The low FODMAP diet is a diet which avoids small fermentable carbohydrates such as fructose, lactose, polyols and oligosaccharides to effectively manage irritable bowel symptoms.
The low chemical diet (FAILSAFE | Royal Prince Alfred Hospital) reduces salicylates, amines, glutamates and troublesome food additives such as msg (621) to treat gut symptoms and many other symptoms such as migraines, chronic mouth ulcers, eczema or rashes and extreme fatigue.
It is not unusual to combine these diets, but it is tricky.
How do you make food choices to satisfy both the low FODMAP and the low chemical or failsafe diets?
JOIN THE COMMUNITY: BRAND NEW Dietitian led Facebook group: Amines, Salicylates and Glutamates: The Food Intolerance Dietitian for great information and community support.
1. Start with foods that are common to both elimination diets
VEGETABLES: peeled potato, green beans, swede, iceberg lettuce (discard outer leaves), mung bean sprouts, bean shoots and most cabbages (normal serve approximately 3/4 cup)
MEAT: chicken, lamb, beef or white fish, most seafood: very fresh for low amines & plain
EGGS: long way from expiry date for low amine)
DAIRY: lactose free milk, lactose free plain and unpreserved cream cheese, lactose free vanilla custard, pure butter, fresh plain or vanilla lactose free Greek yoghurt, and lactose free crea
TOFU: Firm tofu (if soy tolerated) rather than silken tofu
OILS (any low salicylate, amine and glutamate oils): canola or sunflower or safflower or rice bran oil or pure butter (if dairy tolerated)
SWEETENERS: pure maple syrup or rice malt syrup (useful alternatives to honey) or regular white or brown sugars
ALCOHOL: the 3 alcohols low in food chemicals are also low in FODMAPs: plain gin, whisky and vodka. Phew! Note that alcohol can be a gut irritant, so be cautious.
SNACKS: plain potato chips eg Red Rock Deli, 1/2 cup unpreserved wheat pretzels, plain rice crackers, plain rice cakes (no corn) and buckwheat pancakes.
The following GLUTEN FREE grains satisfy both diets:
Arrowroot flour
Buckwheat flour
Corn starch such as White Wings cornflour (avoid corn flour or maize flour)
Millet grains, puffs, flakes, flour
Teff
Oats (traditional- 1/2 cup for Low FODMAP, only 1/4 cups quick oats for low FODMAP)
Potato flour or potato starch
Psyllium husk /powder
Quinoa: flour, puffed, flakes, grain
Rice (white or brown), rice flour, rice bran, rice flakes, puffed rice
Sago
Sorghum flour (eg in GF Weet-Bix)
Tapioca flour & starch
Gluten Free flour and Gluten Free Self Raising flour (check no maize flour or corn flour- maize starch or corn starch is acceptable)
2. Modify some foods so they are safe for both diets
Foods such as spring onion can be mo dified to ensure it stays low FODMAP.
SPRING ONIONS: green tips only
A common mistake is thinking that the green tips of leeks are low salicylates, when in fact they are very high salicylates. A lot of people make this mistake as it is well known in the low FODMAP world that green leek tips (green part) are low FODMAP.
When it comes to leeks, you are best to use low FODMAP doses of the white part which brings us to the nexrt section.
Choose LOW FODMAP serves of HIGH FODMAP + LOW SALICYLATE | GLUTAMATE | AMINE foods
Other foods that are high in FODMAPS in normal serve sizes can used in low FODMAP serving sizes.
To avoid stacking: just choose one of the following form the list below, and can repeat in 3-4 hours, as FODMAPs dont build up in the system like food chemicals do.
BRUSSEL SPROUTS: use Low FODMAP size (2 2/3 medium, 53g)
CELERY: use Low FODMAP dose (10g)
LEEK BULB: use Low FODMAP dose (14g or 2 tablespoons)
CHICKPEAS: use Low FODMAP dose of drained and rinsed tinned chickpeas (1/4 cup)
LENTILS: use Low FODMAP dose of drained and rinsed tinned chickpeas (1/4 cup)
OTHER LEGUMES: different low FODMAP doses depending on the legume (refer to low FODMAP app)
CASHEW PASTE: use Low FODMAP dose (2 teapoons of cashew paste or 9g)- preferable non roasted cashews fpor low amines.
CASHEWS: not yet tested by MOnash app for low FODMAP amounts.
