Low FODMAP in 2017: Lessons learned from clinical trials and mechanistic studies

Eswaran, Shanti

doi:10.1111/nmo.13055

Cited by 25 publications

(14 citation statements)

References 32 publications

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“…[110][111] Colonic hypersensitivity, rather than increased gas production and luminal distension, may drive the FODMAP-related symptoms in some IBS patients. 112 The study by Major et al 111 found that patients with IBS had symptomatic responses to inulin related to levels of intraluminal gas, but peak gas levels did not affect symptom response. This finding indicates that colonic hypersensitivity produces symptoms in patients with IBS rather than excessive gas production.…”

Section: Effect Of Fodmaps In the Gi Tract And The Low-fodmap Dietmentioning

confidence: 99%

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Richards

Al-Muhanna

Roberts

et al. 2018

Journal of the Academy of Nutrition and Dietetics

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Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) that affects 10-20% of adults and adolescents worldwide. A connection has been identified between the consumption of some foods and an exacerbation of IBS symptoms. One nutrition therapy option for IBS is the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet. A lack of data describing the mechanism of action of this dietary pattern has led to insufficient evidence to establish standard clinical guidelines regarding the use of the low-FODMAP diet in IBS. This study aims to define the duration of the low-FODMAP diet elimination phase for optimal symptom relief and the nutritional adequacy of the low-FODMAP diet. Seventy patients with IBS attended low-FODMAP diet group education classes that were provided monthly, and those who consented to the study were instructed to follow the low-FODMAP diet for six weeks. Subjects completed an IBS-Symptom Severity Scale questionnaire (IBS-SSS) at baseline and at weeks 2, 4, and 6. Subjects completed a three-day diet record at baseline and week 2. Dietary compliance was assessed through daily high-FODMAP food checklists. A total of 35 participants enrolled in this study. Complete data was available for 14 (40%) participants. Incomplete data was available for 2 (6%) participants, and 19 (54%) dropped out of the study. Forty-three percent of the original participants (15/35

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Section: Effect Of Fodmaps In the Gi Tract And The Low-fodmap Dietmentioning

confidence: 99%

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Richards

Al-Muhanna

Roberts

et al. 2018

Journal of the Academy of Nutrition and Dietetics

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“…Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs) are rapidly fermentable, poorly absorbed carbohydrates found in food that can cause digestive discomfort, especially for people with IBS [ 145 ]. The action of FODMAPS is likely via multiple pathways [ 146 ], and includes the release of gases from the bacterial fermentation of oligosaccharides and the proportion (if any) of malabsorbed fructose, polyols, and lactose [ 147 ]. Symptoms associated with FODMAPs include abdominal bloating, pain, cramps, excessive flatulence and altered bowel habit [ 146 ].…”

Section: Digestive Healthmentioning

confidence: 99%

The nutritional and health attributes of kiwifruit: a review

Richardson¹,

Ansell

Drummond³

2018

Eur J Nutr

225

161

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PurposeTo describe the nutritional and health attributes of kiwifruit and the benefits relating to improved nutritional status, digestive, immune and metabolic health. The review includes a brief history of green and gold varieties of kiwifruit from an ornamental curiosity from China in the 19th century to a crop of international economic importance in the 21st century; comparative data on their nutritional composition, particularly the high and distinctive amount of vitamin C; and an update on the latest available scientific evidence from well-designed and executed human studies on the multiple beneficial physiological effects.Of particular interest are the digestive benefits for healthy individuals as well as for those with constipation and other gastrointestinal disorders, including symptoms of irritable bowel syndrome. The mechanisms of action behind the gastrointestinal effects, such as changes in faecal (stool) consistency, decrease in transit time and reduction of abdominal discomfort, relate to the water retention capacity of kiwifruit fibre, favourable changes in the human colonic microbial community and primary metabolites, as well as the naturally present proteolytic enzyme actinidin, which aids protein digestion both in the stomach and the small intestine. The effects of kiwifruit on metabolic markers of cardiovascular disease and diabetes are also investigated, including studies on glucose and insulin balance, bodyweight maintenance and energy homeostasis.ConclusionsThe increased research data and growing consumer awareness of the health benefits of kiwifruit provide logical motivation for their regular consumption as part of a balanced diet. Kiwifruit should be considered as part of a natural and effective dietary strategy to tackle some of the major health and wellness concerns around the world.

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“…FODMAPs include foodstuffs that contain fructose (apples, pears, watermelon and honey), vegetables rich in fructan (onions, asparagus, artichoke and leek), wheat-based products (bread, doughs in general), sorbitol (artificial sweeteners) and raffinose (cabbage, lentils and beans). Although highly restrictive, a FODMAP free diet generally brings notable benefits to IBS patients (8,9,16,19,23,29,30) . All foods in the questionnaire were reported as domestic measures converted into grams, using the table set out by the Department of Nutrition at the Federal University of Rio de Janeiro (36) , consumption patterns were recorded for one month and was applied by the interviewer.…”

Section: Figure 1 Relation Between Fodmaps and Functional Intestinalmentioning

confidence: 99%

Evaluation of Carbohydrate and Fiber Consumption in Patients With Irritable Bowel Syndrome in Outpatient Treatment

Lopes

Miszputen

Sachs

et al. 2019

Arq. Gastroenterol.

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BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional condition, which main symptoms of pain, discomfort and abdominal distension, constipation, diarrhea, altered fecal consistency and sensation of incomplete evacuation can be influenced by the presence of dietary fiber and fermentable carbohydrates (FODMAPs). This study aimed to assess the relationship between the quantity of fermentable carbohydrates (FODMAP) and fiber consumed by individuals diagnosed with IBS, and their classification according to the Rome III criteria. METHODS: A transversal study was carried out in the Intestinal Outpatient Clinic of the Gastroenterology Discipline of UNIFESP. The nutrients of interest for the study were: fiber, general carbohydrates and FODMAPs, with intake quantity measured in grams, analyzed through portions consumed. A nutrition log was used, along with a semi-quantitative questionnaire of consumption frequency. RESULTS: The sample included 63 adult patients; 21 with constipated IBS, 21 with diarrhea IBS, and 21 with mixed IBS. Carbohydrate intake was suboptimal in 55.6% of patients in all groups; excessive consumption was identified in 38.1% of the diarrhea group, 14.3% of the mixed group and 38.1% of the constipated group. Low consumption of carbohydrates was found in 28.6% of diarrhea patients and 47.6% of the mixed group. A mean intake of 23 g of fiber per day was identified, lower than recommended. CONCLUSION: The study identified a number of inadequacies in the consumption of different nutrients, excessive carbohydrate intake, especially FODMAPs, identified by the respondents as responsible for a worsening of their conditions. By contrast, other food groups such as meat, eggs and dairy were consumed by the sample population in insufficient quantities.

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Low FODMAP in 2017: Lessons learned from clinical trials and mechanistic studies

Cited by 25 publications

References 32 publications

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

The nutritional and health attributes of kiwifruit: a review

Evaluation of Carbohydrate and Fiber Consumption in Patients With Irritable Bowel Syndrome in Outpatient Treatment

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