The Ultimate Low-FODMAP Diet Guide for Koreans: Permitted vs. Restricted Foods

Permitted Foods vs. Restricted Foods: A Comprehensive Guide

I often experience gas and abdominal pain, so I was diagnosed with 'Irritable Bowel Syndrome' (IBS) and advised to try a 'low-FODMAP' diet. But when it comes down to it, you might feel lost about what to eat and how, wondering if Korean foods like kimchi or doenjang are okay.

Many people are indeed facing these concerns. Most information available online is Western-centric, making it very difficult to apply to our daily Korean meals. Following it incorrectly can even worsen symptoms.

Hello, I'm Choi Yeon-seung, a doctor of Korean medicine at Baengnokdam Korean Medicine Clinic, who has helped countless Irritable Bowel Syndrome patients manage their diets for 15 years.

The Core of the Low-FODMAP Diet

The core of the low-FODMAP diet isn't about indiscriminate 'restriction,' but rather a process of finding 'foods that suit you personally.' If you read this article to the end today, you won't have to feel overwhelmed and worried anymore. Focusing on the Korean food we eat daily, you'll get a complete guide to a 'Korean-style low-FODMAP diet' that anyone can follow, detailing which foods to eat and which to avoid.

Low-FODMAP, What Exactly Is It?

These components serve as a good food source for gut microbes. The problem is that these microbes produce a tremendous amount of gas during the process of consuming and digesting FODMAPs. This gas is the primary culprit causing bloating (abdominal distension), rumbling sounds, abdominal pain, diarrhea, or constipation.

Important Point

It's important to note that the low-FODMAP diet is not meant to be a lifelong eating plan. It is typically used as a 'diagnostic tool' to help you identify foods that don't suit you, following these three stages:

1. Elimination Phase: Strictly restrict high-FODMAP foods for 2-6 weeks to see if symptoms improve.
2. Reintroduction Phase: Gradually reintroduce restricted foods one by one to test which ones cause discomfort.
3. Personalization Phase: Based on the test results, create a 'personalized diet' consisting of foods that suit you.

Permitted Foods vs. Restricted Foods: A Comprehensive Summary for Koreans

This is probably the part you're most curious about. Based on the Korean foods we eat every day, here's a breakdown of foods you can eat comfortably and those you should be careful with.

Grains

• Permitted (O): White rice, rice noodles, rice cakes (tteok), brown rice (small amounts), oats, potatoes, sweet potatoes
• Restricted (X): Barley, wheat (all wheat flour products: bread, noodles, snacks), rye

Vegetables

• Permitted (O): Cucumber, eggplant, carrot, zucchini, bok choy, bean sprouts, bell peppers, tomatoes, (small amounts of rinsed) ripe kimchi
• Restricted (X): Garlic, onion, green onion (white part), chives, legumes, cabbage, broccoli, mushrooms

Fruits

• Permitted (O): Strawberries, bananas (unripe), oranges, tangerines, grapes, blueberries, kiwi
• Restricted (X): Apples, pears, peaches, watermelon, mango, cherries, avocado

Proteins

• Permitted (O): All types of meat, fish, seafood, tofu, tempeh, eggs
• Restricted (X): Marinated meat (beware of garlic/onion/sugar in marinades), soy milk

Dairy Products and Nuts

• Permitted (O): Lactose-free milk, almond milk, hard cheeses (cheddar, parmesan), almonds (10 pieces or less), walnuts
• Restricted (X): Regular milk, ice cream, soft cheeses (ricotta, cream cheese), yogurt, cashews, pistachios

Condiments and Sauces

• Permitted (O): Soy sauce (gluten-free), sesame oil, perilla oil, vegetable oil, salt, pepper, vinegar
• Restricted (X): Gochujang (Korean chili paste), Doenjang (Korean soybean paste), Ssamjang (Korean dipping sauce) (contain garlic, onion, soybeans, wheat flour), oyster sauce, most commercial sauces

Hold on! Why should we avoid 'garlic, onion, and gochujang,' the core ingredients of Korean cuisine?

Many of you have probably felt discouraged looking at the restricted foods list, especially the vegetables and fermented pastes/sauces sections. It's hard to imagine Korean food without garlic, onions, and gochujang. Why are these ingredients, so familiar to us, classified as 'high-FODMAP' foods that cause gut discomfort?

1. Garlic, Onion, Green Onion (Fructan's Impact)

Garlic, onions, green onions (white part), and chives, among others, contain large amounts of a compound called fructan. Fructan is a prime example of the 'O' (Oligosaccharide) in FODMAPs. The human body lacks the enzymes to break down fructans in the small intestine. Consequently, undigested fructans pass directly into the large intestine, where they become an excellent 'food source' for gut microbes. The problem is that bacteria produce a massive amount of gas during the fermentation process of these fructans. This is why you experience excessive gas and abdominal pain after eating garlic or onions.

2. Gochujang, Doenjang, Ssamjang (Complex FODMAPs)

Gochujang, Doenjang, and Ssamjang are like a 'gift set' containing a complex mix of various FODMAP components. Main ingredient 'Soybean': Soybeans are rich in galactans, another type of oligosaccharide (GOS). Secondary ingredient 'Wheat': Most commercial gochujang and doenjang contain 'wheat' to increase viscosity. Wheat is also a representative high-FODMAP food due to its high fructan content. Additional ingredients 'Garlic, Onion': To enhance umami flavor, most fermented pastes contain a large amount of minced garlic and onion.

Starting Your 'Korean Low-FODMAP Diet'!

You might feel overwhelmed thinking, 'How can I cook without garlic, onions, gochujang, and doenjang?' But with a slight change in perspective, you can enjoy delicious, mild 'gut-friendly Korean food.'

Sample Meal Plan

• Breakfast: White rice, clear egg drop soup without green onions/garlic, soy-sauce braised tofu
• Lunch: Beef rice noodles (using permitted vegetables instead of onions and bean sprouts) or salt-grilled fish with white rice
• Dinner: Grilled chicken breast and roasted potatoes, cucumber and carrot salad (using vinegar, sesame oil)

Tip: If you miss the aroma of garlic and onion, use them only to infuse flavor and then remove them, or try using the green parts of green onions, ginger, or herbs.

While today we focused on the low-FODMAP diet, you might also be curious about the imbalance of 'gut bacteria,' or SIBO, which is a fundamental cause of gas. I will delve deeper into this topic if the opportunity arises soon.

The low-FODMAP diet is not a 'painful restriction,' but rather an 'enjoyable journey of understanding your body.' Don't stress, focus on the 'foods you can eat' and reclaim comfortable days.

[This content was written and reviewed by the medical staff of Baengnokdam Korean Medicine Clinic.]

[References] Shepherd, S. J., & Gibson, P. R. (2006). Fructose malabsorption and the bigger picture. The American journal of gastroenterology, 101(9), 2092-2094.