Special Issue "Low FODMAP and Gluten Free Diet for the Treatment of Gastrointestinal Diseases"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (15 December 2019).

Special Issue Editors

Dr. Luca Elli
E-Mail Website
Guest Editor
Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Interests: gastroenterology disorders; FODMAP diet; non-celiac gluten sensitivity
Special Issues and Collections in MDPI journals
Dr. Leda Roncoroni
E-Mail Website
Guest Editor
Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Interests: celiac disease; non-celiac gluten sensitivity (NCGS); FODMAP diet

Special Issue Information

Dear Colleagues,

The role of diet in the management of functional gastrointestinal disorders (FGIDs) is relevant. Dietary modification of FODMAPs (fermentable oligosaccharides-disaccharides, monosaccharides and polyols) has been demonstrated to have significant effects in treating clinical manifestations of patients with irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBDs) (i.e., ulcerative colitis, Crohn’s disease) and could be used to support pharmaceutical therapy usually employed in the treatment of these diseases. The low FODMAP diet requires a trained nutritionist because of its complexity, personalized explanation, follow-up, and reintroduction. It is an effective approach, which improves symptoms such as abdominal pain, stool consistency, bloating, postprandial fullness, and epigastric pain. This diet may reduce the expression of proinflammatory markers (C-reactive protein and fecal calprotectin), play a role in the modulation of the gut microbiome, and may influence epigenetic changes. More data are needed to investigate the long-term effects of the low FODMAP diet on the microbiome and the nutritional status of the patients. There are no studies that correlate the low FODMAP diet with other gastrointestinal diseases (i.e., functional esophageal or duodenal disorders) and more studies are needed in this direction. At the same time, the gluten-free diet (GFD) demonstrated its efficacy in patients with unexplained gastrointestinal symptoms and its use. Nowadays, GFD is used in celiac disease, non-celiac gluten sensibility, and in different gastrointestinal and systemic pathologies. Together with a low FODMAP diet, GFD is the most used diet in medicine.

Research on this topic is widely requested to clarify their indications and potential side effects in the long term.

Dr. Luca Elli
Dr. Leda Roncoroni
Guest Editors

Manuscript Submission Information

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Keywords

  • Low FODMAP diet
  • Gluten-free diet
  • IBS (irritable bowel syndrome)
  • Gastrointestinal diseases

Published Papers (3 papers)

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Research

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Open AccessArticle
Impact of FODMAP Content Restrictions on the Quality of Diet for Patients with Celiac Disease on a Gluten-Free Diet
Nutrients 2019, 11(9), 2220; https://doi.org/10.3390/nu11092220 - 14 Sep 2019
Abstract
Restrictive diets as gluten-free (GFD) or reduced in Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) are used to improve gastrointestinal (GI) symptoms in sensitive individuals. Aiming at comparing the nutritional quality and effects of a regular GFD regimen (R-GFD) and a low-FODMAP GFD [...] Read more.
Restrictive diets as gluten-free (GFD) or reduced in Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) are used to improve gastrointestinal (GI) symptoms in sensitive individuals. Aiming at comparing the nutritional quality and effects of a regular GFD regimen (R-GFD) and a low-FODMAP GFD (LF-GFD), in 46 celiac patients with persistent GI symptoms we conducted a randomized, double-blind intervention-controlled study. Patients received a personalized diet, either a strict GFD (n = 21) or a LF-GFD (n = 25) for 21 days. A validated food-frequency questionnaire before intervention and a 7-day weighed-food record after the intervention assessed the diets. Patients were 41.1 ± 10.1 years (mean ± SD), 94% women, with mean BMI 21.8 ± 2.9 kg/m2. On day 21, patients on R-GFD still showed poor nutritional adequacy compared to dietary recommendations, with decreased energy intake, even though an improvement in carbohydrates and folates was observed (all p < 0.025). In both groups, intake of iron, calcium, vitamin D, sodium and folates did not meet daily recommendations. As expected, consumption of legumes and grains was lower and that of fruits was higher in the LF-GFD group than in the R-GFD one (all p < 0.05). The nutritional quality of both diets was not different. When restrictive diets are useful to improve the persistent GI symptoms, careful nutritional surveillance and counseling is mandatory. Full article
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Review

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Open AccessReview
Low FODMAP Diet: Evidence, Doubts, and Hopes
Nutrients 2020, 12(1), 148; https://doi.org/10.3390/nu12010148 - 04 Jan 2020
Abstract
Food is often considered to be a precipitating factor of irritable bowel syndrome (IBS) symptoms. In recent years, there has been a growing interest in FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols), which can be found in many common foods. A low FODMAP [...] Read more.
Food is often considered to be a precipitating factor of irritable bowel syndrome (IBS) symptoms. In recent years, there has been a growing interest in FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols), which can be found in many common foods. A low FODMAP diet (LFD) is increasingly suggested for IBS treatment. However, long-term, large, randomized controlled studies are still lacking, and certainties and doubts regarding LFDs have grown, often in a disorderly and confused manner. Some potential LFD limitations and concerns have been raised, including nutritional adequacy, cost, and difficulty in teaching the diet and maintaining it. Most of these limitations can be solved with the involvement of a skilled nutritionist, who can clearly explain the different phases of the LFD and ensure nutritional adequacy and compliance. Further studies should focus on new methods of teaching and learning the LFD and on predictors of response. Moreover, particular interest should be focused on the possible use of LFD in gastrointestinal diseases other than functional disorders and, possibly, also in non-gastrointestinal diseases. The aim of the present review was to clarify the effective and appropriate indications and limitations of an LFD and to discuss its possible future uses. Full article
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Other

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Open AccessConcept Paper
Heterozygotes Are a Potential New Entity among Homozygotes and Compound Heterozygotes in Congenital Sucrase-Isomaltase Deficiency
Nutrients 2019, 11(10), 2290; https://doi.org/10.3390/nu11102290 - 25 Sep 2019
Abstract
Congenital sucrase-isomaltase deficiency (CSID) is an autosomal recessive disorder of carbohydrate maldigestion and malabsorption caused by mutations in the sucrase-isomaltase (SI) gene. SI, together with maltase-glucoamylase (MGAM), belongs to the enzyme family of disaccharidases required for breakdown of α-glycosidic linkages in the small [...] Read more.
Congenital sucrase-isomaltase deficiency (CSID) is an autosomal recessive disorder of carbohydrate maldigestion and malabsorption caused by mutations in the sucrase-isomaltase (SI) gene. SI, together with maltase-glucoamylase (MGAM), belongs to the enzyme family of disaccharidases required for breakdown of α-glycosidic linkages in the small intestine. The effects of homozygote and compound heterozygote inheritance trait of SI mutations in CSID patients have been well described in former studies. Here we propose the inclusion of heterozygote mutation carriers as a new entity in CSID, possibly presenting with milder symptoms. The hypothesis is supported by recent observations of heterozygote mutation carriers among patients suffering from CSID or patients diagnosed with functional gastrointestinal disorders. Recent studies implicate significant phenotypic heterogeneity depending on the character of the mutation and call for more research regarding the correlation of genetics, function at the cellular and molecular level and clinical presentation. The increased importance of SI gene variants in irritable bowel syndrome (IBS) or other functional gastrointestinal disorders FGIDs and their available symptom relief diets like fermentable oligo-, di-, mono-saccharides and polyols FODMAPs suggest that the heterozygote mutants may affect the disease development and treatment. Full article
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