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

Authors

Vishnu Narayana
Ann R McMeans
Rona L Levy
Robert J Shulman
Bruno P Chumpitazi

Publication Date

10-1-2022

Journal

Neurogastroenterology & Motility

DOI

10.1111/nmo.14392

PMID

35535019

PMCID

PMC9529764

PubMedCentral® Posted Date

10-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Abdominal Pain, Adolescent, Ascorbic Acid, Child, Diet, Disaccharides, Eating, Female, Fermentation, Humans, Irritable Bowel Syndrome, Magnesium, Male, Micronutrients, Monosaccharides, Oligosaccharides, Polymers, Potassium, Thiamine, Trans Fatty Acids, Vitamin B 6, Vitamin D, Vitamin E. Abdominal pain, Child, Diet, Disorders of gut-brain interaction, Nutrients

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.