Kuźmin Laura, Kubiak Katarzyna, Lange Ewa
Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-776 Warsaw, Poland.
Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-776 Warsaw, Poland.
Nutrients. 2025 Jun 19;17(12):2045. doi: 10.3390/nu17122045.
A low-FODMAP diet is considered as a potential supportive treatment approach in some gastrointestinal disorders. The aim of this study was to systematically review the literature for randomized controlled trials assessing the efficacy of the low-FODMAP diet on the severity of gastrointestinal symptoms and quality of life in patients with gastrointestinal disorders. This review was conducted in accordance with CASP tool and PRISMA guidelines. A comprehensive search of the PubMed, Scopus, and Web of Science databases resulted in the identification of fourteen randomized controlled trials. Ten studies examined the effect of the low-FODMAP diet in patients with irritable bowel syndrome (IBS), three with inflammatory bowel disease (IBD), and one with symptomatic proton pump inhibitor (PPI) refractory gastroesophageal reflux disease (GERD). All interventions compared the low-FODMAP diet with another diet and lasted from 3 to 12 weeks. Most studies on IBS showed significant improvements in abdominal pain, bloating, and quality of life compared to control diets. In IBD, improvements were mainly observed in functional gastrointestinal symptoms, while no clear benefit was demonstrated in GERD. Heterogeneity in study designs, intervention durations, comparator diets, and outcome measures limited the ability to conduct a meta-analysis. Although a low-FODMAP diet may reduce symptoms in selected individuals, it is not universally necessary. Importantly, the diet's restrictive nature and potential long-term effects-such as nutritional deficiencies and alterations in gut microbiota-highlight the need for clinical supervision by dietitians with expertise in gastrointestinal disorders. Furthermore, in some cases, symptom improvement may be achievable through less restrictive changes, such as improving food hygiene and reducing intake of processed or high-sugar foods. Further high-quality randomized controlled trials with standardized endpoints and longer follow-up are needed to clarify the efficacy and safety of the low-FODMAP diet across various gastrointestinal conditions.
低发酵性寡糖、双糖、单糖和多元醇（FODMAP）饮食被认为是某些胃肠道疾病的一种潜在支持性治疗方法。本研究的目的是系统回顾评估低FODMAP饮食对胃肠道疾病患者胃肠道症状严重程度和生活质量影响的随机对照试验的文献。本综述按照批判性评估技能计划（CASP）工具和系统评价和Meta分析的首选报告项目（PRISMA）指南进行。对PubMed、Scopus和科学网数据库进行全面检索后，共识别出14项随机对照试验。10项研究考察了低FODMAP饮食对肠易激综合征（IBS）患者的影响，3项针对炎症性肠病（IBD）患者，1项针对有症状的质子泵抑制剂（PPI）难治性胃食管反流病（GERD）患者。所有干预措施均将低FODMAP饮食与另一种饮食进行比较，持续时间为3至12周。大多数关于IBS的研究表明，与对照饮食相比，腹痛、腹胀和生活质量有显著改善。在IBD中，主要在功能性胃肠道症状方面观察到改善，而在GERD中未显示出明显益处。研究设计、干预持续时间、对照饮食和结局指标的异质性限制了进行Meta分析的能力。尽管低FODMAP饮食可能会减轻部分患者的症状，但并非普遍必要。重要的是，该饮食的限制性本质以及潜在的长期影响，如营养缺乏和肠道微生物群改变，凸显了需要由胃肠道疾病方面的专业营养师进行临床监督。此外，在某些情况下，通过限制较少的改变，如改善食品卫生和减少加工食品或高糖食品的摄入量，也可能实现症状改善。需要进一步开展具有标准化终点和更长随访期的高质量随机对照试验，以阐明低FODMAP饮食在各种胃肠道疾病中的疗效和安全性。
