Search the Community

Celiac.com 08/18/2022 - There's been some evidence that diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), and other ingredients, can help improve symptoms of irritable bowel syndrome. In many cases, diet can trigger or worsen symptoms of IBS. Many IBS patients try restrictive diets to relieve their symptoms, but there's no good information on which diets might be effective, and advisable. A team of researchers recently conducted a systematic review and network meta-analysis of randomized-controlled trials (RCTs) reviewing the efficacy of food restriction diets in IBS. The research team included Seung Jung Yu, Hong Sub Lee, Hyeon Jeong Gung, Ju Seok Kim, Ki Bae Kim, Yong Hwan Kwon, Jae Hak Kim, Hoon Sup Koo, Hyun-Deok Shin, Sam Ryong Jee, Han Byul Lee, Jeehyoung Kim, and Hye-Won Park. To get good data for their systematic review and network meta-analysis, the research team searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov databases until July 21, 2021, to retrieve RCTs assessing the efficacy of restriction diets in adults with IBS. They then had two independent reviewers conduct the eligibility assessment and data abstraction. For the study, the team included RCTs that compared a restriction diet with a control diet, and assessed any improvements in global IBS symptoms. In all, the team found nearly two thousand citations. After full-text screening, they found fourteen RCTs that were eligible for the systematic review and network meta-analysis. Diet Low in FODMAPs, Starch, and Sucrose Works Best The team's analysis showed that a starch- and sucrose-reduced diet and a diet with low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) showed significantly better results than a usual diet. Symptom flare-ups in patients on a gluten-free diet were also significantly lower than in those on high-gluten diets. These findings showed that a diet low in FODMAPs, starch, and sucrose works best to reduce IBS symptoms. There are more studies to conduct to prove the benefits of these dietary restrictions on IBS symptoms, but these findings are definitely interesting for anyone suffering from IBS. Read the full article from the Korean Journal of Gastroenterology The researchers in this study are variously affiliated with the IBS Research Study Group of the Korean Society of Neurogastroenterology and Motility Department of Internal Medicine, Inje University Busan Paik Hospital, Busan; Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon; Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon; Department of Internal Medicine, Chungbuk National University Hospital, Cheongju; Department of Internal Medicine, Kyungpook National University Hospital, Daegu; Department of Internal Medicine, Dongguk University College of Medicine, Goyang; Department of Internal Medicine, Konyang University Hospital, Daejeon; Department of Internal Medicine, Dankook University Hospital, Cheonan; Department of Public Health, Ajou University Graduate School of Public Health, Suwon; Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul; Inje University Medical Library, Busan, Korea.

Celiac.com 07/06/2022 - More and more people are avoiding gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) over concerns about their potential connection to celiac-like reactions in the gut. In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) have become more popular across the globe. This is due to intolerances or allergies in some people, but also due to the direct influence of marketing movements or diet trends on eating choices. At the same time, understanding, diagnosing and treating neurological and psychiatric diseases is becoming more important in numerous countries. A number of researchers have started to examine FODMAPs for that reason. Because of this, the research team conducted a bibliographic systematic review to see if there is a pathophysiological relationship between consumption of gluten or FODMAPs and mental disorders. The research team included Egoitz Aranburu; Silvia Matias; Edurne Simón; Idoia Larretxi; Olaia Martínez; María Ángeles Bustamante; María del Pilar Fernández-Gil; and Jonatan Miranda. They are variously affiliated with the Gluten Analysis Laboratory of the University of the Basque Country, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the Bioaraba, Nutrición y Seguridad Alimentaria, in Vitoria, Spain; and the Centro Integral de Atención a Mayores San Prudencio in Vitoria-Gasteiz, Spain. The team's review gathered data from clinical and randomized controlled trials, based on the PRISMA statement, published since 2012. Their analysis found that limiting or ruling out gluten or FODMAPs may improve symptoms such as depression, anxiety, or cognition deficiency, and to a lesser extent for schizophrenia and the autism spectrum. Nevertheless, further studies are needed to obtain completely reliable conclusions. Read more in Nutrients 2021, 13(6), 1894.

Celiac.com 02/21/2022 - For most people with celiac disease, a gluten-free diet typically leads to mucosal remission, but many people continue to have ongoing symptoms. A low FODMAP diet, that is a diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAPS), has been shown to improve symptoms of irritable bowel syndrome (IBS). Could a low FODMAP diet help gluten-free celiacs with ongoing symptoms? A team of researchers recently set out to assess the effects of a moderately low FODMAP diet on ongoing symptoms in gluten-free celiac patients. The research team included Frida van Megen, Gry I. Skodje, Simon Lergenmuller, Stephanie Zühlke, Lars Aabakken, Marit B. Veierød, Christine Henriksen, and Knut E. A. Lundin. They are variously affiliated with the Department of Clinical Services, Oslo University Hospital Rikshospitalet, Oslo, Norway; the Department of Nutrition, Institute of Basic Medical Sciences; the K.G. Jebsen Coeliac Disease Research Centre; the Oslo Centre for Biostatistics and Epidemiology; the Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; ||Healthy Life Centre, Municipality of Nes, Årnes, Norway; and the Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway. The team conducted a randomized controlled trial on 70 adults with biopsy-proven celiac disease from 2018 to 2019. The study included patients with persistent gastrointestinal symptoms, as defined by a Gastrointestinal Symptom Rating Scale (GSRS)–IBS version score of 30 or higher, gluten-free diet treatment for 12 months or longer, and serologic and mucosal remission. The team randomized study subjects into a group receiving a low FODMAP–gluten-free diet (intervention) or the usual gluten-free diet (control group). The team recorded GSRS-IBS scores at baseline and at weeks 1 to 4, and the Celiac Symptom Index at baseline and at week 4. Their statistical analysis included marginal models for repeated data and analyses of covariance. Time development of GSRS–IBS total scores differed significantly between the 34 participants in the intervention group and 36 in the control group, was evident after 1 week, and persisted through week four. Moreover, the intervention group showed significantly lower scores for the dimensions of pain, bloating, diarrhea, and satiety, but not constipation. FODMAP intake during the intervention was moderately low, averaging just over eight grams per day. The Celiac Symptom Index was significantly lower in the intervention group at week four. In this study, a short-term moderately low FODMAP diet significantly reduced gastrointestinal symptoms and increased celiac disease–specific health in celiacs with persistent symptoms, and should be considered for managing the disease in those patients. Read more in the cghjournal.org