CAROB POWDER : use Low FODMAP dose (One heaped teaspoon or 6g)
GOLDEN SYRUP: use Low FODMAP dose (One teaspoon or 7g)
3. Including Some Moderate or Higher Salicylate Vegetables
To be nutritionally adequate, some low FODMAP foods moderate in food chemicals need to be included.
Some like to go strict for one week to lower content of food chemicals and FODMAPs then bring in some moderate salicylate or amine foods. How much to bring in depends on your individual sensitivity.
Including higher salicylate fruit options that are also low in FODMAPS
BANANA: As the only fruit for the strict elimination level is pears which is super high in FODMAPS, compromise usually involves including common bananas (just ripe of course), which are low in salicylates, but moderate in amines if just ripe (if ripe , then amine levels significantly increase as do FODMAP levels). Dont choose lady finger bananas as they are naturally higher in amines than Cavendish bananas.
BLUEBERRIES: small amounts of very high salicylate fruits in small doses can be considered: blue berries are often included in small doses for the precise reason that it is easy to low dose blueberries and feel it is worth it!
PEAR: small amounts of pear may be trialled as often used in recipes - noting that just less than one teaspoon (4g) is low in FODMAPs.
Including higher salicylate vegetable options that are also low in FODMAPS
Including either restricted aounts oas discussed with your Specialised Dietitian or liberal amounts of vegetables that are moderate in food chemicals and also low in FODMAPs can sigficiantly broaden the diet.
Moderate vegetables are lower in salicylates than moderate fruit so if you want to included some salicylates in the diet, then vegetables maybe a better bet.
Low FODMAP and Moderate Salicylate Vegetables in Normal Serve Sizes
BOK CHOY
CARROT (peel otherwise salicylates will be high and choose bland tasting)
CELERIAC
CUCUMBER: peeled
EDAMAME
KOHLRABI
MOST LETTUCE
PARSNIP
MOST POTATOES
SNOW PEAS
SWEET POTATO (does have an upper FODMAP limit)
TURNIP
4. Garlic Oil: a Special Mention
Garlic Infused Oil is an garlic taste replacer in the low FODMAP diet but is an issue if reducing salicylates,amines and glutamates in the diet as commercial gafrlic oil is in extra virgin olive oil which is very high in amimnes and salicylates.
An option is making your own garlic infused oil using tolerated oil such as rice bran oil however need to be careful about sterilising jars to reduce the risk of botulism.
Make the day you needtact as part of the process of cooking. Place an intact segment/clove of garlic in oil in a pan, and fry for 3-5 minutes then remove the intact garlic clove. VOILA! You have made your own ga;rlic infused oil.
Note- freezes well.
5. Avoid the Following
CHEESE:" Ripened cheeses: such as parmesan, Colby, tasty, brie, Coon, Swiss, although low in lactose (FODMAPs) are high or very high in amines.
NUTS: All nuts except small amounts of raw cashews/ cashew paste
SEEDS: All seeds (except poppy seeds)
SUGAR: Raw sugar (all other regular sugars are fine)
OILS: Olive oil: swap for Canola, sunflower, safflower or rice bran oil
CHOCOLATE: very high in amines
FERMENTED FOODS: very high in amines
DRIED FRUITt: very high in salicylates and some will also be very high in amine and of course FODMAPs is usually an issue.
IMPORTANT POINTS
Combining both diets requires more time and planning but can be done.
Moderate salicylate foods need to be included especially fruit/ vegetables otherwose nutritional inadequacy is likely. It can be useful to set up with your specialised Detitian what level of moderate salicylate foods to include in your eliminafion diet.
Only restrict FODMAPs as required- if can tolerate lactose then don't need lactose free milk etc, or if can tolerate wheat fructans (ie bread) then can use unpreserved wheat bread as often as you like
As the combined diet is very nutrtiiotnally limited, suitable multi and targetted nutritional supplementation is highly recommended to cover any gaps in micronutrients
Guidance by a Food Intolerance Dietitian well versed in both diets is required to ensure nutritional replacements for lost nutrients, provide options to increase protein and calorie intake to sustain weight and muscle.
This diet can be done, but to minimise elimination pain and enhance chances of success- enlist a Dietitian experienced and trained in food intolerances. Invest in your health.
Give me a call to see how I can help you.
Blog updated 17/2/2025
REFERENCES
RPAH elimination diet handbooks 1 and 2: with food and shopping guide. Anne Swain, Velencia Soutter, Robert Loblay, 2019 (revised edition).
Monash University low FODMAP app
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