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FODMAP (Fermentable, Oligo-, Di-, Monosaccharides, & Polyols)

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. - fermentable, poorly absorbed, short-chain carbohydrates, including: - fructose, lactose, fructans (found in wheat), galactans, & polyol sweeteners - high FODMAP foods [7,8] - dairy-based milk, yogurt, ice cream, soy milk made from whole soy beans, custard - wheat, rye & barley-based cereal, bread, crackers, snacks - beans & lentils - some marinated meat, poultry, seafood, processed meats - some vegetables: artichokes, asparagus, cauliflower, green peas, sugar snap peas, mushrooms, onions, garlic, brussel sprouts - some fruits: apples & apple juice, cherries, pears, peaches, nectarines, mango, plums, watermelon - high fructose corn syrup, honey, sugar-free candy - nuts: cashews, pistachios - low FODMAP foods [7,8] - eggs, firm tofu, tempeh, meat, poultry & seafood (marinated with lemon juice & olive oil, black pepper or Italian herbs) - certain cheese: brie, cheddar, feta, hard cheeses, lactose-free dairy - almonds & almond milk, soy milk made from soy protein, walnuts, peanuts, pumpkin seeds, macadamia nuts - grains: rice quinoa, oats, corn, sourdough spelt bread - vegetables: eggplant, potatoes, tomatoes, cucumbers, zucchini, green beans, bok choy, bell pepper, carrots, lettuce - fruits: grapes, oranges, strawberries, blueberries, pineapple, cantaloupe, kiwifruit, mandarin - dark chocolate, maple syryp, sucrose, Pathology: - diarrhea predominant irritable bowel syndrome (IBS-D) [3,4] - may be culprit in gluten sensitivity without celiac disease - patients with irritable bowel syndrome who report gluten sensitivity may be sensitive to FODMAPs Management: - low FODMAP diet [2] - low FODMAP diet leads to clinical response in 50%-80% of patients with IBS-D, in particular with improvements in bloating, flatulence, & diarrhea [4] - low FODMAP diet leads to profound changes in intestinal flora, the duration & clinical relevance are unknown [4] - low FODMAP diet superior to antispasmodic agent for treatment of irritable bowel syndrome (IBS-D) [6] Notes: - FODMAPs in wheat, rye, & legumes

Related

celiac sprue (gluten-sensitive enteropathy) irritable bowel syndrome (IBS) low FODMAP diet

General

food

References

  1. Biesiekierski JR et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology 2013 Aug; 145:320 PMID: 23648697
  2. Halmos EP1, Power VA2, Shepherd SJ2, Gibson PR3, Muir JG3 A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome. Gastroenterology. 2014 Jan;146(1):67-75.e5. PMID: 24076059
  3. Eswaran SL et al. A randomized controlled trial comparing the low FODMAP diet vs. modified NICE guidelines in US adults with IBS-D. Am J Gastroenterol 2016 Dec; 111:1824 PMID: 27725652
  4. Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017 Aug;66(8):1517-1527. Epub 2017 Jun 7. Review. PMID: 28592442
  5. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  6. Carbone F et al. Diet or medication in primary care patients with IBS: The DOMINO study - a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut 2022 Nov; 71:2226. PMID: 35483886 PMCID: PMC9554021 Free PMC article https://gut.bmj.com/content/71/11/2226
  7. Galon Veloso J FODMAP Diet: What You Need to Know Johns Hopkins Medicine. Health https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know
  8. Cleveland Clinic Low FODMAP diet https://my.clevelandclinic.org/health/treatments/22466-low-fodmap-diet
  9. The Low FODMAP Diet Stanford Hospital and Clinics http://stanfordhospital.org/digestivehealth/nutrition/DH-Low-FODMAP-Diet-Handout.pdf

Components

fructan fructose galactan gluten lactose polyol