Celiac.com 08/04/2021 - Dietary restriction of fermentable carbohydrates (a low-FODMAP diet) is getting a good deal of attention as a potential method for reducing symptoms in patients with irritable bowel syndrome (IBS), particularly in combination with a gluten-free diet. Several studies have associated IBS with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in the gastrointestinal (GI) system of adults with IBS. A team of researchers recently set out to investigate the effects of a low FODMAP-gluten free diet (LF-GFD) on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS. The research team included Kaveh Naseri, Hossein Dabiri, Mohammad Rostami‑Nejad, Abbas Yadegar, Hamidreza Houri, Meysam Olfatifar, Amir Sadeghi, Saeede Saadati, Carolina Ciacci, Paola Iovino, and Mohammad Reza Zali. They are variously affiliated with the Celiac Disease Department, Gastroenterology and Liver Diseases; the Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and the Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Shahid Arabi Ave., Yemen St., Velenjak, Tehran, Iran. In their clinical trial study, the team put 42 IBS patients, with Rome IV criteria, on a low-FODMAP, gluten-free diet for 6 weeks and assessed symptoms using the IBS symptom severity scoring (IBS-SSS), and collected and analyzed fecal samples by quantitative 16 S rRNA PCR assay at baseline, and after the gluten-free diet. They compared gut microbiota diversity at baseline and after 6 weeks of dietary intervention, and analyzed all fecal calprotectin using the ELISA method. Thirty patients, ranging in age from about 25 to 49 years old, completed the six-week diet. After the diet, they showed substantially reduced IBS-SSS overall, compared to the baseline scores. The team noted significant microbial differences in fecal samples taken before and after the dietary period. They found a significant increase in Bacteroidetes, and a decrease in the ratio of Firmicutes to Bacteroidetes (F/B) after the dietary intervention, and also noted decreased FC values. The team's results suggest that IBS patients on a low FODMAP-gluten-free diet show marked reduction in IBS symptom severity, along with reduced FC level after normalization of gut microbiota. The team advocates for more rigorous trials to better assess long-term efficacy and safety of a a low FODMAP-gluten free diet for personalized nutrition in IBS. Read more in BMC Gastroenterol (2021) 21:292

Celiac.com 03/06/2019 - FODMAPs is an acronym, short for “fermentable, oligosaccharides, disaccharides, monosaccharides and polyols.” FODMAPs is a single name for a bunch of different molecules, common in many in foods, that are poorly absorbed by some people. People who can’t tolerate FODMAPs can suffer celiac-like gastrointestinal symptoms. A low FODMAP diet has been shown to help reduce symptoms of IBS, and could be helpful to some people with celiac disease. FODMAPs have also been shown to play a role in non-celiac gluten sensitivity (NCGS). Now, a new app can help people zero in on FODMAPs in food. FODMAPS Trigger Celiac-Like Symptoms in Some People In case you didn’t know, there’s a group of carbohydrates called FODMAPs that may play trigger celiac-like symptoms in certain sensitive people. New research shows that reducing or avoiding FODMAPs, which are poorly absorbed by the gastrointestinal tract, can help to alleviate symptoms of IBS. A Low FODMAP diet works by restricting foods that are high in FODMAPs. Some people with celiacs who experience GI symptoms on a gluten-free diet, and some people with IBS may benefit from eliminating FODMAPS. High FODMAP foods include, but are not limited to: apricots avocado beans cherries dairy fruits garlic high fructose corn syrup honey legumes (soy) lentils maltitol mannitol nectarines onion peaches plums sorbitol wheat xylitol FODMAPs and Gluten-sensitivity in IBS? Some research points to a connection or connections between FODMAPs and gluten-sensitivity in IBS. Doctors have been working to figure out the best dietary strategies, including gluten-free, wheat-free and low FODMAP diets, for the management of IBS symptoms. A recent study of IBS patients shows that rye bread low in FODMAPs can reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms, compared to regular rye bread. APP Helps You Avoid FODMAPs Researchers with the Department of Gastroenterology at Monash University in Australia have developed a diet and related smartphone application to help manage gastrointestinal symptoms associated with Irritable bowel syndrome (IBS) The app is available on both iPhone and Android. Users in over 100 countries worldwide have helped the app become the most popular medical app in over 50 countries. Traffic Lights for FODMAPS The app is based on a comprehensive database of FODMAP content in food, and lists FODMAP foods with a traffic light system and by serving size. Foods coded red are high in FODMAPs and should be avoided, orange coded foods are moderate in FODMAPs and may be tolerated by some people. Foods coded green are low in FODMAPs and are safe to eat. The app features specific food serving size suggestions help users know how much of a given food is safe to eat. The app also contains other information about IBS as well as recipes and meal ideas to help IBS patients interpret and follow the diet. Proceeds from the sale of the application will go towards funding further research. More information about the app can be found on the Monash University website. Read more at: Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity