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How To Re-Challenge & Reintroduce FODMAPs

Last updated on Feb 28th, 2020 Authored by Alana Scott     Reviewed by Joanna Baker (APD)
FODMAP Reintroduction Guide

Well done on surviving the first phase of the low FODMAP diet! Hopefully, your gut is now mostly calm and you know that low FODMAP foods can help you settle your symptoms. That means it is now time to regain your food freedom and tackle the FODMAP reintroduction phase to help you identify your trigger foods.

If it still feels like your gut has a vendetta against you, then it’s time to talk to a dietitian and to troubleshoot with these strategies before you attempt the reintroduction phase.

Please note that this article does not replace the advice or expertise of a registered dietitian, who specialises in the low FODMAP diet. A dietitian can help tailor FODMAP challenges to suit your lifestyle and medical needs (1 2 3).

What is the FODMAP reintroduction phase?

The goal of the FODMAP reintroduction phase is to find out what FODMAPs trigger your gut symptoms through a series of food challenges (1 2).  This process is also often referred to as finding your tolerance level for a FODMAP group.

Remember that FODMAP is an acronym that represents four different types of fermentable sugars. Each week during the reintroduction phase you choose one of the FODMAP groups to challenge and then you eat a food from that group over a 3 day period, each day increasing the amount of the challenge food you eat (1  2)

During each challenge you monitor your gut symptoms to see how well you tolerate the FODMAP group.

You will discover what FODMAP groups you can eat freely, which ones you might need to enjoy in small serves, and which FODMAPs you need to limit most of the time to keep your gut settled.

The good news is that most people find they have a tolerance level for most FODMAP groups and create a flexible long term diet that contains a variety of high and low FODMAP foods.

The FODMAP reintroduction phase can also be called the FODMAP challenge phase.

SUMMARY

The FODMAP reintroduction phase can also be called the FODMAP challenge phase and it is a series of food challenges that helps you identify which of the FODMAP groups are triggering your gut symptoms.

Why Should You Challenge And Reintroduce FODMAPs?

Now if you are feeling awesome on the low FODMAP diet, then you might be wondering why you need to do your FODMAP challenges. Surely it would just be easier to stay on the low FODMAP diet forever, right? BUT figuring out exactly what your gut triggers are and which FODMAP groups you can bring back into your diet is really important.

Our gut bacteria love to feast on high FODMAP foods. Many FODMAPs act like prebiotics and have a positive effect on our gut health (1 2 3). This means restricting FODMAPs long term could have a negative impact on your gut health and your overall health.

The low FODMAP diet is also restrictive and socially isolating, as it can be very difficult to eat out or attend social events while only eating low FODMAP foods. With your new found food freedom you will be able to enjoy a wider range of foods which makes socialising easier.

Additionally, your overall long term health and wellbeing can be affected by a strict low FODMAP diet. Reintroducing some high FODMAP foods increases the variety of your diet, and helps it remain nutritionally adequate in the long term.

SUMMARY

Reintroducing some high FODMAP foods can help you support your gut health, make socialising easier and keep your diet nutritionally adequate.

 What Happens When You Find A Trigger Food

The reintroduction phase is a bit like being on a roller coaster, it’s both exciting and a little bit scary at the same time.  What we love most about this process is you really get to know your body and understand exactly what is triggering your gut symptoms.

While you should find a few FODMAP foods that you can eat freely (Yay!), at some point you are likely to find a high FODMAP food that at a certain serving size triggers your symptoms.

Don’t panic if you react to a FODMAP challenge. You haven’t undone all the hard work you’ve put into the first phase of the low FODMAP diet. These symptoms will pass within a few days as the high FODMAP food moves through your system and you should go back to feeling good. You can then pick up where you left off.

Finding a threshold is also a good thing. You now have a confirmed trigger and can actively work on limiting that FODMAP group most of the time.

Also remember that if you are sensitive to a FODMAP group now, that doesn’t mean you can’t reintroduce it at a later date. Our FODMAP tolerance levels are constantly changing so it’s a good idea to go back are retest FODMAP groups you’ve struggled with in the past.

