FODMAPs, Part 4: Fueling the Athlete
Sports dietitians advise athletes, depending on the situation, to consume quick carbohydrates before and during exercise. The reasoning is to quickly move fuel from mouth to muscle, avoiding slowed digestion and absorption in the presence of fat, protein, and fiber.
However, the majority of sports foods and beverages I reviewed contained high-FODMAP items:
Fructans: Wheat, cashews, and beet root.
Excess fructose: High-fructose corn syrup, dates, and cherries.
GOS: Inulin, soy flour, and almonds.
Lactose: Whey protein concentrate and hydrolysate.
Polyols: Apples and dried apricots.
Rather than avoiding fueling all together due to frustration or discarding anything that contains honey or dates, read on to learn what products are, and which can be, FODMAP-friendly.
Free downloadable handouts that relate to this article:
Common FODMAP ingredients to look for in sports fuel.
High- and low-FODMAP sports fuel organized by group (e.g., protein powders, chews, recovery drinks).
A Product’s Ingredients List Tells You A Lot
When reviewing if a sport food or beverage contains a high-FODMAP ingredient, keep in mind how the ingredients list is structured: Ingredients are listed in descending order of weight. For instance, assuming a cashew and almond weigh the same, a bag of trail mix containing 500 cashews and 100 almonds would list cashews as the first ingredient and almonds as the second. The only issue is that the consumer doesn’t know what these specific quantities are--consumers only know the order.
If honey, a source of excess fructose, is listed as the second ingredient and an athlete is sensitive to fructose, I would avoid the product. However, if honey is listed as “contains less than 1%” (e.g., Core Power Elite 42, chocolate flavor) or is the 11th ingredient (e.g., KIND Breakfast Bar, dark chocolate cocoa flavor), then it may not be an issue for the athlete. Honey is considered Low FODMAP in quantities of:
Half teaspoon for clover honey (3 grams).
One teaspoon for regular honey (7 grams).
So since the KIND bar lists honey as its 11th ingredient, and the athlete is sensitive to excess fructose, consider if the bar contains half-to-one teaspoon and then make a judgment--rather than flat out nixing the product because honey is an ingredient.
The same goes for almonds. Almonds become high in GOS when 20 nuts (or 1 tbsp. almond butter) are consumed. So if a bar visibly contains five slivered almonds, you're probably OK.
To go a step further, since honey is a common ingredient in sport fuel, check the nutrition label’s line item “Added Sugars”. “Added” means those that were added during the item's processing stage whereas “Total Sugars” include both added sugars and those naturally found in the product (e.g., dried fruit as an ingredient). So, if regular honey was listed as an ingredient, along with other sweeteners that would be considered “added” (e.g., dextrose, sugar), and the “Added Sugars” line listed 5 grams, one could assume that not 100% of the sugars are derived from honey.
Peanut butter is another example. Natural peanut butter, which contains only peanuts and maybe salt, is a low-FODMAP choice. However, shelf-stable jars or on-the-go packets may include high-fructose corn syrup (excess fructose) or dates (fructans in RX Nut Butters and Jif Honey).
Low- and high-FODMAPs lists are always a starting point, but take your time to review the ingredients list and use some common sense when deciding if a product is OK for the athlete's specific FODMAP intolerance(s).
Fueling the Low-FODMAP Athlete: Products
Recommended fueling options for low-FODMAP athletes are listed in a handout found in the free download section of my website. Remember: Neither of these columns means one is inherently better over the other. The only concern here is for athletes who are sensitive to certain FODMAPs.
When it comes to runner’s gut (read my post here), one solution is to avoid relying on high-volumes of excess glucose. When an athlete consumes too much glucose per hour of training (~60 grams/hour), they overwhelm the SGLT1 transporter (i.e., the door that opens when glucose is present in the small intestine). Once overwhelmed, glucose remains in the small intestine, leading to water being pulled into the intestine and leading to diarrhea. Rather, consuming a mixture of fructose and glucose allows another transporter, GLUT5, to become active and increase carbohydrate absorption of up to ~90 grams/hour.
Take-away Message: Be Informed, but Avoid Inappropriate Mass Restriction
"The dose is the poison" is a saying stating that anything, even water, can be hazardous to the body depending on its dose. That holds true for FODMAPs.
Included in my free download that lists high- and low-FODMAP sports fuel by category, I've explained why an item would be considered high FODMAP. As mentioned throughout my four-part FODMAP series, if a food item contains a high-fructan source, that doesn't mean it's high FODMAP across the board.
Remember, an athlete and their dietitian need to figure out what FODMAP group(s) the athlete cannot tolerate and only restrict those. There's no need to restrict when one doesn't need to.
Further Reading:
Lists out commonly-found ingredients and includes their low-FODMAP serving size and what FODMAP(s) the ingredient is high in.
Categorizes fuel into 5 categories: (1) pre- and during-exercise beverages; (2) pre- and during-exercise gels, chews, and waffles; (3) post-exercise beverages; (4) protein powders; and (5) snacks, energy bars, and nut butters. Plus, an explanation is provided as to why each high-FODMAP item is considered high.
This post covers what FODMAPs are, why they can be a problem for some athletes, and why one would follow a low FODMAP diet.
Learn more about where to start and what plan works best for your athlete.
The diet's nuances are plentiful, so dig in for a behind-the-scenes look. Topics include why eliminating gluten may not be the answer, what country of origin FODMAP cut-off values arise from, and what items to use during the challenge phase.
Lis, D.M., Kings, D., & Larson-Meyer, D.E. (2019). IJSNEM, ahead of print.
Kate is a leading dietitian and researcher in the area of FODMAPs. Her free resources include low FODMAPs grocery and a high- and low-foods lists. Follow her on Instagram for FODMAP-friendly recipes and products.
“The Complete Low-FODMAP Diet” by Sue Shepherd, PhD and Peter Gibson, MD.
The book includes lists of low-, medium-, and high-FODMAP options, which is helpful during the challenge and modified diet stages. It also includes a library of recipes and is my go-to book when counseling symptomatic athletes.
The university that penned the term FODMAPs, and continues to lead research on the topic, created an app that allows users to filter by FODMAP subgroup—making it helpful during both the challenge and modified diet stages. The app has a one-time fee and is a tool I use when counseling.
