The low-FODMAP diet is a new dietary therapy for the management of irritable bowel syndrome that is gaining in popularity around the world. Developing the low-FODMAP diet required not only extensive food composition data but also the establishment of "cutoff values" to classify foods as low-FODMAP. These cutoff values relate to each particular FODMAP present in a food, including oligosaccharides (fructans and galactooligosaccharides), sugar polyols (mannitol and sorbitol), lactose, and fructose in excess of glucose. Cutoff values were derived by considering the FODMAP levels in typical serving sizes of foods that commonly trigger symptoms in individuals with irritable bowel syndrome, as well as foods that were generally well tolerated. The reliability of these FODMAP cutoff values has been tested in a number of dietary studies. The development of the techniques to quantify the FODMAP content of foods has greatly advanced our understanding of food composition. FODMAP composition is affected by food processing techniques and ingredient selection. In the USA, the use of high-fructose corn syrups may contribute to the higher FODMAP levels detected (via excess fructose) in some processed foods. Because food processing techniques and ingredients can vary between countries, more comprehensive food composition data are needed for this diet to be more easily implemented internationally.

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The topic "Food at the Intersection of Gut Health and Disease" was chosen owing to the mounting evidence for the role of diet in modulating gastrointestinal disorders coupled with the paucity of formal training in nutrition for gastroenterologists. The conference faculty was unique by including registered dietitians who provided insight into dietary management. An R13 grant was awarded by the National Institutes of Health (NIDDK) for young faculty who moderated sessions and collaborated on this meeting summary.

The aim of this study was to identify benefits and barriers to using a gastroenterology (GI) dietitian for irritable bowel syndrome (IBS) care. METHODS:A 25-question survey was electronically distributed to the members of the American College of Gastroenterology. Information pertaining to demographics, barriers, and values to using a GI dietitian for IBS patient care was collected. RESULTS:Two hundred seventy-nine survey responses were collected. Although 56% of the GI providers feel they are trained to provide nutrition education, almost half (46%) sometimes, rarely, or never provided information to aid menu planning, label reading, or grocery shopping, and 77% spent £10 minutes for nutrition counseling. Of those with access to a local dietitian, 91% strongly agreed or agreed that having access to a GI dietitian would help them manage their IBS patient care more effectively, but 42% lack access to a local GI dietitian. DISCUSSION:Our survey identified gaps in nutrition-based interventions for IBS care.