Laura Schoenfeld: As far as the fermentable carbohydrates are concerned, yes, FODMAPs are definitely something you would consider a fermentable carbohydrate. Prebiotics and FODMAPs are not technically the same thing, but all FODMAPs are prebiotics. The best way to say that is, like I said, all FODMAPs are prebiotics, and not all prebiotics are FODMAPs. A prebiotic is anything that’s going to feed beneficial bacteria in your gut, and that can be things like the various FODMAPs, so fructose … I’m sorry. I’m blanking on the different ones. Oligosaccharides and fructans and polyols—all those different types of FODMAP foods—are going to be feeding gut bacteria, and that’s what causes them to have that symptom effect on anyone who has gut dysbiosis or IBS or SIBO. They’re feeding the gut bacteria, and the byproducts of the bacterial fermentation are gases and possibly some toxins that, if you have a pathogen, might be causing some of the symptoms.
Now, that doesn’t mean that only FODMAPs are prebiotics. Some examples of prebiotics that are not FODMAPs would be things like resistant starch-containing foods. Things like cooked and cooled white potatoes, white rice, plantains, those have resistant starch in them, but they don’t have FODMAPs. You might have noticed on certain FODMAP lists that white rice is not considered a FODMAP, but if you cook white rice and then put it in the fridge overnight and then eat it either cold or reheated the next day, it will contain resistant starch, which does feed beneficial bacteria in the gut.
When you’re trying to increase fermentable carbohydrates in a client, you can do either just foods that contain resistant starch, or you can do FODMAPs, or you can do a combination of both. Depending on the client—and I might even talk about this in a couple of minutes because I know I have another question in here about reintroducing foods—you can kind of decide which ones you want to start with, and you don’t necessarily have to go straight into FODMAPs if you’re trying to get some prebiotic foods into somebody’s diet who is possibly FODMAP sensitive. A lot of times, you’ll have clients that have gut issues that don’t do super well with really high FODMAP-containing foods, and that’s the kind of person you can use some of those more resistant starch-rich foods to start with and then see if you can sneak some FODMAPs into their diet.