Simões Catarina D, Maganinho Marta, Sousa Ana S
Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
CIBIO-InBIO Research Centre in Biodiversity and Genetic Resources, University of Porto, Vairão, Portugal.
Eur J Nutr. 2022 Apr;61(3):1187-1198. doi: 10.1007/s00394-021-02755-1. Epub 2022 Jan 6.
Based on the fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) hypothesis, the low-FODMAP diet has been suggested as a potential therapeutic approach for inflammatory bowel disease (IBD) with promising results on disease management. However, this diet implies a specific broad food restriction, which potentially increases the risk of nutritional deficiencies and may aggravate gut microbiota dysbiosis of IBD patients. The aim of the present study is to review the effect of individual FODMAPs on the human gut microbiota. In addition, this narrative review provides an updated overview of the use of the low-FODMAP diet in IBD, namely the implementation, advantages, limitations, and the impact on the gut microbiota.
The literature search strategy was applied to PubMed and Web of Science using relevant keywords, IBD, FODMAPs, Fructose, Lactose, Polyols, FOS, GOS, low-FODMAP diet and gut microbiota.
Current data suggest that the low-FODMAP diet may effectively improve clinical outcomes in the management of IBD and ensure better quality of life for IBD patients. However, there is evidence highlighting some issues of concern, particularly the adequacy of the diet and the impact on the gut microbiota. The various FODMAP types differently modulate the gut microbiota.
IBD management should be achieved with the least possible dietary restriction to avoid detrimental consequences, particularly on nutritional adequacy and gut microbiota. Thus, it is important to individualize and monitor the nutrition intervention. Further studies are required to better characterize the relationship between diet, the gut microbiota, and IBD to support the generalization of this approach for clinical practice in IBD therapy and management.
基于可发酵的低聚糖、双糖、单糖和多元醇（FODMAP）假说，低FODMAP饮食已被提议作为炎症性肠病（IBD）的一种潜在治疗方法，在疾病管理方面取得了有前景的结果。然而，这种饮食意味着特定的广泛食物限制，这可能会增加营养缺乏的风险，并可能加重IBD患者的肠道微生物群失调。本研究的目的是综述个体FODMAPs对人体肠道微生物群的影响。此外，本叙述性综述提供了低FODMAP饮食在IBD中应用的最新概述，即实施方法、优点、局限性以及对肠道微生物群的影响。
使用相关关键词“IBD”“FODMAPs”“果糖”“乳糖”“多元醇”“低聚果糖”“低聚半乳糖”“低FODMAP饮食”和“肠道微生物群”，在PubMed和Web of Science上应用文献检索策略。
目前的数据表明，低FODMAP饮食可能有效地改善IBD管理中的临床结果，并确保IBD患者有更好的生活质量。然而，有证据突出了一些令人担忧的问题，特别是饮食的充足性以及对肠道微生物群的影响。不同类型的FODMAPs对肠道微生物群的调节方式不同。
IBD的管理应通过尽可能少的饮食限制来实现，以避免产生有害后果，特别是对营养充足性和肠道微生物群的影响。因此，个性化和监测营养干预很重要。需要进一步的研究来更好地描述饮食、肠道微生物群和IBD之间的关系，以支持将这种方法推广到IBD治疗和管理的临床实践中。