SUMMARY

Reacting to a FODMAP challenge can be a good thing as it confirms a FODMAP trigger. Remember symptoms will pass after a few days as the high FODMAP food moves through your system.

Your FODMAP Reintroduction Phase Guide

Before you jump into your FODMAP challenges, there are a few key things you need to know.

FODMAP Challenge Success Tips

  1. Only use a recommended challenge food for your FODMAP challenge. A challenge food normally only contains one of the FODMAP sugars. For example, cow’s milk only contains lactose while mango only contains excess fructose. These foods only contain one FODMAP group so they will give you clear results.
  2. Be mindful about your symptoms. A little bit of bloating or gas is a normal reaction. We would classify these symptoms as a mild gut fluctuation, and they don’t mean you have failed the challenge.
  3. Wait until any symptoms have settled and then have a 3 day rest period (washout period) between each challenge. This will make sure you are feeling well and your gut is stable before moving onto the next challenge.
  4. Stop the challenge if you get moderate to severe symptoms after eating a challenge food. These are symptoms that are painful or affect the quality of your life. This level of symptoms indicates that you have a low threshold for that FODMAP group, but you may be able to bring it back in a smaller amount. Make sure you make a note of your symptoms, what challenge food you ate, and when they happened.
  5. Seek support as need from your FODMAP trained dietitian or our FODMAP Wellness Club.

FODMAP Challenge Schedules

A challenge schedule is how you space out your food challenges through out the week. There are two ways you can test FODMAPs. This is the first way is having 3 challenge days back to back. This method is good for your fructose, lactose, sorbitol and mannitol challenges. This challenge schedule also means you get through your challenges faster.

Challenge schedule 1:

Increase the amount of the high FODMAP challenge food over the 3 day period. Stop the challenge if you experience moderate to severe symptoms.

Challenge schedule 2:

Increase the amount of the high FODMAP challenge food with each challenge day. Stop the challenge if you experience moderate to severe symptoms.

If you are concerned about testing three days in a row, you can use challenge schedule two where you have a washout day/rest day between each challenge (4).

This testing schedule should be used when testing fructans and GOS (5). These FODMAPs can take longer to move through our digestive system and that means it can take longer to feel these FODMAPs.

Also keep in mind that your dietitian might create a testing schedule that is more suitable for your personal needs.

FODMAP Challenge Food Options

As we previously mentioned, FODMAP challenge foods are foods that only contain one of the FODMAP groups  (1 2 5). Once you have chosen your challenge schedule you can choose a challenge food. Then increase the serving size of the food on each challenge day.

Reintroduction Plan & FODMAP Challenge Food

Challenge 1: Excess Fructose

Choose 1 challenge food:

1 teaspoon of honey increasing to 1 tablespoon of honey

1/4 a medium sized mango increasing to 1 medium sized mango

Challenge 2: Sorbitol

Choose 1 food: 

3 blackberries increasing to 12 blackberries

1/4 of an avocado increasing to a 3/4 of an avocado

3/4 of a fresh apricot to 2 small apricots (this serve also contains moderate amounts of fructans).

Some dietitians may also use coconut or sugar free mints containing sorbitol.

Challenge 3: Mannitol

Choose 1 food:

1/4 portobello mushroom increasing to 1 portobello mushroom

100g of sweet potato increasing to 200g serve

20g cauliflower increasing to 70g serve

Challenge 4: Lactose

Choose 1 food:

60ml cow’s milk increasing to 250ml of cow’s milk

Challenge 5: Fructan Containing Grain

Choose 1 food:

1 slice of white wheat bread increasing to 2 slices of wheat bread. If you would normally eat 4 slices of bread in a sitting then add an additional challenge day and test that amount.

50g wheat pasta increasing to 200g (use the cooked weight of the pasta).

Challenge 6: Garlic Challenge

This is a fructan challenge.

1/4 of a clove of garlic increasing to 1 clove of garlic

Challenge 7: Onion Challenge

This is a fructan challenge. Choose one option:

1/4 of a medium leek increasing to 1/2 whole leek (white and green sections)

1 tablespoon onion increasing to 1/2 onion

Challenge 8: Galactans/GOS

This is an oligosaccharide challenge. Choose 1 food:

1/4 cup canned chickpeas (rinsed) increasing to 1 cup.

