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Low FODMAP rye bread benefits patients with IBS
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Modified low FODMAP rye bread improved symptom control in patients with irritable bowel syndrome in a randomized clinical trial.
“Our study shows that reduction of FODMAP content of a major food staple, such as rye bread, may reduce some symptoms of IBS but is not enough per se to reach adequate overall symptom control in IBS,” Reijo Laatikainen, MD, from University of Helsinki and Aava Medical Center in Finland, said in a press release. “It’s likely that a holistic low-FODMAP diet is needed in most cases in order to reach adequate control of overall symptoms. Low-FODMAP rye bread seems to be one way to increase fiber intake of patients with IBS. Just like the rest of the population, IBS patients tend to have a lower than recommended intake of fiber.”
Rye is the most important source of dietary fiber in Finland, but rye bread is also high in fructans. Laatikainen and colleagues therefore aimed to determine whether substituting a low FODMAP rye bread without any other dietary changes would affect symptoms, gas accumulation or quality of life in patients with IBS.
They performed a randomized, double blind, crossover study of 87 mostly female IBS patients who were not on a dietary therapy. After a 1-week run-in period, participants followed two 4-week treatment periods during which they received either the low FODMAP rye bread or regular rye bread. Participants were advised to consume seven to eight slices per day after the first week and half that dose during the first week. The treatment periods were separated by a washout period of at least 4 weeks. The IBS-Symptom Severity Score served as the primary endpoint, and visual analogue scale assessments of symptoms, quality of life and colonic fermentation were also evaluated.
There were no significant differences in IBS-SSS and quality of life between study breads. However, weekly visual analogue scale measurements showed a number of IBS symptoms were alleviated on the low FODMAP bread, including flatulence (P = .04), abdominal pain (P = .049), cramps (P = .01) and stomach rumbling (P = .001). The mean of all symptom measurements using visual analogue scale also showed the low FODMAP bread was beneficial (P = .02).
Furthermore, breath hydrogen levels were also found to be significantly lower with the low FODMAP bread (median AUC, 52.9 vs. 72.6 ppm; P = .01). Compared to baseline, dietary fiber intake also increased during both treatment periods.
“This study showed that the low FODMAP rye bread caused less fermentation in [the] colon, less flatulence, less abdominal pain, less cramps and less stomach rumbling than regular rye bread,” and was well accepted by participants, the investigators concluded. “The present study reveals that low FODMAP rye bread is feasible and palatable bread for IBS patients who want to follow a healthy, fiber-rich low FODMAP diet.” – by Adam Leitenberger
Disclosures: This study was funded by Fazer Bakeries. Laatikainen reports he has written a book on diet and IBS, and is a founder and owner of Booston Ltd. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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