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Open AccessArticle

A Retrospective Study on Dietary FODMAP Intake in Celiac Patients Following a Gluten-Free Diet

1
Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20131 Milan, Italy
3
Department of Nutrition, University of Chile, 8380453 Santiago, Chile
4
Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
5
Gastroenterology and Endoscopic Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
6
Human Nutrition Unit, Department of Food and Drug, University of Parma, 43121 Parma, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(11), 1769; https://doi.org/10.3390/nu10111769
Received: 13 October 2018 / Revised: 7 November 2018 / Accepted: 12 November 2018 / Published: 15 November 2018
(This article belongs to the Special Issue Gluten-Free Diet)
Our aim was to evaluate the intake of foods containing fermentable oligo/di/mono-saccharides and polyols (FODMAP) as a possible factor that induces gastrointestinal symptoms in treated celiac disease (CD) patients. We collected seven-day weighed food records for 104 CD patients and 91 healthy volunteers. All evaluated food items were from sources with high and low content of FODMAP, which were divided into cereals and sweets, sweeteners and soft drinks, fruits, dried fruits, and vegetables. Nutrient intake was calculated using the food database of the European Institute of Oncology. The symptoms reported were assessed by a Rome IV Irritable bowel syndrome (IBS) diagnostic questionnaire and by specific questions for the evaluation of functional gastrointestinal disorders (FGIDs). The 12% of CD patients met IBS symptoms criteria as opposed to 6% of controls (p = 0.09) and 27% of patients reported FGIDs symptoms vs. 22% of healthy controls (p = 0.42). The intake by CD patients was significantly higher than healthy volunteers for: sweeteners and sugars with low content of FODMAP (p = 0.0007), fruits, dried fruits, and vegetables high in FODMAP (p = 0.003) and low in FODMAP (p = 0.04) when compared to controls. CD patients had a lower intake of cereals and sweets with a high content of FODMAP (p = 0.00001). Healthy volunteers consumed significantly higher alcoholic beverages and fats high in FODMAP (both p < 0.044). The mean daily intake of other food categories did not differ between both groups. Even though CD patients had a low intake of gluten-free cereals high in FODMAP, they still consumed a significant amount of fruits and vegetables high in FODMAP. The clinical effect of a concomitant gluten-free diet and low-FODMAP diet should be prospectively evaluated as a supportive therapy in CD patients. View Full-Text
Keywords: FODMAP intake; celiac disease; irritable bowel syndrome; gluten-free diet; gastrointestinal symptoms FODMAP intake; celiac disease; irritable bowel syndrome; gluten-free diet; gastrointestinal symptoms
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Roncoroni, L.; Elli, L.; Doneda, L.; Bascuñán, K.A.; Vecchi, M.; Morreale, F.; Scricciolo, A.; Lombardo, V.; Pellegrini, N. A Retrospective Study on Dietary FODMAP Intake in Celiac Patients Following a Gluten-Free Diet. Nutrients 2018, 10, 1769.

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