Iacovou Marina, Tan Victoria, Muir Jane G, Gibson Peter R
Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Australia.
Department of Medicine, University of Hong Kong, Hong Kong.
J Neurogastroenterol Motil. 2015 Oct 1;21(4):459-70. doi: 10.5056/jnm15111.
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 com - monly 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.
利用食物选择/饮食改变来影响肠易激综合征(IBS)患者的临床结局,正引发越来越多的关注。低可发酵寡糖、双糖、单糖和多元醇(FODMAPs)饮食是一种基于证据的方法,在许多西方国家越来越受欢迎。低FODMAP饮食基于限制短链碳水化合物的膳食摄入,这些碳水化合物吸收缓慢或难以消化,在通过小肠时不被吸收。这些碳水化合物统称为“FODMAPs”,包括寡糖(主要是果聚糖、低聚半乳糖)、糖醇、葡萄糖以外的果糖,以及乳糖吸收不良者体内的乳糖。该饮食的总体策略是避免高FODMAPs食物,并用低FODMAPs食物替代,长期限制仅限于控制症状所需的食物。其可能的作用机制是,对于内脏高敏者,通过减少肠腔内因渗透作用产生的水分和细菌发酵产生的气体扩张对机械感受器的刺激。这种饮食方法的成功很大程度上取决于对该国常见食物FODMAP成分的详细了解。虽然与东亚和东南亚美食相关的食物成分尚未得到充分研究,但高FODMAPs的主要来源经常被使用,包括洋葱、大蒜、葱、豆类/豆类,以及小麦制品。因此,这种饮食方法在治疗东亚和东南亚的IBS患者方面具有很大的前景。本综述的目的是强调该饮食的实施方式、疗效,以及亚洲菜肴中常用的麻烦食材。