Mustafa Uzma, Ghoshal Uday C
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
Indian J Gastroenterol. 2022 Feb;41(1):104-113. doi: 10.1007/s12664-022-01250-7. Epub 2022 Feb 24.
Low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet is used in irritable bowel syndrome (IBS). However, data on the utility and challenges of implementing such a diet in India are scanty. Since dietary practices in India are different from other Asian and Western countries, the existing Indian data were analyzed.
This study attempted to analyze the existing Indian data on the frequency of vegetarianism, cereal (wheat vs. rice), milk/milk product consumption, and lactose malabsorption (LM). A 5-point scale (quiet easy, easy, moderately easy, not easy, difficult) for implementation of low FODMAP diet for IBS patients was proposed based on regional dietary diversity and LM in India.
Our analysis showed that vegetarianism is high in India with regional differences in frequency. Similarly, there is regional variation in frequency of LM though it is quite high in most parts of India where data are available. While southern, eastern, and north-eastern [corrected] parts of the country have rice as the staple cereal, wheat is consumed more in other parts. We suggest that implementing a low FODMAP diet in north-eastern India may be most easy compared to northern India, where it may be most difficult. Implementing a low FODMAP diet in southern and eastern India may be easy, moderately easy in western India, and not easy in central India.
The variation in the difficulty in implementing a low FODMAP diet in India may stem from the regional food preference and differences in vegetarianism, as well as frequency of LM.
低可发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食用于肠易激综合征（IBS）。然而，在印度实施这种饮食的效用和挑战方面的数据很少。由于印度的饮食习惯与其他亚洲和西方国家不同，因此对现有的印度数据进行了分析。
本研究试图分析现有的关于印度素食主义频率、谷物（小麦与大米）、牛奶/奶制品消费以及乳糖吸收不良（LM）的印度数据。基于印度的区域饮食多样性和乳糖吸收不良情况，为IBS患者实施低FODMAP饮食提出了一个5分制量表（非常容易、容易、中等容易、不容易、困难）。
我们的分析表明，印度的素食主义比例很高，且频率存在区域差异。同样，乳糖吸收不良的频率也存在区域差异，尽管在印度大多数有数据的地区这一比例相当高。该国南部、东部和东北部地区以大米为主食谷物，而其他地区小麦的消费量更大。我们认为，与印度北部相比，在印度东北部实施低FODMAP饮食可能最容易，而在印度北部可能最困难。在印度南部和东部实施低FODMAP饮食可能容易，在印度西部中等容易，而在印度中部不容易。
在印度实施低FODMAP饮食的难度差异可能源于区域食物偏好、素食主义差异以及乳糖吸收不良的频率。
