Current estimations show that around 10-15% of people worldwide now suffer with some form of IBS or IBD, and numbers are on the increase. The low FODMAP diet has been touted as a solution, however is it really a front-line remedy for all? And should these emerging producers be taking more responsibility for how and to whom their products are sold? There is plenty of food for thought in the battle of the irritable bowel, writes Tom Smart.
This writer is no doctor, but to him the numbers stack up. In 50% - 86% of IBS/IBD flares (study dependent) the introduction of a low FODMAP diet has been seen to improve symptoms. No wonder then that specific low-FODMAP foods such as sauces, soups and supplements are beginning to hit the market in greater numbers, while dedicated websites emerge allowing consumers to access such products with greater ease. So what are the likely obstacles to market growth? We picked out our top three:
1. Regulation and Labelling
There is very little official labelling for low FODMAP foods in the UK and EU currently, and with good reason. Labelling a product as ‘Low-FODMAP’ would most likely be classed as a nutrition claim and currently this would need to be positively assessed by the European Food Safety Authority (EFSA) before being printed. Would this still be the plan post-Brexit? Westminster have promised to ‘review and improve’ food legislation following the split, however where this lies on the growing list of priorities is open for deliberation.
There is the independent accreditation route, however there are a few jostling for position which paints a confusing picture for consumers. On one shelf or webpage it is possible to find products labelled as ‘FODMAP friendly’, ‘Monash University Low FODMAP Certified™’ and even ‘Tummy Friendly’). The emergence of a recognised industry leader would surely be helpful for producers and consumers alike.
2. The Re-introduction Phase and Medical Approval
The Low-FODMAP diet is made up of three phases: elimination followed by re-introduction and then personalisation. First low FODMAP foods are strictly reduced, being gradually re-integrated depending on tolerance during phase two in a bid to develop a personalised plan that could potentially be followed long term.
Multiple sources advise the elimination phase should span no longer than six weeks due to potential adverse effects, which could pose questions regarding responsibility for producers to educate their consumers about the timelines involved. According to one 2017 paper ‘awareness of the risks of the low-FODMAP diet—and indeed any restrictive diet—is paramount’.
Due to this requirement for awareness, the strict nature of the regime and the potential pitfalls of long-term use, many health websites dictate that the low-FODMAP diet should only be followed under the supervision of a health-care professional or as prescribed by your doctor or dietician. That very same 2017 paper noted that ‘there are no studies in which the diet has been self-taught via information from printed material or the Internet.’ While this poses a challenge to producers, it also provides an opportunity to lead the market.
3. Easier Alternatives
While the low-FODMAP diet is recommenced by N.I.C.E. in the UK as a clinical management strategy for IBS, it does fall at the bottom of their hierarchy. General lifestyle and diet improvements have also proved effective in treating symptoms, as have the use of probiotics in certain patients. There is always potential for further development to change the playing field.
There are additional complications that fall outside the scope of this article, however the overall view seems to be that growth of the Low-FODMAP industry is likely, but not without its challenges. Interest is certainly on the increase, no doubt linked to the rise in patients and so expanding the customer base. Further education, online support and regulation should allow producers to flourish in a buoyant market and an emergence of a recognised label could be a tipping point. There are many parallels with the rise of the gluten free market, but with the added complication of Brexit and its potential effect on both UK and EU processes don’t expect the battle of the irritable bowel to be won any time soon.