J Neurogastroenterol Motil.  2015 Oct;21(4):459-470. 10.5056/jnm15111.

The Low FODMAP Diet and Its Application in East and Southeast Asia

Affiliations
  • 1Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Australia. marina.iacovou@monash.edu
  • 2Department of Medicine, University of Hong Kong, Hong Kong.

Abstract

There is growing interest in using food choice/dietary change to influence clinical outcomes in patients with irritable bowel syndrome (IBS). The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) diet is an evidence-based approach that is gaining popularity in many Western countries. The low FODMAP diet is based on restricting dietary intake of short chain carbohydrates that are slowly absorbed or indigestible and not absorbed during passage through the small intestine. These are collectively described as "FODMAPs" and comprise oligosaccharides (mostly fructans, galacto-oligosaccharides), sugar polyols, fructose in excess of glucose, and lactose in lactose malabsorbers. The general strategy of the diet is to avoid foods high in FODMAPs and replace them with foods low in FODMAPs, with long-term restriction limited to what is required to control symptoms. The likely mechanism of action is minimisation of the stimulation of mechanoreceptors exerted by distension of the intestinal lumen with water from osmotic effects and gases from bacterial fermentation in those with visceral hypersensitivity. The success of this dietary approach greatly depends on detailed knowledge about the FODMAP composition of food commonly consumed in that country. While the content of foods associated with East and Southeast Asian cuisines has not been fully explored, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat-based products. Thus, this dietary approach holds great promise in treating IBS patients in East and Southeast Asia. The aim of this review is to highlight how the diet is implemented, its efficacy, and troublesome ingredients frequently used in Asian dishes.

Keyword

Asia; Diet; FODMAPs; Irritable bowel syndrome

MeSH Terms

Asia
Asia, Southeastern*
Asian Continental Ancestry Group
Carbohydrates
Diet*
Fermentation
Fructans
Fructose
Garlic
Gases
Glucose
Humans
Hypersensitivity
Intestine, Small
Irritable Bowel Syndrome
Lactose
Mechanoreceptors
Oligosaccharides
Onions
Shallots
Water
Carbohydrates
Fructans
Fructose
Gases
Glucose
Lactose
Oligosaccharides
Water
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