FODMAP

The term FODMAP is an acronym, derived from 'Fermentable Oligo-, Di-, Mono-saccharides And Polyols'. They are short chain carbohydrates that are poorly absorbed in the small intestine. They include short chain oligo-saccharide polymers of fructose (fructans) and galactooligosaccharides (GOS, stachyose, raffinose), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols), such as sorbitol, mannitol, xylitol, and maltitol. Most FODMAPs are naturally present in food and the human diet, however, the polyols may be added artificially in commercially-prepared foods and beverages. The term FODMAP is an acronym, derived from 'Fermentable Oligo-, Di-, Mono-saccharides And Polyols'. They are short chain carbohydrates that are poorly absorbed in the small intestine. They include short chain oligo-saccharide polymers of fructose (fructans) and galactooligosaccharides (GOS, stachyose, raffinose), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols), such as sorbitol, mannitol, xylitol, and maltitol. Most FODMAPs are naturally present in food and the human diet, however, the polyols may be added artificially in commercially-prepared foods and beverages. FODMAPs may cause digestive discomfort in people who are hypersensitive to luminal distension, but they do not cause intestinal inflammation. In fact, naturally occurring FODMAPs help avert digestive discomfort because they produce beneficial alterations in the gut flora. They are not the cause of these disorders, but a low-FODMAP diet, restricting FODMAPs, might help to improve short-term digestive symptoms in adults with irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGID). Avoiding FODMAPs long-term can have a detrimental impact on the gut microbiota and metabolome. FODMAPs, especially fructans, are present in small amounts in gluten-containing grains and have been identified as a possible cause of symptoms in people with non-celiac gluten sensitivity. They are only minor sources of FODMAPs when eaten in the usual standard quantities in the daily diet. As of 2019, reviews conclude that although FODMAPs present in wheat and related grains may play a role in non-celiac gluten sensitivity, they only explain certain gastrointestinal symptoms, such as bloating, but not the extra-digestive symptoms that people with non-celiac gluten sensitivity may develop, such as neurological disorders, fibromyalgia, psychological disturbances, and dermatitis. The use of a low FODMAP diet without a previous medical evaluation could cause health risks because it can ameliorate and mask digestive symptoms of celiac disease, delaying or avoiding its correct diagnosis and therapy. FODMAPs are poorly absorbed in the small intestine and subsequently fermented by the bacteria in the distal small and proximal large intestine. This is a normal phenomenon, common to everyone. The resultant production of gas potentially results in bloating and flatulence. Nevertheless, although FODMAPs can cause certain digestive discomfort in some people, not only do they not cause intestinal inflammation, but they help to prevent it because they produce beneficial alterations in the intestinal flora that contribute to maintain the good health of the colon. FODMAPs are not the cause of irritable bowel syndrome nor other functional gastrointestinal disorders, but rather a person develops symptoms when the underlying bowel response is exaggerated or abnormal. Fructose malabsorption and lactose intolerance may produce IBS symptoms through the same mechanism but, unlike with other FODMAPs, poor absorption of fructose is found in only a minority. Lactose intolerance is found in a majority of adults with the exception of certain geographic populations, notably those of European descent. Many who benefit from a low FODMAP diet need not restrict fructose or lactose. It is possible to identify these two conditions with hydrogen and methane breath testing and thus eliminate the necessity for dietary compliance if possible. The significance of sources of FODMAPs varies through differences in dietary groups such as geography, ethnicity, and other factors. Commonly used FODMAPs comprise the following: Sources of fructans include wheat, rye, barley, onion, garlic, Jerusalem and globe artichoke, beetroot, dandelion leaves, the white part of leeks, the white part of spring onion, brussels sprouts, savoy cabbage, and prebiotics such as fructooligosaccharides (FOS), oligofructose and inulin. Asparagus, fennel, red cabbage and radicchio contain moderate amounts but may be eaten if the advised portion size is observed.