This is not just any FODMAP diet: Hispanic adaptation of the FODMAP diet and a reintroduction guide

Elena Garicano Vilar; Paula Mendive; Maritza G. Ríos; Sara Sanz Rojo; Ismael San Mauro Martin; Spanish Speakers FODMAP Diet Expert Group

doi:10.19230/jonnpr.4274

Autores/as

Elena Garicano Vilar Research Centre in Nutrition and Health (CINUSA group). Paseo de la Habana, 43. 28036, Madrid, Spain. https://orcid.org/0000-0001-6327-6758
Paula Mendive Universidad de la República. Escuela de Nutrición. Avenida Américo Ricaldoni 2010, CP: 11600, Montevideo, Uruguay. Universidad de Belgrano. Zabala 1837, C1426 DQG, Buenos Aires, Argentina. https://orcid.org/0000-0001-9610-6683
Maritza G. Ríos Consultorio ENNA 324, del Hospital Pacífica Salud, Boulevard Pacífica y Vía Punta Darién, Ciudad de Panamá. Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP). Calle Pullpn. Ciudad de Panamá, Panamá. https://orcid.org/0000-0002-4663-6085
Sara Sanz Rojo Research Centre in Nutrition and Health (CINUSA group). Paseo de la Habana, 43. 28036, Madrid, Spain https://orcid.org/0000-0003-4737-5857
Ismael San Mauro Martin Research Centre in Nutrition and Health (CINUSA group). Paseo de la Habana, 43. 28036, Madrid, Spain. https://orcid.org/0000-0002-7415-0293
Spanish Speakers FODMAP Diet Expert Group Spanish Speakers FODMAP Diet Expert

DOI:

https://doi.org/10.19230/jonnpr.4274

Palabras clave:

FODMAP, dietoterapia, guía de práctica, hispano, cultura

Resumen

Los carbohidratos de cadena corta y los alcoholes de azúcar se absorben mal en el intestino delgado y las bacterias los fermentan rápidamente. Se ha medido el contenido de oligo, di, monosacáridos y polioles fermentables (FODMAP) de una amplia gama de alimentos. Sin embargo, la lista de alimentos permitidos, así como las cantidades de FODMAP de cada alimento, difieren entre estudios, lo que dificulta el manejo de la dieta baja en FODMAP.
El objetivo de esta investigación fue proponer una guía dietética FODMAP adaptada culturalmente a diferentes países hispanos para facilitar a dietistas-nutricionistas y expertos en nutrición el manejo de los pacientes que se benefician de la dieta baja en FODMAP.
Se creó un consorcio de expertos en dieta FODMAP entre países de habla hispana. Dietistas de 11 países latinoamericanos (Argentina, Colombia, Ecuador, El Salvador, Guatemala, Honduras, México, Panamá, Perú, Uruguay y Venezuela) y España elaboraron una dieta baja en FODMAP ajustada cada una a la cultura gastronómica del país. También crearon una lista de alimentos para ser reintroducidos en la fase 2 (o fase de reintroducción) de la dieta FODMAP, junto con recetas típicas del país.
Se diseñaron doce dietas bajas en FODMAP con su correspondiente fase de reintroducción, cada una adaptada a los alimentos y recetas de consumo común de cada país. La adaptación de la dieta a la gastronomía local fue pertinente, ya que puede aumentar la adherencia a la dieta y una mejor respuesta a la sintomatología.
Existen limitaciones en el desarrollo de tablas de alimentos ricos y pobres en FODMAP. Los niveles de corte del contenido de FODMAP no están claramente definidos. Se necesitan más estudios para alcanzar un consenso unificado, ya que se ha encontrado inconsistencia en los datos proporcionados en estudios relacionados con la dieta FODMAP.

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Citas

Gibson PR, Shepherd SJ. Personal view: Food for thought - Western lifestyle and susceptibility to Crohn’s disease. The FODMAP hypothesis. Aliment Pharmacol Ther. 2005;21:13991–1409.

Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010;25:252–8.

Monash University. The Low FODMAP diet [Internet]. 2019 [cited 2020 Jun 5]. Available from: https://www.monashfodmap.com/

Wang XJ, Camilleri M, Vanner S, Tuck C. Review article: biological mechanisms for symptom causation by individual FODMAP subgroups - the case for a more personalised approach to dietary restriction. Aliment Pharmacol Ther. 2019;50(5):517–29.

Ladas SD, Grammenos I, Tassios PS, Raptis SA. Coincidental malabsorption of lactose, fructose, and sorbitol ingested at low doses is not common in normal adults. Dig Dis Sci. 2000;45:2357–62.

Truswell AS, Seach JM, Thorburn AW. Incomplete absorption of pure fructose in healthy subjects and the facilitating effect of glucose. Am J Clin Nutr. 1988;48:1424–30.

Pedersen A, Sandström B, Van Amelsvoort JMM. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. Br J Nutr. 1997;78:215–22.

Goldstein R, Braverman D, Stankiewicz H. Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints. Isr Med Assoc J. 2000;2:583–7.

Staudacher HM, Lomer MCE, Anderson JL, Barrett JS, Muir JG, Irving PM, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with Irritable Bowel Syndrome. J Nutr. 2012;142(8):1510–8.

