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Differences in Dietary FODMAP Content Affected Gut Microbiota
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Diets that differed in fermentable oligosaccharides, disaccharides, monosaccharides and polyols, or FODMAP content, were shown to impact the composition of the gut microbiome, with significant differences noted, according to researchers.”
In studying whether a low FODMAP diet recommended for treating irritable bowel syndrome adversely affects the microenvironment in the colon, researchers from Australia compared fecal microbiota and biomarkers of colonic health associated with a low FODMAP diet and a regular diet. They evaluated 27 patients with IBS and six healthy controls in a randomized controlled efficacy trial of the two diets.
Participants were randomly assigned to a low FODMAP diet or a typical Australian diet (total FODMAP content, 23.7 [16.9-30.6] vs. 3.05 [1.86-4.25] g/day; P<.001) for 21 days, then crossed over to the other diet after a washout period of at least 21 days during which they resumed their usual diet. Fecal pH, short-chain fatty acid levels and bacterial abundance and diversity were measured at several points.
The researchers found that higher fecal pH levels were associated with the low FODMAP diet (7.37 [7.23-7.51] vs. 7.16 [7.02-7.3]; P=.001). Both diets were associated with similar short-chain fatty acid levels, but low FODMAP also was found to be associated with increased microbial diversity and reduced total bacterial abundance (9.63 [9.53-9.73] vs. 9.83 [9.72-9.93] log10 copies/g; P<.001).
The typical Australian diet was found to increase relative abundance of butyrate-producing Clostridium cluster XIVa (median ratio, 6.62; P<.001) and mucus-associated Akkermansia muciniphila (19.3; P<.001), but decreased Ruminococcus torques.
“The functional significance and health implications of such changes might lead to caution about reducing FODMAP intake in the longer term,” the researchers concluded. “Liberalizing FODMAP restriction to the level of adequate symptom control should be exercised. The low FODMAP diet should not be recommended for asymptomatic populations.”
Disclosure: Two of the researchers report having published books related to the topic of the study.
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