15 almonds increasing to 25 almonds

3 tbsp silken tofu increasing to 3/4 cup

Challenge 9: Fructose + Sorbitol

This is a combined FODMAP challenge. Only complete this challenge if you pass both the excess fructose and sorbitol challenge.

Choose 1 food:

1/4 apple increasing to one whole apple

1/4 pear increasing to one whole pear

(Table References:  4, 5)

For more FODMAP challenge food options check out our FODMAP Challenge Course in the Wellness Club.

Once you have completed your FODMAP challenges you should have a good idea of what FODMAP groups you can enjoy while keeping your symptoms settled. You can then move from the FODMAP Reintroduction Phase onto a long term modified low FODMAP diet where you add those high FODMAP foods back into your diet.

Get FODMAP Challenge Help

The reintroduction phase can be a high stress time. Not only are you juggling work life stress, trying to keep your diet low FODMAP but also trying to pick the right challenge foods.

You don’t have to do your FODMAP challenges alone, we can guide you step by step through the FODMAP reintroduction phase by:

  1. Providing you with a 12 week online course that tells you what to do week by week
  2. Answering the 10 most commonly asked questions about the reintroduction phase
  3. Giving you a guide to help you manage your challenge anxiety
  4. Teaching you how to create a flexible challenge schedule around your work and social life
  5. Providing you with a downloadable success list to make things easy
  6. Giving you access to more challenge foods that suit your taste preferences
  7. Providing chat support and cheerleading if something goes wrong or you just need more support
  8. Giving you a 15 page downloadable workbook to help you track your challenges
  9. Helping you to analyse your challenge results.

Sound good? Join FODMAP Wellness Club and jump into our FODMAP Challenge Course now.

JOIN THE CLUB

Common Challenge Mistakes

If you react to all of the re-challenge foods then it might mean you are making one of the common reintroduction phase mistakes, or that there are additional medical conditions, or food sensitivities that need to be considered.

Here are some of the common reasons why you could be struggling to reintroduce FODMAPs:

 

Choosing the wrong challenge foods.

Make sure you and your dietitian are choosing challenge foods that only contain one FODMAP  (3).

For example, a pear would not be a good re-challenge food when testing excess fructose as it contains high levels of both fructose and polyols.

If you are trying to challenge excess fructose it would be better to choose honey or mango as the challenge food as they only contain excess fructose, and will give you a clearer indication of your fructose tolerance levels.

How we can help: Get extensive lists of FODMAP challenge foods in our FODMAP Challenge course in the Wellness Club.

 

Not sticking to the low FODMAP diet while doing your FODMAP challenges.

You need to follow the low FODMAP diet carefully while completing the reintroduction phase. This means eating low FODMAP foods and using low FODMAP portions sizes while you do your challenges except for the challenge food you are testing.

This will help you get clear results. If you get gut symptoms during the challenge then you know it’s due to the challenge food and not something else you have eaten.

It is also advised to avoid eating out during your challenge days as you never know 100% what is in your food. If alcohol or caffeine bother you, then you might want to limit these gut irritants on your challenge days, even though they are generally low FODMAP  (6 7).

If you think alcohol or caffeine might be additional IBS triggers, then you can test them at the end of the reintroduction phase with the help of your dietitian.

How we can help: Use our low FODMAP meal plans and delicious recipes to stay on track during the challenge phase. We’re available via chat to help you integrate your challenge foods into recipes each week. Join the FODMAP Wellness Club.

 

Starting the FODMAP challenge test with a high amount of the challenge food.

If you start with a large serving size of the food and it triggers symptoms, then you might miss out on discovering that you can enjoy smaller amounts of that FODMAP group.

When testing a challenge food, start with a small amount of the food and then increase the amount over the next 2 challenge days if your gut remains settled. 

For example, if you start by testing one whole clove of garlic your digestive system might freak out. Instead start with ¼ clove per serve and then increase your serve to ½ a clove.

This process of slowly increasing your serving size increases your chance of finding a serving size of that FODMAP group that you can tolerate and enjoy.

How we can help: Let us guide you each week with recommended challenge amounts, daily tracking sheets and chat support to help you determine what serving sizes are right for you. Get your challenge support in the FODMAP Wellness Club.