Pedersen N, Ankersen D V., Felding M, Vegh Z, Burisch J, ABSTRACT PM. Mo1210 Low FODMAP Diet Reduces Irritable Bowel Symptoms and Improves Quality of Life in Patients With Inflammatory Bowel Disease in a Randomized Controlled Trial. Gastroenterology. 2014;146(5):S-587.

Pedersen N, Andersen NN, Végh Z, Jensen L, Ankersen DV, Felding M, et al. Ehealth: Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol. 2014;20(43):16215–1626.

Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(1):67–75.

Schultz M, Harvie R, Chisholm A. A reduction in FODMAP intake correlates strongly with a reduction in IBS symptoms-The FIBS study. J Gastroenterol Hepatol. 2013;28:623–93.

Zugasti Murillo A, Estremera Arévalo F, Petrina Jáuregui E. Dieta pobre en FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) en el síndrome de intestino irritable: Indicación y forma de elaboración. Endocrinol y Nutr. 2016;63(3):132–8.

Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP diet improves irritable bowel syndrome symptoms: A meta-analysis. Nutrients. 2017;9(9):940.

Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013;145(2):320–8.

Testa A, Imperatore N, Rispo A, Rea M, Tortora R, Nardone OM, et al. Beyond Irritable Bowel Syndrome: The Efficacy of the Low Fodmap Diet for Improving Symptoms in Inflammatory Bowel Diseases and Celiac Disease. Dig Dis. 2018;36(4):271–80.

Marum AP, Moreira C, Tomas-Carus P, Saraiva F, Guerreiro CS. A low fermentable oligo-di-mono-saccharides and polyols (FODMAP) diet is a balanced therapy for fibromyalgia with nutritional and symptomatic benefits. Nutr Hosp. 2017;34(3):667–74.

Smith E, Pauling JD. The efficacy of dietary intervention on gastrointestinal involvement in systemic sclerosis: A systematic literature review. Semin Arthritis Rheum. 2019;49(1):112–8.

Moore JS, Gibson PR, Perry RE, Burgell RE. Endometriosis in patients with irritable bowel syndrome: Specific symptomatic and demographic profile, and response to the low FODMAP diet. Aust New Zeal J Obstet Gynaecol. 2017;57(2):201–5.

Shepherd SJ, Gibson PR. Fructose Malabsorption and Symptoms of Irritable Bowel Syndrome: Guidelines for Effective Dietary Management. J Am Diet Assoc. 2006;106(10):1631–9.

Monash University. FODMAP Diet App [Internet]. 2019 [cited 2020 Jun 24]. Available from: https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/

Mazzawi T, Hausken T, Gundersen D, Magdy ES. Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome. Mol Med Rep. 2013;8(3):845–52.

Østgaard H, Hausken T, Gundersen D, El-Salhy M. Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome. Mol Med Rep. 2012;5(6):1382–90.

San Mauro Martin I, Brachero S, Garicano Vilar E. Histamine intolerance and dietary management: A complete review. Allergol Immunopathol (Madr). 2016;44(5):475–83.

Casellas F, Burgos R, Marcos A, Santos J, Ciriza de los Ríos C, García Manzanares A, et al. Documento de consenso sobre las dietas de exclusión en el síndrome del intestino irritable (SII). Rev Española Enfermedades Dig. 2018;110(12):806–24.

Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Gibson PR, Muir JG. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut. 2015;64(1):93–100.

Staudacher HM, Whelan K, Irving PM, Lomer MCE. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet. 2011;

Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, et al. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25(8):1366–73.

Wilder-Smith CH, Materna A, Wermelinger C, Schuler J. Fructose and lactose intolerance and malabsorption testing: The relationship with symptoms in functional gastrointestinal disorders. Aliment Pharmacol Ther. 2013;37(11):1074–83.

De Roest RH, Dobbs BR, Chapman BA, Batman B, O’Brien LA, Leeper JA, et al. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: A prospective study. Int J Clin Pract. 2013;67(9):895–903.

Shepherd SJ, Parker FC, Muir JG, Gibson PR. Dietary Triggers of Abdominal Symptoms in Patients With Irritable Bowel Syndrome: Randomized Placebo-Controlled Evidence. Clin Gastroenterol Hepatol. 2008;6(7):765–71.

Böhn L, Störsrud S, Liljebo T, Collin L, Lindfors P, Törnblom H, et al. Diet low in FODMAPs reduces symptoms of Irritable Bowel Syndrome as well as traditional dietary advice: A Randomized Controlled Trial. Gastroenterology. 2015;149(6):1399–407.

Johlin FJ, Panther M, Kraft N. Dietary fructose intolerance: diet modification can impact self-rated health and symptom control. Nutr Clin Care. 2004;7:92–7.

Shepherd SJ, Gibson PR. Fructose Malabsorption and Symptoms of Irritable Bowel Syndrome: Guidelines for Effective Dietary Management. J Am Diet Assoc. 2006;106:1631–9.

Muir J, Rose R, Rosella O, Liels K, Barrett J, Shepherd, Susan Gibson P. Measurement of short-chain carbohydrates (FODMAPs) in common Australian vegetables and fruit by high performance liquid chromatography (HPLC) with evaporative light-scattering detection (ELSD). J Agric Food Chem. 2009;57(2):554–65.

Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146:67–75.

Molina-Infante J, Serra J, Fernandez-Bañares F, Mearin F. The low-FODMAP diet for irritable bowel syndrome: Lights and shadows. Gastroenterol Hepatol. 2016;39:55–65.