I recently received some interesting and direct questions from T-J on the differences between the Fast Tract Diet and the FODMAP approach. Here are the questions and answers. You might also be interested in my article on SIBO Diets.
Q: “Since I have only just heard of your research, can you advise about the outcome of peer review it has received?”
NR: The Fast Tract Diet is new quantitative approach treating IBS, GERD and other SIBO-related illness. We have completed a pilot study with 20 people (19 completed the study) that have chronic heartburn. This work has been submitted for publication. We are also in the planning stage for a larger collaborative study – with people who have acid reflux but don’t respond well on PPI medicines. We want to expand our clinical testing to IBS and other conditions. In the meantime, we are sharing this concept with people based on its scientific merits outlined in the Fast Tract Diet book series so they can try the diet for themselves. Based on the responses we are getting from people with chronic heartburn and IBS we are optimistic about the diet for IBS and GERD and have every reason to believe the diet will benefit people with a variety of other SIBO / dysbiosis –related conditions.
Q: “The two approaches are similar in limiting intake to what should be well tolerated, but your approach doesn’t seem to address the possibility that we all have different tolerances or are affected by different carb types.“
NR: While both approaches are based on the same concept, there are significant differences (also see SIBO Diets article). The Fast Tract Diet is a quantitative approach while the FOPMAP approach is qualitative. The Fast Tract Diet limits lactose, fructose, resistant starch and all fiber types including sugar alcohols and other FODMAPs – though as I understand it, some AOAC fiber test methods are better at measuring sugar alcohols and other FODMAPs than others. Another major difference is that the FODMAP approach recommends supplementing with resistant starch (RS) and fiber while the Fast Tract Diet limits both. There is considerable evidence that RS and Fiber can contribute to excessive intestinal fermentation which often leads to SIBO, IBS and GERD.
If you have read my book, you will notice I discuss individual differences at some length. For instance, people of Northern European decent will likely be lactose tolerant and won’t need to limit lactose. Other underlying problems, surgery, low stomach acid, immune deficiency, pancreas problems or cystic fibrosis and many other factors will drive different tolerances for individuals and will need to be addressed on a case by case basis.
Q: “I have near zero tolerance for onion and garlic. Other questionable ingredients in your recipes are broccoli, cabbage, asparagus, mushrooms, avocado and sprouts”
NR: I have looked, but cannot find publication of the exact amount of FODMAPs in reported “high FODMAP foods”. I only find lists of foods “high in FODMAPs”. If you have a source for this info, please let me know. If I have the exact amounts of FODMAPs in each food, I can adjust the FP for those foods.
But relatively small amounts of onions and garlic used to flavor a stir fry for instance doesn’t add appreciable amounts of overall carbs so most people should be able to tolerate them even though some of those carbs are FODMAPs. Of course some people are more sensitive. My dad can’t tolerate even small amounts of uncooked onions. Broccoli, cabbage, asparagus, mushrooms, avocado and sprouts all have relatively low FPs. So even if half of those carbs are FODMAPs, the symptom potential will be limited when consumed in moderation. Of course, if you find that any of these foods cause you problems, I support you in avoiding them.
Q: “I notice an apparent obsession with Splenda. Are you assuming that your audience is typically overweight? Why not use glucose?”
NR: If you have read my books or blog on sweeteners on this site, you will notice that I present my views on sweeteners and also talk about the use of glucose as a perfectly acceptable alternative to Splenda. I also talk about its ability to facilitate fructose absorption. While not natural or Paleo, I occasionally use Splenda, which has a decent safety record, is good for both cold and hot dishes, doesn’t contain the more damaging sugar alcohols (I have several warnings in my books on the presence of these in many sweeteners including some forms of Stevia) and is much better than sucrose – the most toxic of all sweeteners next to pure fructose. How much sweetener people use is a personal choice and not something I feel I need to comment on. The Fast Tract approach is for people with SIBO, which can affect people who are underweight, overweight or normal weight.
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