 

Additional intolerances or medical conditions that need to be taken into consideration.

If you find you cannot tolerate any FODMAPs (despite having the guidance of a FODMAP trained dietitian), then further investigation is needed (3 8).

It is possible that you could have additional sensitivities to gluten, have food chemical intolerances (salicylates, amines, glutamates, sulphites), small intestine bacterial overgrowth (SIBO) or another condition that needs treatment (3 8).

Your dietitian is the best person to help you investigate these further.

Author: Alana Scott

In 2013, Alana was diagnosed with Irritable Bowel Syndrome. She also suffers from coeliac disease, is allergic to nuts and is intolerant to dairy products. This means she understands how difficult it can be to cook with multiple food intolerances. Her exp... Read More

Professional Reviewer: Joanna Baker (APD)

Joanna is a foodie, an accredited practising dietitian and a registered nurse, who is passionate about digestive health. She now works exclusively in IBS and food intolerance in her Melbourne based private practice Everyday Nutrition. Joanna works alon... Read More

SHOW REFERENCES

1. Mansueto, P., Seidita, A., D’Alcamo, A., Carroccio, A. Role of FODMAPs in Patients with Irritable Bowel Syndrome: A Review. Nutrition in Clincial Practice Journal. 2015-02-18. DOI: 10.1177/0884533615569886. Retrieved from http://ncp.sagepub.com/content/early/2015/02/17/0884533615569886

2. Mullin, G., Shepherd, S., Roland, B., Ireton-Jones, C., & Matarese, L. Irritable Bowel Syndrome: Contemporary Nutrition Management Strategies. Journal of Parenteral & Enteral Nutrition. 2014: Volume 38: Number 7. 781-799. DOI: 10.1177/0148607114545329. Retrieved from http://pen.sagepub.com/content/38/7/781.abstract

3. Scarlata, K. Low FODMAP Diet is Not a Forever Diet. Well Balanced. 2014-09-02. Retrieved from:http://blog.katescarlata.com/2014/09/02/low-fodmap-diet-forever-diet/. Retrieved on: 2015-03-21. (Archived by WebCite® at http://www.webcitation.org/6XD0gY6EH)

4. Martin, L. Re-Challenging & Reintroducing FODMAPs: A guide to the whole reintroduction phase of the low FODMAP diet. Lee Martin. 2015. Retrieved from:http://www.reintroducingfodmaps.com/welcome.html. Retrieved on: 2015-12-07. (Archived by WebCite® at http://www.webcitation.org/6dbukJJ4o)

5. Tuck C., & Barret, J. Re-challenging FODMAPs: The low FODMAP diet phase two. Journal of Gastroenterology and Hepatology. 2017: Volume 32: Issue 1, p. 11-15. Doi 10.1111/jgh.13687

6. Monash University App.  Food Guide. The Monash University Low FODMAP Diet App. 2014: Edition 4. Date retrieved: 2015-03-05. Retrieved from :http://www.med.monash.edu/cecs/gastro/fodmap/iphone-app.html. Accessed: 2015-03-05. (Archived by WebCite® at http://www.webcitation.org/6Wog73c8B)

7. BPACnz. Irritable bowel syndrome in adults: Not just a gut feeling. Best Practice Journal. 2014: Issue 58. 14-25. Retrieved from http://www.bpac.org.nz/BPJ/2014/February/ibs.aspx

8. Gibson, P., Barrett, J. & Muir, J. Functional bowel symptoms and diet. Internal Medicine Journal. 2013: Issue 42. 1067-1074. DOI:10.1111/imj.12266. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24134168

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Mar 6

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Happy Sunday everyone. Who needs a weekend pick-me-up? I know I do. I promise you this recipe won’t disappoint.

Say hello to my low FODMAP cheesecake.

It has a golden crunchy biscuit base layered with a smooth and tangy vanilla cream cheese filling and topped with pops of passionfruit. If you are not a passionfruit fan, then that’s okay just sub in your favourite fruit.

This recipe is low FODMAP (yes there is lactose free cream cheese) and gluten free. You can find the recipe on alittlebityummy.com or follow my profile link.

