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The Low FODMAP Diet: Many Question Marks for a Catchy Acronym

Department of Pediatrics, Università Politecnica delle Marche, Via F. Corridoni 11, 60123 Ancona, Italy
Author to whom correspondence should be addressed.
Nutrients 2017, 9(3), 292;
Received: 29 December 2016 / Revised: 6 March 2017 / Accepted: 13 March 2017 / Published: 16 March 2017
PDF [227 KB, uploaded 17 March 2017]


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. View Full-Text
Keywords: low-FODMAP diet; irritable bowel syndrome; non-celiac gluten sensitivity; fermentable sugars; polyols; nutritional risk low-FODMAP diet; irritable bowel syndrome; non-celiac gluten sensitivity; fermentable sugars; polyols; nutritional risk
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Catassi, G.; Lionetti, E.; Gatti, S.; Catassi, C. The Low FODMAP Diet: Many Question Marks for a Catchy Acronym. Nutrients 2017, 9, 292.

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