Department of Nutritional Sciences, King's College London, London, UK.
Proc Nutr Soc. 2021 Feb;80(1):19-28. doi: 10.1017/S0029665120006990. Epub 2020 May 29.
Dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is clinically effective and a commonly utilised approach in the management of functional symptoms in irritable bowel syndrome. Despite this, the low FODMAP diet has a number of challenges: it can alter the gut microbiota; impact nutrient intake and diet quality; is complex to understand; requires the patient to be adequately supported to follow the diet accurately and safely; and lastly, not all patients respond to the diet. The current review highlights the evidence for the clinical effectiveness of the low FODMAP diet, but focusses on the challenges associated with the diet to the patient, health professionals and the wider healthcare service. Finally, the review discusses research findings and practical guidance for how these challenges can be minimised and mitigated. The low FODMAP diet is a useful management strategy for irritable bowel syndrome, with data from clinical trials suggesting a 50-80% response rate, and when administered appropriately, the challenges to implementing the diet can be overcome so that these outcomes can be realised effectively and safely in clinical practice.
限制可发酵的低聚糖、双糖、单糖和多元醇（FODMAP）的饮食是临床上有效的，也是治疗肠易激综合征功能性症状的常用方法。尽管如此，低 FODMAP 饮食存在一些挑战：它会改变肠道微生物群；影响营养摄入和饮食质量；理解起来很复杂；需要患者得到充分的支持才能准确、安全地遵循饮食；而且，并非所有患者对饮食都有反应。本综述强调了低 FODMAP 饮食在临床有效性方面的证据，但重点关注了该饮食对患者、医疗保健专业人员和更广泛的医疗保健服务带来的挑战。最后，综述讨论了研究结果和实用指导，以帮助减轻和缓解这些挑战。低 FODMAP 饮食是肠易激综合征的一种有用的管理策略，临床试验数据显示，其反应率为 50-80%，并且如果管理得当，实施该饮食的挑战是可以克服的，从而可以在临床实践中有效地、安全地实现这些结果。
