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Nutrients
Volume 12
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10.3390/nu12020407
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Article

Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer

by
Reetta Holma
1,
Reijo Laatikainen
1,2,
Helena Orell
3,
Heikki Joensuu
4,
Katri Peuhkuri
5,
Tuija Poussa
6,
Riitta Korpela
1 and
Pia Österlund
4,7,*
1
Faculty of Medicine, Pharmacology, Medical Nutrition Physiology and Human Microbe Research Program, University of Helsinki, P.O. Box 63, FI-00014 Helsinki, Finland
2
Booston Oy Ltd., Viikinkaari 6, FI-00790 Helsinki, Finland
3
Department of Clinical Nutrition Therapy, Helsinki University Hospital, P.O. Box 100, FI-00029 HUS, Finland
4
Department of Oncology, Helsinki University Hospital and University of Helsinki, P.O. Box 180, FI-00029 HUS, Finland
5
Social Services and Health Care Division, P.O. Box 6230, FI-00099 City of Helsinki, Finland
6
STAT-Consulting, Vahverokatu 6, FI-37130 Nokia, Finland
7
Department of Oncology, Tampere University Hospital and Tampere university, P.O. Box 2000, FI-33521 Tampere, Finland
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(2), 407; https://doi.org/10.3390/nu12020407
Submission received: 22 December 2019 / Revised: 30 January 2020 / Accepted: 31 January 2020 / Published: 4 February 2020
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Abstract

Chemotherapy-induced mucosal injury of the small intestine may interfere with the enzymes and transporters responsible for the hydrolysis and absorption of dietary carbohydrates causing diarrhoea, abdominal discomfort and pain. The aim of this study was to investigate the association between the consumption of foods rich in FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) and gastrointestinal symptoms in patients receiving adjuvant therapy for colorectal cancer. The patients (n = 52) filled in a 4-day food diary at baseline and during therapy and kept a symptom diary. The intakes of FODMAP-rich foods were calculated as portions and the intakes were divided into two consumption categories. Patients with high consumption of FODMAP-rich foods had diarrhoea more frequently than those with low consumption (for lactose-rich foods the odds ratio (OR) was 2.63, P = 0.03; and for other FODMAP-rich foods 1.82, P = 0.20). Patients with high consumption of both lactose-rich and other FODMAP-rich foods had an over 4-fold risk of developing diarrhoea as compared to those with low consumption of both (OR, 4.18; P = 0.02). These results were confirmed in multivariate models. Conclusion: Consumption of lactose-rich foods results in an increased risk of diarrhoea during adjuvant therapy for colorectal cancer, especially when the consumption of other FODMAP-rich foods is also high.
Keywords: chemotherapy; colorectal cancer; diarrhoea; 5-fluorouracil; FODMAP; gastrointestinal symptoms; hypolactasia; lactose intolerance chemotherapy; colorectal cancer; diarrhoea; 5-fluorouracil; FODMAP; gastrointestinal symptoms; hypolactasia; lactose intolerance

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MDPI and ACS Style

Holma, R.; Laatikainen, R.; Orell, H.; Joensuu, H.; Peuhkuri, K.; Poussa, T.; Korpela, R.; Österlund, P. Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer. Nutrients 2020, 12, 407. https://doi.org/10.3390/nu12020407

AMA Style

Holma R, Laatikainen R, Orell H, Joensuu H, Peuhkuri K, Poussa T, Korpela R, Österlund P. Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer. Nutrients. 2020; 12(2):407. https://doi.org/10.3390/nu12020407

Chicago/Turabian Style

Holma, Reetta, Reijo Laatikainen, Helena Orell, Heikki Joensuu, Katri Peuhkuri, Tuija Poussa, Riitta Korpela, and Pia Österlund. 2020. "Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer" Nutrients 12, no. 2: 407. https://doi.org/10.3390/nu12020407

APA Style

Holma, R., Laatikainen, R., Orell, H., Joensuu, H., Peuhkuri, K., Poussa, T., Korpela, R., & Österlund, P. (2020). Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer. Nutrients, 12(2), 407. https://doi.org/10.3390/nu12020407

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