PS I’d also love to know your favourite cheesecake flavour so leave me a comment below👇

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It’s meatless Monday! What’s on your dinner menu today? Leave me a comment below 👇

On our menu is a low FODMAP vegan chili.

#chilli #veganchile  #tummyfriendly #foodintolerances #ibs #fodmapfriendly #fodmap #glutenfree #glutenfreelife #coeliac #fodmap #lowfodmap #meatlessmonday #inmykitchen

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Feb 26

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End of summer veggies are the best and these roasted eggplants are call my name right now.

These are super simple too - roast the eggplant in oil, salt and pepper until golden and tender. Smother in golden sunshine tahini sauce and sprinkle with toasted seeds.

If you are low FODMAP the 1 small-medium eggplant = 4 servings.

Sunshine tahini dressing:
1 tsp garlic infused oil
1.5 tsp gluten free soy sauce
1 tbsp olive oil
1 tbsp lemon juice
2 tbsp water
3 tbsp tahini
1/2 tbsp pure maple syrup

Place in a jar and shake until well combined.

This recipe is part of our premium FODMAP recipe club (along with 700+ other low FODMAP recipes).

#lowfodmap #fodmap #roastedeggplant #aubergine #vegan #seasonalfood #glutenfreeliving #coeliac #foodintolerances #food52 #inmykitchen #nutfree #nutrition #plantbased

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Feb 22

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I'm stuck at the office and I'm staving! Definitely didn't pack enough snacks today... if I could I'd be drinking this right now.

Give me a ❤️ if you want to be drinking this too. Say hello to my low FODMAP strawberry and rhubarb smoothie.

Strawberries and rhubarb make the best smoothie buddies. It might sound like an odd combo but the tanginess of the rhubarb pairs super well with the sweetness from the strawberries to create a refreshing and vibrant drink.

1 serve 👇

🍓140 g (1 cup)fresh or frozen strawberries
🍓60 g (1/4 cup)stewed rhubarb
🍓250 ml (1 cup) low FODMAP milk 
🍓2 tsp pure maple syrup (add to taste) 
🍓1/2 tsp vanilla essence
🍓6 ice cubes (use if you are using fresh strawberries)

METHOD
Slice the strawberries in half, be super careful doing this if they are frozen. Place all the ingredients in the blender. Add the ice cubes if your strawberries aren’t frozen.

Blend until smooth. Taste and add a little bit more sweetener if it’s too tangy. The tanginess will depend on your stewed rhubarb (ours wasn’t sweetened).

Pour into your favourite glass and enjoy! 

FYI this recipe is also in our premium recipe club.

#lowfodmap #vegan #strawberries #rhubarb #strawberrysmoothie #fodmap #dairyfree #foodintolerances #ibsdiet #bloatfree #happytummy #nutrition #goodfood #fodmapfriendly #foodphotography #lowfodmapdiet #coeliac #glutenfreelife #foodblogger

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Feb 13

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It’s brunch time! It’s also Valentine’s Day so I thought I’d treat my man to a cooked breakfast. Say hello to my Greek scrambled eggs.
 
Serves 2:

1 medium-sized ripe tomato (diced or grated)
1 tbsp fresh chives (finely chopped)
1 tbsp fresh parsley (finely chopped)
2 tsp garlic infused oil
2 tsp olive oil 
3 eggs (beaten)
Salt and pepper

Fry the diced tomato in the garlic infused oil for 2 to 3 minutes until the liquid reduces. Then add the olive oil, chives and parsley to the pan along with the beaten eggs. Season with salt and pepper. Move the egg mixture gently around the pan for 1 to 2 minutes until the eggs are cooked to your liking.

Serve on toast of your choice (we used gluten free bread). Enjoy!

Do you have a favourite brunch meal? Tell me below 👇

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Who loves eating the rainbow for dinner? 🙌 I do! 

It's hot here at the moment which means rice paper rolls make a refreshing low FODMAP dinner option.

I love that you can prep all of the ingredients in advance so you don't have to slave over a hot stove in the evenings.

What's your go-to summer meal?

P.S. You can get the recipe on alittlebityummy.com or follow my profile link.
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