Stacking – What It Is and How to Handle It

Stacking – What It Is and How To Handle It

The Tummy Clinic | January 14th, 2023

It’s time to clear the confusion around stacking. Read on for additional information on low FODMAP options for holiday food.

FODMAPs, as we know, are types of carbohydrates found in certain foods, including wheat and beans. Studies have shown strong links between FODMAPs and digestive symptoms like gas, bloating, stomach pain, diarrhoea, and constipation. Low FODMAP diets can provide remarkable benefits for many people with common digestive disorders. When people say FODMAP diet, they generally refer to a diet low in FODMAPs. This diet is designed to help people with irritable bowel syndrome (IBS) and/or small intestinal bacterial overgrowth (SIBO) figure out which foods are problematic and which foods reduce symptoms.

FODMAP stacking, as defined by Monash researchers, refers to how FODMAPs can ‘add up’ in our gut. This means you could ingest a small amount of FODMAPs and not experience any IBS symptoms; however, if you eat more of the exact same food(s), you ingest a greater amount of FODMAPs, and could develop IBS symptoms.

When following the low FODMAP diet, we consume amounts of foods in their various FODMAP levels. These can be broadly determined by using the Monash University Low FODMAP Diet Smartphone App or the FODMAP Friendly App. It provides information about what serving sizes of a particular food will be low FODMAP according to lab testing.

Monash University presents the traffic light system (Green for Low FODMAP; Yellow for Moderate; Red for High FODMAP). Most times, it indicates which individual FODMAP is involved. FODMAP Friendly has a system which always lists each type of FODMAP, as well as percentages of those FODMAPs, which can be used to assess stacking on a more micro level.

In one sitting, the total amount of FODMAPs consumed (be it from fructose, fructans, lactose, GOS or sugar polyols) influences whether the meal is tolerated or whether symptoms are induced. It allows people to include more than one ‘green serve’ of food per sitting. The Monash FODMAP Diet App green light cut-offs allow for safe combinations of multiple foods together in a meal.

Understanding FODMAP Stacking

FODMAP stacking refers to IBS symptoms possibly occurring due to consuming multiple “green” FODMAP servings of foods. This usually happens when they contain amber and red amounts of FODMAPs in higher quantities. Thus, the total amount of FODMAPs eaten in one sitting/ meal gets ‘stacked’ up.

Stacking refers to the consumption of foods of not only the same type of FODMAP but any type of FODMAPs.

Tips To Avoid Stacking

The concept of stacking generally relates to a single sitting or meal. This assumes that meals are spaced out over the day, with at least 2-3 hours between each meal or snack. This allows food to be digested between meals and slows the rate at which the gut is exposed to FODMAPs. Here are some simple tips to avoid stacking…

  • First of all, if your symptoms are well controlled, you don’t need to start worrying about stacking. Consider FODMAP stacking if you notice that while a low FODMAP diet has improved most of your symptoms, you still experience some symptoms even though you are only eating low FODMAP foods.
  • It’s important to space out your meals. A gap of 2-3 hours should be maintained between meals and snacks to avoid potential additive effects.
  • Consume naturally low FODMAP foods for example protein foods like eggs, meat, fish, grains like rice or vegetables like carrots.
  • Include low FODMAP, protein and fibre-rich foods with each meal or snack to help you feel full. Snack ideas can include a small handful of nuts such as almonds or walnuts, fruit like orange or banana, low lactose yoghurt, cheese, a small tin of salmon or tuna, boiled egg, or plain popcorn.
  • Maintain a food and symptom diary to keep track of issues. This will also help you notice if you are constantly snacking, or eating shortly after a meal, for reasons other than physical hunger. Working with a GI dietician who specializes in using a FODMAP diet is the best way to work out what your individual IBS triggers are, and whether FODMAP stacking is an issue for you.
  • Even if foods have amber or red lights for larger serve quantities, they can be safely consumed in green serving sizes combined in one meal without fear of triggering symptoms.

Frequently Asked Questions

Irritable bowel syndrome (IBS) is characterized by a variety of symptoms, including cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term. The cause is not well understood.

There is no definitive test to diagnose IBS. IBS is diagnosed after your doctor has reviewed your symptoms and occasionally ordered tests to rule out other conditions.

Visits at the Tummy Clinic are not covered by OHIP or your provincial health care system, however, most extended healthcare plans cover many aspects of the care you will receive here, such as visits to Naturopathic Doctors, Dietitians, Social Workers or Psychotherapists. Check your benefits package or contact your insurance company for more information.