Review article: FODMAPS, prebiotics and gut health‐the FODMAP hypothesis revisited

Gibson, Peter R; Halmos, Emma P; Muir, Jane G.

doi:10.1111/apt.15818

Cited by 89 publications

(98 citation statements)

References 93 publications

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“…80 Third, changes in gut microbiology and physiology resulting from chronic restriction of FODMAPs or the lack of episodic high FODMAP intake might have altered the response to mechanoreceptor activation. 81 In this way, FODMAP intake might have a pathogenic role in the underlying pathophysiology of IBS, not just the genesis of symptoms.…”

Section: Fodmaps Can Trigger Gastrointestinal Symptomsmentioning

confidence: 99%

Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome

et al. 2021

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Irritable bowel syndrome (IBS) is a common, symptombased condition that has negative effects on quality of life and costs health care systems billions of dollars each year. Until recently, management of IBS has focused on over-thecounter and prescription medications that reduce symptoms in fewer than one-half of patients. Patients have increasingly sought natural solutions for their IBS symptoms. However, behavioral techniques and dietary modifications can be effective in treatment of IBS. Behavioral interventions include gastrointestinal-focused cognitive behavioral therapy and gut-directed hypnotherapy to modify interactions between the gut and the brain. In this pathway, benign sensations from the gut induce maladaptive cognitive or affective processes that amplify symptom perception. Symptoms occur in response to cognitive and affective factors that trigger fear of symptoms or lack of acceptance of disease, or from stressors in the external environment. Among the many dietary interventions used to treat patients with IBS, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols is the most commonly recommended by health care providers and has the most evidence for efficacy. Patient with IBS who choose to follow a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols should be aware of its 3 phases: restriction, reintroduction, and personalization. Management of IBS should include an integrated care model in which behavioral interventions, dietary modification, and medications are considered as equal partners. This approach offers the greatest likelihood for success in management of patients with IBS.

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Section: Fodmaps Can Trigger Gastrointestinal Symptomsmentioning

confidence: 99%

Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome

et al. 2021

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“…In particular sucrose and maltose are not among the most commonly discussed FODMAPs but should not left unconsidered. It was discussed in recent publications that these saccharides should be included in the concept of "new FODMAPs" [33,34]. Deficiencies of brush border hydrolases can lead to these saccharides reaching the colon, where they are rapidly fermented by the gut microorganisms.…”

Section: Fodmaps Of Different Flour Typesmentioning

confidence: 99%

Determination of FODMAP contents of common wheat and rye breads and the effects of processing on the final contents

Schmidt

Sciurba

2020

Eur Food Res Technol

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The benefits of a diet, low in fermentable oligo-, di- and monosaccharides and polyols (FODMAP) for patients suffering from irritable bowel syndrome (IBS) has been well established. Thus, the exact knowledge of the amount and composition of FODMAPs in foods is of vital importance for these patients. This study investigated the possibilities of FODMAP reduction by adjusting the processing parameters, which are feasible in practise, while still producing marketable breads. Therefore, the impact of prolonged proofing and the addition of sourdough on the FODMAPs in the final products was evaluated. High performance anion exchange chromatography was used for qualitative and quantitative analysis. A prolonged proofing time resulted in reduction of the fructan content and in consequence of the total FODMAPs. In contrast, the addition of sourdough only altered the FODMAP composition, by reducing the fructan content but increasing the mannitol content. While all the breads produced from refined wheat flour meet the low-FODMAP criteria, the breads from rye and whole meal wheat flour have to be considered as high-FODMAP, regardless of the processing conditions investigated. Breads produced from rye flour exceeded the limits for fructans and mannitol, while whole meal wheat breads were found to exceed the threshold for excess fructose. Overall, the production of low-FODMAP rye breads was identified as the biggest challenge for future research, since it could not be achieved using conventional processing parameter.

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“…B. wadsworthia is often classified as a pathobiont, due to its frequent detection in patient groups [59][60][61], its ample virulence potential [62,63], and the potentially deleterious nature of its metabolic end-products [57,64]. Several mechanisms are proposed to underlie the observed reduction in Bilophila abundance with FODMAP components, namely, (i) the induction of quantitative or qualitative changes in bile acid production away from sulfite-containing taurine-conjugated components [50,65], (ii) a suppressive effect on hydrogen sulfide production [66,67], or simply (iii) the acidic environment created by carbohydrate fermentation [50,64].…”

Section: Resultsmentioning

confidence: 99%

Effects of Low and High FODMAP Diets on Human Gastrointestinal Microbiota Composition in Adults with Intestinal Diseases: A Systematic Review

Vandeputte

Joossens

2020

Microorganisms

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A diet high in non-digestible carbohydrates is known to promote health, in part through its effect on the gut microbiome. While substantially proven for healthy individuals, these effects are more ambiguous in subjects with intestinal diseases. At the same time, a diet low in these fermentable carbohydrates, the low FODMAP (acronym for Fermentable Oligo-, Di-, Mono-saccharides, And Polyols) diet, is gaining popularity as a treatment option for symptom relief in irritable bowel syndrome and inflammatory bowel disease. There are, however, several indications that this diet induces effects opposite to those of prebiotic supplementation, resulting in gut microbiome changes that might be detrimental. Here, we provide a systematic review of the effects of low and high FODMAP diets on human gastrointestinal microbiota composition in adults with intestinal diseases, through literature screening using the databases PubMed, Embase, and Web of Science. We summarize study findings on dietary impact in patients, including the effect on bacterial taxa and diversity. In general, similar to healthy subjects, restricting non-digestible carbohydrate intake in patients with intestinal diseases has opposite effects compared to prebiotic supplementation, causing a reduction in bifidobacteria and an increase in bacteria associated with dysbiosis. Future studies should focus on assessing whether the induced microbial changes persist over time and have adverse effects on long-term colonic health.

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Review article: FODMAPS, prebiotics and gut health‐the FODMAP hypothesis revisited

Abstract: This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 89 publications

References 93 publications

Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome

Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome

Determination of FODMAP contents of common wheat and rye breads and the effects of processing on the final contents

Effects of Low and High FODMAP Diets on Human Gastrointestinal Microbiota Composition in Adults with Intestinal Diseases: A Systematic Review

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