pad Thai is full of low fodmap vegetables.
High FODMAP Vegetables
- Whole artichoke – high in fructan
- Asparagus – high in fructan and fructose
- Garlic – high in fructan
- Onion – high in fructan
- Cauliflower – high in mannitol
- Mushrooms (button, white, shitake) – mannitol and fructan
The main fodmaps found in these vegetables include fructan and mannitol. High fodmap vegetables often trigger digestive symptoms such as bloating and IBS, but they are also prebiotics for healthy gut bacteria.
During the reintroduction phase, when you start to come off the low fodmap diet, pay attention to the food groups and fodmaps that cause digestive issues. You may notice that you have lactose intolerance and don’t tolerate the lactose fodmap but are okay with the fodmaps in vegetables or vice versa. You might also tolerate some high fodmap foods in small portions.
While following the low FODMAP diet for a short time is beneficial for someone with IBS or SIBO, the low fodmap diet can harm the gut microbiome in the long term.
A strict low FODMAP diet has been associated with reducing the abundance of beneficial bifidobacteria species and butyrate-producing bacteria.
An increase in mucus-degrading bacteria has also been noted among people following a strict low fodmap diet (which should only be followed for 2-6 weeks).
While the FODMAP diet has a purpose when dealing with IBS and SIBO, it is not a diet that should be strictly adhered to for the long term due to disruption in the microbiome.
Identifying trigger foods and reducing or eliminating high fodmap triggers foods to be beneficial and more sustainable for the long term. The ultimate goal when dealing with SIBO is to reduce the excessive amount of bacteria in the small intestine so people can tolerate fiber and fodmap foods as a wide range of foods, especially fruits, vegetables, and legumes, are crucial for building a diversified and robust microbiome in the large intestine.
Once SIBO has been reduced, slowly reintroducing and bringing back the fiber and high fodmap foods in small amounts benefit a diverse, healthy microbiome. Supporting the body with lots of low fodmap fruits and vegetables is especially important for anyone on the fodmap diet for fatty liver as a high-fat and low fodmap diet will still burden the liver.
So, I will leave you with two questions.
Which high FODMAP foods do you notice are trigger foods? 1, 2, or all of them?
And which low fodmap vegetables do you love eating?
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If you are struggling with SIBO, Dr. Nirala Jacobi from the SIBO Doctor has a very informative patient SIBO success course to beat SIBO for good. This course covers
- additional underlying causes of SIBO
- testing for SIBO
- Symptoms of SIBO
- types of SIBO
- biphasic SIBO diet
- antimicrobials for SIBO
And much more!
Dr. Nirala Jacobi has been my go-to resource for information on SIBO. There is so much to know about SIBO, and the SIBO success plan covers all the essentials you need to know about SIBO so you can beat SIBO for good.
References:
Controversies and Recent Developments of the Low-FODMAP Diet
The monash university fodmap diet app
Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
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