The Low FODMAP Diet: Many Question Marks for a Catchy Acronym.
The Low FODMAP Diet: Many Question Marks for a Catchy Acronym.
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DOI：
10.3390/nu9030292
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发表时间：
2017-03-16
期刊：
影响因子：
5.9
通讯作者：
Catassi C
中科院分区：
文献类型：
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作者：
Catassi G;Lionetti E;Gatti S;Catassi C
FODMAP，“可发酵的低聚、二聚和单聚碳水化合物和多元醇”，是一组高度可发酵但吸收性差的短链碳水化合物和多元醇。膳食FODMAPs可能通过增加小肠水量、结肠产气和肠道蠕动而加重肠道症状。近年来，用于治疗肠易激综合征（IBS）的低FODMAP饮食越来越受欢迎。在本综述中，我们的目的是总结生理，临床和营养问题，建议谨慎在现有文献的基础上长期使用这种饮食治疗。列入FODMAPs列表的标准尚未完全定义。虽然低FODMAP饮食可以对IBS的症状产生积极影响，特别是腹胀和腹泻，但由于经常出现方法缺陷，特别是缺乏适当的对照组和/或缺乏盲法，证据的质量低于最佳水平。特别是，它仍然有待证明是否这种方案是优于传统的肠易激综合征饮食上级。FODMAP摄入量的急剧减少具有生理后果，例如，对肠道微生物组和结肠细胞代谢的影响，这仍然知之甚少。低FODMAP饮食对饮食选择施加了重要的限制，因为消除了一些主食，如小麦衍生物，含乳糖的乳制品，许多蔬菜和豆类以及几种水果。由于这个原因，患者可能会减少纤维、钙、铁、锌、叶酸、B和D维生素以及天然抗氧化剂的摄入。低FODMAP饮食的营养风险可能更高的人有限的访问昂贵的，替代饮食项目包括在低FODMAP饮食。
FODMAP, “Fermentable Oligo-, Di- and Mono-saccharides And Polyols”, is a heterogeneous group of highly fermentable but poorly absorbed short-chain carbohydrates and polyols. Dietary FODMAPs might exacerbate intestinal symptoms by increasing small intestinal water volume, colonic gas production, and intestinal motility. In recent years the low-FODMAP diet for treatment of irritable bowel syndrome (IBS) has gained increasing popularity. In the present review we aim to summarize the physiological, clinical, and nutritional issues, suggesting caution in the prolonged use of this dietary treatment on the basis of the existing literature. The criteria for inclusion in the FODMAPs list are not fully defined. Although the low-FODMAP diet can have a positive impact on the symptoms of IBS, particularly bloating and diarrhea, the quality of the evidence is lower than optimal, due to frequent methodological flaws, particularly lack of a proper control group and/or lack of blinding. In particular, it remains to be proven whether this regimen is superior to conventional IBS diets. The drastic reduction of FODMAP intake has physiological consequences, e.g., on the intestinal microbiome and colonocyte metabolism, which are still poorly understood. A low-FODMAP diet imposes an important restriction of dietary choices due to the elimination of some staple foods, such as wheat derivatives, lactose-containing dairy products, many vegetables and pulses, and several types of fruits. For this reason, patients may be at risk of reduced intake of fiber, calcium, iron, zinc, folate, B and D vitamins, and natural antioxidants. The nutritional risk of the low-FODMAP diet may be higher in persons with limited access to the expensive, alternative dietary items included in the low-FODMAP diet.