April is IBS Awareness Month. IBS stands for Irritable Bowel Syndrome, a digestive disorder that has no known cure yet as the causes are complex. But, it can be managed well with lifestyle changes.
Some of my long-time readers will know that I have had IBS for the past 15 years, and it is one of the reasons (other than ethical and environmental) that I adopted a whole food, plant-based diet. 20% of the population in Singapore has IBS and many don’t know about it. I believe in spreading awareness to help those affliccted make beneficial changes to improve quality of life.
One of the ways recommended by doctors to manage IBS is to try a low FODMAP diet for some time. Such a diet mainly involves avoiding foods that may be triggering the gut and identify intolerances. Currently, I am not able to try low FODMAP, but I’m putting out a couple of suitable recipes for those on this diet. Most FODMAP-friendly recipes online now are Western or Westernised dishes. With some creativity and care, Southeast Asian IBS sufferers can enjoy familiar foods again, like a local Chinese rice noodles dish, Sin Chew Bee Hoon.
Sin Chew Bee Hoon means Singapore Rice Noodles. Don’t confuse it with the Singapore Noodles popular in Western countries. Actually, you can’t find that in Singapore. Singapore Noodles are rice noodles stir-fried with curry powder, a combination that originated from Hong Kong, not Singapore .
What is FODMAP?
FODMAP stands for:
- Fermentable i.e. Foods that are digested by intestinal bacteria – producing gas that causes bloating.
- Oligosaccharides i.e. Starchyose, Raffinose e.g. sources from legumes, beans, lentils, certain vegetables. Acts as soluble fiber.
- Disaccharides i.e. sucrose (refined sugar), lactose (milk sugar) and maltose (malt sugar).
- Monosaccharides i.e. simplest form of carbohydrate such as glucose, fructose (fruit sugar).
- Polyols e.g. sugar alcohol such as xylitol, sorbitol; low calorie/no calorie sweetener which are poorly digested.
Low FODMAP simply means avoiding foods high in FODMAP.
Pointers to keep in mind:
- A vegan diet low in FODMAP is highly restrictive and it serves as a short term solution to reduce IBS symptoms and find out intolerances.
- Low FODMAP doesn’t mean no FODMAP. You would definitely consume FODMAP in many recipes but in amounts that are suitable for your body.
- Eating actual main meals and less sweet desserts can help to reduce your intake of FODMAP. By reducing sugar intake, you are treating your gut well. Certain fruits such as grapes, strawberry, pineapple can be used as dessert as they are lower in FODMAP.
- Portion size matters to keep the amount of FODMAP in check.
Sin Chew Bee Hoon 星州米粉 is usually made with high FODMAP ingredients like garlic, onion, shallots, spring onion and oyster sauce. Vegetarian oyster sauce likely contains MSG which is another gut irritant. For this FODMAP-friendly version, I used tomatoes, traditional soy sauce and miso to achieve a rich, natural, MSG-free umami.
Low-FODMAP SIN CHEW BEE HOON
- 1 serving of rice noodles, soaked till just softened.
- 1/2 tbsp traditional soy sauce (use tamari or Bragg’s for gluten-free option)
- 1 tbsp miso
- 5cm ginger, cut into matchsticks
- 1/2 block sprouted firm tofu, sliced to bite sized pieces
- 1 tbsp cooking oil
- 1 cup water
- 1 tomato, cut into wedges
- 1/3 carrot, julienned
- 2 chilli padi, halved, seeds removed (some IBS patients are sensitive to chilli, omit if needed)
- 1 piece bamboo shoot, sliced to bite sized pieces
- White pepper, to taste
- Coriander, to garnish
- 1 Lime, to garnish (some IBS patients are sensitive to citruses even in small amounts, omit if needed)
In a pan, fry tofu slices in oil till evenly browned. Set aside. Dissolve miso and soy sauce into water in a bowl, set aside. In a wok, heat oil and add ginger, chilli, fry till fragrant. Add tomato and stir for a minute over medium heat, till softened. Add bamboo shoots, carrot and fry for a minute or so. Add rice noodles with the miso and soy sauce mixture. Cover and simmer over low heat for 5 minutes, stirring when needed till noodles soften and liquid is almost absorbed. If you like to have more gravy, remove from heat earlier. Garnish with coriander and lime and serve hot.
What makes it low FODMAP?
Vegetables such as cauliflower and broccoli are cruciferous vegetables which are more difficult to digest as it contain higher amounts of raffinose compared to other vegetables such as carrots, tomatoes and bamboo shoots used in the recipe.
Tofu and Miso
Firm tofu is slightly easier to digest than regular soybeans because it went through process of soaking and finally squeezing out the excess liquid — which removes the galacto-oligosaccharides present in soy. Miso is made from fermented soybean so it makes it easy for the gut to digest.
Rice is a gluten free complex carbohydrate (starch) and FODMAP only consist of short to medium chain carbohydrate. Therefore it is considered low FODMAP. It is also easier to digest than the regular wheat noodles which is on the high FODMAP scale; plus it also contains gluten which is worse for people with gluten sensitivities. Most IBS sufferers can take rice at moderate amounts without triggering symptoms.
The most efficient ways to manage light to mild IBS is a holistic lifestyle approach – stress management, eating suitably and regularly, regular exercise and sufficient rest. My detailed tips to manage IBS here. When in doubt, always consult a healthcare professional. Wish everyone happy guts and stay tuned for the next recipe!
For a more complete list of FODMAP-friendly foods, visit here. Note that not all Asian ingredients are listed. When in doubt, avoid or test small amounts.
Nutritional information provided by Krystle Co.