FODMAP intake in children with coeliac disease influences diet quality and health-related quality of life and has no impact on gastrointestinal symptoms

Cyrkot, Samantha; Marcon, Margaret; Brill, Herbert; Mileski, Heather; Dowhaniuk, Jenna; Frankish, Alena; Carroll, Matthew; Persad, Rabin; Turner, Justine; Mager, Diana R.

doi:10.1080/09637486.2021.1880553

Cited by 6 publications

(13 citation statements)

References 50 publications

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“…From 53 publications and registers screened, 7 studies (4 randomized clinical trials (RCT) (8)(9)(10)(11) and 3 interventions (12)(13)(14) without control group or observational studies) were included -all on functional abdominal pain disorders (Table 2). No pediatric studies were found on non-celiac gluten sensitivity (NCGS), small intestinal bacterial overgrowth (SIBO) or inflammatory bowel disease (IBD).…”

Section: Overview Of the Evidence Of The Use Of Low-fodmap Diet In Ch...mentioning

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Excluding oligo-, di-, monosaccharides and polyols (FODMAPs) from the diet is increasingly being used to treat children with gastrointestinal complaints. The aim of this position paper is to review the available evidence on the safety and efficacy of its use in children and provide expert guidance regarding practical aspects in case its use is considered. Members of the Gastroenterology Committee, the Nutrition Committee and the Allied Health Professionals Committee of the European Society for Pediatric Gastroenterology Hepatology and Nutrition contributed to this position paper. Clinical questions regarding initiation, introduction, duration, weaning, monitoring, professional guidance, safety and risks of the diet are addressed. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. The systematic literature search revealed that the low-FODMAP diet has not been comprehensively studied in children. Indications and contraindications of the use of the diet in different pediatric gastroenterological conditions are discussed and practical recommendations are formulated. There is scarce evidence to support the use of a low-FODMAP diet in children with Irritable Bowel Syndrome and no evidence to recommend its use in other gastrointestinal diseases and complaints in children. Awareness of how and when to use the diet is crucial, as a restrictive diet may impact nutritional adequacy and/or promote distorted eating in vulnerable subjects. The present article provides practical safety tips to be applied when the low-FODMAP diet is considered in children.

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Section: Overview Of the Evidence Of The Use Of Low-fodmap Diet In Ch...mentioning

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…This reflects the high levels of heterogeneity across the included studies. Studies used both parental-proxy and child self-reports: 3 studies (34,37,38) found lower parental reported HRQOL than children’s reports, 1 study (39) found higher parental reported HRQOL than child reports, and another found no difference (18). Overall, evidence suggests that inconsistencies in HRQOL may be due to differences in factors such as gastrointestinal symptoms, GFD adherence, time since diagnosis, and the child’s current age.…”

Section: Resultsmentioning

confidence: 99%

“…GFD adherence may improve HRQOL due to reduced gastrointestinal symptoms. Studies measured symptoms using structured validated questionnaires, which were GI‐specific (eg, GSS) (39) and non‐specific (eg, SF‐36) (49). In 3 studies (17,40,41) which found no significant difference in HRQOL related to adherence, levels of symptoms were not measured, or data were only collected on symptoms at diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…No significant difference was found between the HRQOL of asymptomatic children with CD and healthy controls before and after GFD commencement, indicating increased gastrointestinal symptoms may impact HRQOL (24). Additionally, children with CD had higher HRQOL than those with other minor GI symptoms and CD ruled out (39), suggesting that symptom reduction improves HRQOL, despite the demands of the GFD.…”

Section: Resultsmentioning

confidence: 99%

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Examining the Psychosocial Well‐Being of Children and Adolescents With Coeliac Disease

Atkinson

David

2022

J. pediatr. gastroenterol. nutr.

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This review aimed to synthesize the available literature regarding the psychosocial well-being of children and adolescents with coeliac disease (CD). Research on psychosocial well-being outcomes in children and adolescents with CD under the age of 18 were identified through a systematic search in the PsychInfo, Medline, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases in July 2021. Outcomes, including health-related quality of life (HRQOL), psychological adjustment, mental health, and social functioning were examined. Changes in outcomes over time and the geographic representation of the included studies were also analyzed. A total of 43 studies were included. Mixed results were found in the domain of HRQOL and mental health. Both challenges with psychological adjustment and adaptive coping strategies were identified. Social functioning was found to be an area of difficulty for children and adolescents with CD. However, there was high heterogeneity in methodology and participant characteristics between studies. This review concluded there were mixed findings regarding the HRQOL and mental health of young people with CD. However, CD and the gluten-free diet initiates a need for psychological adjustment and impacts on social functioning. The review highlights the need for the integration of physical and psychosocial care, and further research to determine the most appropriate screening measures, and the most efficacious psychological interventions for this group. Future research should continue examining changes in psychosocial outcomes over time given the increase in the availability of gluten-free foods and changes in food labeling policies.

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“…Although gluten-free, some pseudo-cereals such as amaranth have a dubious reputation for containing FODMAPs. Processed products made from amaranth grains, which are rich in micronutrients and bioactive compounds, can have high FODMAPs levels [ 13 ]. Still, the FODMAPs content of amaranth bran (AB) has not been reported yet.…”

Section: Introductionmentioning

confidence: 99%

Bioprocessing of Wheat and Amaranth Bran for the Reduction of Fructan Levels and Application in 3D-Printed Snacks

Habuš

Mykolenko

Iveković

et al. 2022

Foods

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Bran can enrich snacks with dietary fibre but contains fructans that trigger symptoms in people with irritable bowel syndrome (IBS). This study aimed to investigate the bioprocessing of wheat and amaranth bran for degrading fructans and its application (at 20% flour-based) in 3D-printed snacks. Bran was bioprocessed with Saccharomyces cerevisiae alone or combined with inulinase, Kluyveromyces marxianus, Limosilactobacillus fermentum, or commercial starter LV1 for 24 h. Fructans, fructose, glucose, and mannitol in the bran were analysed enzymatically. Dough rheology, snack printing precision, shrinkage in baking, texture, colour, and sensory attributes were determined. The fructan content of wheat bran was 2.64% dry weight, and in amaranth bran, it was 0.96% dry weight. Bioprocessing reduced fructan content (up to 93%) depending on the bran type and bioprocessing agent, while fructose and mannitol remained below the cut-off value for IBS patients. Bran bioprocessing increased the complex viscosity and yield stress of dough (by up to 43 and 183%, respectively) in addition to printing precision (by up to 13%), while it lessened shrinkage in baking (by 20–69%) and the hardness of the snacks (by 20%). The intensity of snack sensory attributes depended on the bran type and bioprocessing agent, but the liking (“neither like nor dislike”) was similar between samples. In conclusion, snacks can be enriched with fibre while remaining low in fructans by applying bioprocessed wheat or amaranth bran and 3D printing.

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FODMAP intake in children with coeliac disease influences diet quality and health-related quality of life and has no impact on gastrointestinal symptoms

Cited by 6 publications

References 50 publications

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Examining the Psychosocial Well‐Being of Children and Adolescents With Coeliac Disease

Bioprocessing of Wheat and Amaranth Bran for the Reduction of Fructan Levels and Application in 3D-Printed Snacks

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