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FODMAP Diet Could be Effective Managing IBD

More research is needed on how the various FODMAP diets impact the gut microbiota and IBD management.

New research shows the fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet can be a promising supplemental therapeutic approach to better managing patients with inflammatory bowel disease (IBD).

A team, led by Catarina D. Simões, Faculty of Health Sciences, University Fernando Pessoa, reviewed the effect of individual FODMAP diets on the human gut microbiota in patients with IBD and developed an updated overview of low-FODMAP diets for IBD, particularly the implementation, advantages, limitations, and the impact of the gut microbiota.

The FODMAP Diet

This diet values whole grains, fruits, vegetables, and lean proteins like chicken and fish, while eliminating the processed sugars and sweeteners that are prevalent in many diets today.

Currently the diet has also shown promise as a therapeutic option for patients with irritable bowel syndrome (IBS) as well as IBD.

The low-FODMAP diet has been in the past hypothesized as a potential therapeutic approach for patients with IBD in disease management. However, when implementing this diet there is the potential risk of nutrition deficiencies due to the specific broad food restrictions. There is also the possibility of aggravating gut microbiota dysbiosis for patients with IBD.

In the study, the investigators examined data from various literature searches for studies on IBD and various versions of the FODMAP diet.

Clinical Impact

The investigators found the low-FODMAP diet could effectively improve clinical outcomes in managing IBD, as well as ensure a better quality of life for patients with IBD. However, there are some areas of concern, namely the adequacy of the diet and the impact it has on the gut microbiota.

In addition, the various types of FODMAP diets differently modulate the gut microbiota.

“IBD management should be achieved with the least possible dietary restriction to avoid detrimental consequences, particularly on nutritional adequacy and gut microbiota,” the authors wrote. “Thus, it is important to individualize and monitor the nutrition intervention.”

Future Research

The investigators also said further research is needed on FODMAP diets and the impact on IBD.

Here, they would like to better characterize the relationship between the diet, gut microbiota, and IBD to support the generalization of using the dietary approach for clinical practice in IBD therapy and management.

More Promising Data

In 2019, investigators found the FODMAP diet could help reduce lower gut symptoms for patients with quiescent IBD.

The investigators found a higher proportion of patients reported adequate relief of gut symptoms following a low FODMAP diet (52%) than the control group (16%, P =.007).

Patients had a greater reduction in IBS severity scores following the low FODMAP diet (mean reduction of 67, standard error, 78) than the control diet (mean reduction of 34; standard error, 50), but the difference was not statistically significant (P =.075).

Patients also had higher quality of life scores (81.9 ± 1.2) following a low FODMAP diet than patients on the control diet (78.3 ± 1.2, P = .042).

The study, “FODMAPs, inflammatory bowel disease and gut microbiota: updated overview on the current evidence,” was published online in the European Journal of Nutrition.