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A brief look at the FODMAPS

Food and the art of cooking are strong passions of mine. When patients come into my office, a discussion around food and eating habits is very important. Nurturing ourselves is a primal instinct, and what we feed ourselves is an individual thing based on many factors. And so, a big conversation is – does dieting or food restrictions have clinical outcomes? This is a topic I cover in my nutrition course, and is also one I am constantly researching. Naturopathic doctors, nutritionists, holistic nutritionists work with diet to identify nutritional needs but also to have therapeutic outcomes. And in children, it is even more important to seek advice when restricting or avoiding certain food groups, and which ones are important.

First, understanding a bit about gut function is necessary at baseline. What are the symptoms? How frequent are they? This information can point to where along the alimentary canal is there some dysfunction. Next we would look at the stool and microbiome to assess digestive metabolism of protein, carbohydrates, and fat, levels of friendly versus pathogenic bacteria, presence of small bacterial overgrowth, malabsorption, and markers of gastrointestinal inflammation.

What to do next is the question. There are variations. I wanted to present recent (2014) studies, from doctors on Australia, on the FODMAPS diet for kids and adults, for symptoms of IBS, or SIBO. A randomized, double-blind placebo controlled study a diet low in FODMAPS was found to be statistically significant in reducing symptoms of IBS compared to controls (1). Another study found results in children to be effective for symptoms as well (2). A more in depth analysis of the FODMAP diet may be found here http://www.medscape.com/viewarticle/848686_4

Because it is new research, the long-term effects of the diet are unknown. Because of this, limiting the diet to a time-frame, under the care of a qualified practitioner, would allow for safety and efficacy.

Following the diet, learning about resistant starches and other pre- and pro-biotics, would be important for maintaining a good micribiome and ensuring healthy digestibility of carbohydrates.

  1. Halmos EP, Power VA, Shepherd SJ, et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014; 146: 67–75.
  2. Chumpitazi BP, Hollister EB, Oezguen N, et al. Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome. Gut Microbes 2014; 5: 165–75.
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