Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia.
Aliment Pharmacol Ther. 2019 Jan;49(2):124-139. doi: 10.1111/apt.15079.
Despite the efficacy of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) for patients with irritable bowel syndrome, many questions remain unanswered with respect to its clinical implementation.
To review literature to identify, synthesise, and provide direction for future research in the implementation and evaluation of the low FODMAP diet.
Bibliographical searches were performed in Ovid Medline, CINAHL, Scopus and PubMed from database commencement until September 2018, with search terms focused on the population (irritable bowel syndrome) and intervention of interest (FODMAP).
Predictors of response to a low FODMAP diet remain under investigation, with preliminary data supporting faecal microbiota or faecal volatile organic compound profiling. Training of clinicians, and standards for the education of patients about the phases of a low FODMAP diet, as well as the role of Apps, require formal evaluation. There are limited data on the longer term efficacy and safety of the low FODMAP diet with respect to sustained symptom control, effect on quality of life and healthcare utilisation, nutritional adequacy, precipitation of disordered eating behaviours, effects on faecal microbiota and metabolomic markers, and subsequent translation to clinical effects.
Many gaps in implementation of the low FODMAP diet in clinical practice, as well as long-term safety and efficacy, remain for further investigation.
尽管低发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食对肠易激综合征患者有效，但在其临床实施方面仍有许多问题尚未得到解答。
回顾文献，确定、综合并为低 FODMAP 饮食的实施和评估提供未来研究的方向。
在 Ovid Medline、CINAHL、Scopus 和 PubMed 中进行文献检索，检索时间从数据库开始至 2018 年 9 月，检索词集中于研究人群（肠易激综合征）和干预措施（FODMAP）。
对低 FODMAP 饮食反应的预测因素仍在研究中，初步数据支持粪便微生物群或粪便挥发性有机化合物分析。临床医生的培训以及患者关于低 FODMAP 饮食各阶段的教育标准，以及应用程序的作用，都需要进行正式评估。关于低 FODMAP 饮食的长期疗效和安全性的数据有限，包括对持续性症状控制、对生活质量和医疗保健利用的影响、营养充足性、饮食行为紊乱的诱发、对粪便微生物群和代谢组学标志物的影响，以及对临床效果的后续转化。
在临床实践中实施低 FODMAP 饮食以及长期安全性和疗效方面仍存在许多需要进一步研究的空白。
