FODMAP

from Wikipedia, the free encyclopedia

FODMAP is the abbreviation for “fermentable oligo-, di-, monosaccharides and polyols” (German for “ fermentable oligo- , di- , monosaccharides and polyols ”, for example fermentable poly-, double- , single-sugar and polyvalent alcohols ). It is a group of carbohydrates and sugar alcohols that are found in many foods and are poorly absorbed in the small intestine. This group includes fructose (monosaccharide), lactose (disaccharide), fructans , galacto-oligosaccharides (oligosaccharides), sorbitol and mannitol (polyols). In a clinical study published in 2010, a positive effect of a low-FODMAP diet on the symptoms of functional bowel diseases, e.g. B. Irritable Bowel Syndrome (IBS) reported.

concept

IBS is a diagnosis of exclusion . This is provided when gastrointestinal complaints such as For example, diarrhea and / or constipation , flatulence , abdominal pain or nausea persist despite the exclusion of possible underlying diseases such as celiac disease , Crohn's disease or ulcerative colitis or (as e.g. in the case of lactose intolerance ) not go away despite an adequate diet. Treating this syndrome is correspondingly difficult.

Peter Gibson and Susan Shepherd conducted a clinical study of IBS patients in 2010 and found that following a low-FODMAP diet reduced their symptoms. The FODMAP concept is based on the assumption that the functional gastrointestinal complaints in IBS can be traced back to flatulence in the intestinal area, among other things.

To the above Symptoms occur because FODMAPs are poorly absorbed in the small intestine . They quickly migrate to the large intestine , where they are fermented (fermented) by bacteria. As a by-product of the fermentation process, gases, e.g. B. hydrogen, released and lead to the complaints mentioned.

It is now assumed that an assumed non-celiac disease-non-wheat allergy-wheat sensitivity in an increased proportion of patients is actually a FODMAP reaction.

Low FODMAP diet

With the FODMAP-poor or FODMAP-reduced diet, FODMAPs are only consumed in small amounts. FODMAPs are found in different amounts in different foods:

  • Fructose is a component of most fruits and vegetables . However, different fruits have different fructose contents and are therefore z. B. tolerated differently well with fructose malabsorption. For example, apples contain around 5.9 g of fructose in 100 g, while cucumbers only contain 0.86 g. The ratio of glucose to fructose is a decisive factor for the tolerance of fruit or vegetables : A food is considered to be well tolerated in the case of malabsorption if this ratio is not less than 1.
  • Lactose is the dominant carbohydrate in milk and can therefore be found in all conventional milk products. Products also differ with regard to this sugar content: While condensed milk contains 9 to 13 grams of lactose in 100 grams, hard cheeses only contain up to 0.4 grams.
  • Sorbitol , like other sugar alcohols ( erythritol , isomalt , lactitol , mannitol and xylitol), is often used as a sweetener in low-sugar or sugar-free foods, but is also found in larger quantities in some types of fruit, e.g. B. in plums, apricots, apples and pears.
  • Oligosaccharides can arise during the industrial fermentation of wheat or other cereal flours. Ancient grains can also have high levels of oligosaccharides. This can be counteracted by using a suitable dough guide.

The most important requirement that must be met before switching to a low-FODMAP diet is the exclusion of organic diseases that can lead to IBS-like symptoms in the gastrointestinal tract. In the case of corresponding intolerances (incompatibilities) or allergies , appropriate measures should also be taken, primarily avoiding the food that causes the symptoms.

Tables with the FODMAP content of many foods can now be found in German-language books and, above all, on English-language websites. Basically: Any change in diet should ideally be carried out under medical supervision or with the help of a qualified nutritionist. However, a change in diet can also be attempted for a limited time without medical supervision. Furthermore, it is important to consider the individual (incompatibilities) of different foods containing and free of FODMAPs, as each person can react differently to the same food. Therefore, a FODMAP-reduced diet should only be carried out for a limited period of time. Then different foods of the different FODMAP groups are reintroduced in order to test their tolerance or the respective tolerable amount. In this way, the diet is individually adapted and then continued in this modified form.

Individual evidence

  1. ↑ What are FODMAPs? . As of September 2, 2018.
  2. ↑ a b Gibson PR, Shepherd SJ: Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach . In: J Gastroenterol Hepatol . 25, No. 2, August 2010, pp. 252-8. PMID 20136989 .
  3. ↑ Salvioli B, Serra J, Azpizoz F, Malagelada JR .: Impaired small bowel gas propulsion in patients with bloating during intestinal lipid infusion. . In: Am. J. Gastroenterol. . 101, No. 8, February 2006, pp. 1853-7. PMID 16817837 .
  4. ↑ Patsy Catsos: IBS - Free at Last with the FODMAP Elimination Diet In: Pond Cove Press.
  5. ↑ German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS): Celiac Disease, Wheat Allergy and Wheat Sensitivity ( Memento of the original from February 26, 2019 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / www.awmf.org archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ; Guideline; As of April 30, 2014, valid until April 30, 2019, p. 42.
  6. ↑ a b Fructose content of various dishes , as of August 11, 2013.
  7. ↑ Lactose content of different foods . As of August 11, 2013.
  8. ↑ Dr. Andrea Flemmer and Anne Kamp: Stevia: The healthy and calorie-free alternative to sugar (GU health advice) In: GU-Verlag .
  9. ↑ Jochen U. Ziegler, Deborah Steiner, C. Friedrich H. Longin, Tobias Würschum, Ralf M. Schweiggert: Wheat and the irritable bowel syndrome - FODMAP levels of modern and ancient species and their retention during bread making . In: Journal of Functional Foods . tape 25 , August 2016, p. 257–266 , doi : 10.1016 / j.jff.2016.05.019 ( elsevier.com [accessed February 19, 2020]).
  10. ↑ Martin Storr: The great patient guide irritable bowel syndrome with FODMAP diet In: Zuckschwerdt-Verlag - Ratgeber.
  11. ↑ Martin Storr: The nutritional guide to the FODMAP diet. The slightly different diet for irritable bowel syndrome, wheat intolerance and other digestive disorders In: Zuckschwerdt-Verlag - Ratgeber.
  12. ^ Starting the Low FODMAP Diet . As of September 2, 2018.