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Adherence to a Low FODMAP Diet in Relation to Symptoms of Irritable Bowel Syndrome in Iranian Adults

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Abstract

Background

Most studies assessing the influence of a low fermentable oligo-, di-, monosaccharides and polyols (FODMAP) diet on irritable bowel syndrome (IBS) symptoms were clinical trials with a small sample size.

Objective

This study was done to examine the association between adherence to a low FODMAP diet and symptoms of irritable bowel syndrome in Iranian adults.

Methods

In this cross-sectional study, data on 3362 Iranian adults were collected. Dietary intakes of study participants were assessed using a validated 106-item self-administered dish-based, semi-quantitative food frequency questionnaire. Based on earlier studies, we identified all foods with a high FODMAP content in our dataset. Participants were categorized into quartiles in terms of dietary intakes of these foods. Total FODMAP score for each individual was computed by summing up the scores of all foods. Individuals in the highest quintile of FODMAP score were defined as those with the greatest adherence to the low FODMAP diet. A modified Persian version of the ROME III questionnaire was used for assessment of IBS, which was defined according to ROME III criteria.

Results

Adherence to the low FODMAP diet was significantly associated with low intakes of macro- and micro-nutrients as well as all food groups (P < 0.001 for all). Participants with the greatest adherence to the low FODMAP diet, compared to those with the lowest adherence, had not significantly lower odds for having IBS, either before (95% CI 0.93, 1.58, P < 0.05) or after adjustment for potential confounders (95% CI 0.80, 1.60, P < 0.05). This was also the case for IBS subtypes; such that those with the greatest adherence to the low FODMAP diet, compared to those with the lowest adherence, were not less likely to have these types of IBS.

Conclusion

In conclusion, we did not find any significant association between adherence to the low FODMAP diet and IBS. Further studies are required to reach a definite conclusion in this regard.

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Abbreviations

FODMAP:

Fermentable oligo-, di-, monosaccharides and polyols

GI:

Gastrointestinal

LFD:

Low FODMAP diet

HFD:

High FODMAP diet

TACD:

Typical American childhood diet

IBS:

Irritable bowel syndrome

IBS-D:

IBS with diarrhea predominant

IBS-C:

IBS with constipation predominant

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Acknowledgments

We wish to thank all staff of Isfahan University of Medical Sciences, who kindly participated in our study and staffs of Public Relations Unit, and other authorities of IUMS for their excellent cooperation. The present study was supported by a grant from National Institute for Medical Research Development (NIMAD), Islamic Republic of Iran. The Grant Number is 963261. The authors would like to thank all participants and their parents.

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Authors and Affiliations

  1. Students’ Research Committee, Tehran University of Medical Sciences, Tehran, Iran

    Helia Pourmand

  2. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran

    Helia Pourmand & Ahmad Esmaillzadeh

  3. Department of Medicine, University of Alberta, Edmonton, AB, Canada

    Ammar Hassanzadeh Keshteli

  4. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Parvane Saneei

  5. Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Hamed Daghaghzadeh & Peyman Adibi

  6. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Ahmad Esmaillzadeh

  7. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

    Ahmad Esmaillzadeh

Authors
  1. Helia Pourmand
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  2. Ammar Hassanzadeh Keshteli
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  3. Parvane Saneei
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  4. Hamed Daghaghzadeh
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  5. Ahmad Esmaillzadeh
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  6. Peyman Adibi
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Contributions

HP and AE conducted the study, carried out the statistical analyses, wrote the manuscript and contributed in the interpretation of the findings. AHK, PS, HD and PA contributed to the conception, design and data collection. AE supervised the study. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Ahmad Esmaillzadeh.

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Conflict of interest

None of the authors had any personal or financial conflicts of interest.

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Pourmand, H., Keshteli, A.H., Saneei, P. et al. Adherence to a Low FODMAP Diet in Relation to Symptoms of Irritable Bowel Syndrome in Iranian Adults. Dig Dis Sci 63, 1261–1269 (2018). https://doi.org/10.1007/s10620-018-4986-7

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  • DOI: https://doi.org/10.1007/s10620-018-4986-7

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