TWV Podcast Episode 457: The Problem with a Low-FODMAP Diet

It’s been a hot minute since the last time we dove deep into FODMAP intolerance on The Whole View podcast, but a collection of scientific studies over the last few years made a topic revisit necessary! We discuss FODMAPs in the context of prebiotics, the gut microbiome, and bacterial cross-feeding in order to understand how gut dysbiosis can lead to FODMAP intolerance and Irritable Bowel Syndrome, but also why the new studies show that long-term low-FODMAP diets can actually perpetuate that gut dysbiosis! Finally, we discuss studies using prebiotic and probiotic supplementation and even high-FODMAP diets for IBS, and propose an alternative approach to avoiding FODMAPs for the long term.

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Recommended Reading and Listening

• The Gut Health Guidebook
• The Gut Health Cookbook
• TPV Podcast Episode 238, What’s a FODMAP and Why Do Some People Avoid Them?
• Modifying Paleo for FODMAP-Intolerance (a.k.a. Fructose Malabsorption)
• 5 Gene Variants Linked to Gluten Sensitivity
• The Great Dairy Debate
• What Is the Gut Microbiome? And Why Should We Care About It?

Citations

Validation of a food frequency questionnaire to measure intakes of inulin and oligofructose

Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity

Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial

Food Allergy and Intolerance in IBS – PMC

Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies

Deviations in human gut microbiota: a novel diagnostic test for determining dysbiosis in patients with IBS or IBD

Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome

Diets that differ in their FODMAP content alter the colonic luminal microenvironment

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A low FODMAP diet is associated with changes in the microbiota and reduction in breath hydrogen but not colonic volume in healthy subjects – PMC

Effects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized Trial

Altered gastrointestinal microbiota in irritable bowel syndrome and its modification by diet: probiotics, prebiotics and the low FODMAP diet

Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials