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. 2022 Oct;34(10):e14392.
doi: 10.1111/nmo.14392. Epub 2022 May 9.

Children with functional abdominal pain disorders successfully decrease FODMAP food intake on a low FODMAP diet with modest improvements in nutritional intake and diet quality

Vishnu Narayana  1 , Ann R McMeans  1   2 , Rona L Levy  3 , Robert J Shulman  1   2 , Bruno P Chumpitazi  1   2
Affiliations

Children with functional abdominal pain disorders successfully decrease FODMAP food intake on a low FODMAP diet with modest improvements in nutritional intake and diet quality

Vishnu Narayana et al. Neurogastroenterol Motil. 2022 Oct.

Abstract

Background: We sought to determine how a low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet (LFD) affected high FODMAP food intake, nutrient intake, and diet quality in children with functional abdominal pain disorders (FAPD).

Methods: Children (ages 7-13 years) with Rome IV FAPD began a dietitian-guided LFD. Three-day food records were captured at baseline and 2-3 weeks into the LFD. Intake of high FODMAP foods, energy, macronutrients, micronutrients, food groups, and ultra-processed foods were determined.

Key results: Median age of participants was 11 years, and 19/31 (61%) were female. Twenty-eight (90%) decreased high FODMAP food intake on the LFD: overall median (25-75%) high FODMAP foods/day decreased from 5.7 (3.6-7.3) to 2 (0.3-3.7) (p < 0.001). A more adherent subset (n = 22/71%) of participants consumed on average ≤3 high FODMAP foods per day during the LFD. Baseline nutritional intake and quality were generally poor with several micronutrient deficiencies identified. Diet quality improved on the LFD with increased servings of vegetables and protein and decreased consumption of ultra-processed foods, trans-fatty acids, and added sugars. On the LFD, there were significant decreases in total carbohydrates and thiamin (remained within recommended intake) and significant increases in vitamin B6 (p = 0.029), vitamin C (p = 0.019), and vitamin E (p = 0.009). Children more adherent to the LFD further increased vitamin D, magnesium, potassium, and fat servings.

Conclusions and inferences: The majority of children with FAPD on a dietitian-led LFD successfully decreased high FODMAP food intake. Children with FAPD on the LFD (vs. baseline) modestly improved micronutrient intake and diet quality.

Keywords: abdominal pain; child; diet; disorders of gut-brain interaction; nutrients.

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Conflict of interest statement

Conflict of Interest Statement: RJS and BPC receive royalties from the Rome Foundation for use of the modified Bristol Stool Scale for children which is not included in this manuscript.

Figures

Figure 1:
Figure 1:. Distribution of Mean Number of High FODMAP Foods Consumed per Day
(A) during the baseline habitual diet and (B) during a low FODMAP diet. Red bars denote participants defined as not adherent to the LFD. Study participants who consumed on average ≤ 23 high FODMAP foods per day were considered more adherent to the low FODMAP diet (green bars) compared to the rest of the cohort.
See this image and copyright information in PMC

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