Gut-Brain Axis and Psychopathology: Exploring the Impact of Diet with a Focus on the Low-FODMAP Approach

Abstract

Background: The gut-brain axis (GBA) is a bidirectional communication network connecting the central nervous system with the gastrointestinal (GI) tract, influencing both mental and physical health. Recent research has underscored the significant role of diet in modulating this axis, with attention to how specific dietary patterns can impact anxiety and depression, particularly when linked to disorders of gut-brain interaction (DGBIs), like intestinal bowel syndrome (IBS).

Aims and methods: This narrative review examines the effects of specific diet regimens on the GBA and its potential role in managing psychopathology, focusing on anxiety and depression, IBS, and the low-FODMAP diet. We conducted a search on PubMed and MEDLINE by combining the following key terms: "Gut-Brain Axis", "Irritable Bowel Syndrome", "Low FODMAP diet", "Mediterranean Diet", "Psychopathology", "Anxiety and Depression", and "Gut Microbiota". We applied the following filters: "Clinical Trials", "Randomized Controlled Trials", "Reviews", "Meta-Analyses", and "Systematic Reviews". In total, 59 papers were included.

Results: Low-FODMAP diet, originally developed to alleviate GI symptoms in IBS, may also positively influence mental health by modulating the GBA and improving the gut microbiota (GM) composition. New insights suggest that combining the low-FODMAP diet with the Mediterranean diet could offer a synergistic effect, enhancing both GI and psychological therapeutic outcomes.

Conclusions: Understanding the complex interactions between diet, the GM, and mental health opens new avenues for holistic approaches to managing psychopathology, particularly when linked to GI symptoms.

Keywords: anxiety; depression; gut brain axis; gut microbiota; irritable bowel syndrome; low FODMAP diet; psychopathology.

Figure 1

Overview of dietary amino acid precursors and their corresponding neurotransmitters involved in mental health and neurobiology. Abbreviation: GABA, gamma-aminobutyric acid. * serve as neurotransmitter modulators.

Figure 2

Impact of diet on the gut–brain axis: effects on gut health, mental well-being, and psychopathology. Abbreviations. PUFAs: Polyunsaturated fatty acids; GM: Gut microbiota; SCFAs: Short-chain fatty acids; GLP-1: Glucagon-like peptide-1; PYY: Peptide YY; FODMAP: Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. The arrows represent the bidirectional interaction within the gut-brain axis.