Nutritional implications of dietary interventions for managing gastrointestinal disorders

Abstract

The role of therapeutic diets in the management of gastrointestinal disorders is increasingly recognized, but there are limited studies investigating their nutritional implications. The judicious use of dietetic expertise should minimize potential nutritional deficits, however further prospective trials are needed to identify the individuals and nutrients most at risk.

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

“…151 Many dairy products, including milk, evaporated milk, and yogurt, are also required to be avoided during the elimination phase. A reduction in dairy is concerning because dairy products provide calcium, fat-soluble vitamins, and are fortified with vitamin D. 150,151 The significant reductions in these groups supports the importance of confirming that patients are reintroducing FODMAPs properly and as soon as they can to promote a well-rounded intake and avoid inadequacies. This further emphasizes the important role a trained RDN plays in low-FODMAP diet education.…”

“…A reduction in grains is concerning, because grains such as wheat, rye, and barley, are important sources of carbohydrates, fiber, B vitamins, and iron. 151 Many dairy products, including milk, evaporated milk, and yogurt, are also required to be avoided during the elimination phase. A reduction in dairy is concerning because dairy products provide calcium, fat-soluble vitamins, and are fortified with vitamin D. [150][151] The low-FODMAP education class that patients attended before participating in this study focused on proper replacement of foods, such as fruits and vegetables, to promote the consumption of a nutritionally adequate diet.…”

“…151 Many dairy products, including milk, evaporated milk, and yogurt, are also required to be avoided during the elimination phase. A reduction in dairy is concerning because dairy products provide calcium, fat-soluble vitamins, and are fortified with vitamin D. [150][151] The low-FODMAP education class that patients attended before participating in this study focused on proper replacement of foods, such as fruits and vegetables, to promote the consumption of a nutritionally adequate diet. Sufficient low-FODMAP diet education could be the reason why the intake of fruits and vegetables did not decrease during the intervention, and this emphasizes the importance of a low-FODMAP diet education to be led by a trained dietitian.…”

Prebiotics – an added benefit of some fibre types

“…; Staudacher et al . ). A small study carried out in 10 healthy subjects aged 23–40 years (with no history of digestive pathology) reported significant decreases in Bifidobacterium and Lactobacillus species and significant increases in some opportunistic pathogens such as Escherichia coli in subjects following a gluten‐free diet for 1 month (De Palma et al .…”

“…Gluten-free was the primary 'free-from' claim being made on products in the UK in 2016 (Mintel 2017), despite the prevalence of coeliac disease estimated as being only 1% of the UK population (Coeliac UK 2018). There is a common misperception that a gluten-free diet is generally more healthy than one that contains gluten (Kim et al 2016), but studies suggest that glutenfree diets are lower in fibre and some micronutrients and higher in sugar (Vici et al 2016;Staudacher et al 2018). A small study carried out in 10 healthy subjects aged 23-40 years (with no history of digestive pathology) reported significant decreases in Bifidobacterium and Lactobacillus species and significant increases in some opportunistic pathogens such as Escherichia coli in subjects following a gluten-free diet for 1 month (De Palma et al 2009).…”