• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.8
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• pp.1200-1205
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• 2015

Medical foods are enteral nutrition for patients, but they cause maladaptation symptoms like diarrhea. Although the cause of diarrhea remains unknown, some studies have indicated that the cause of diarrhea is fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP). This is a consideration for medical foods since they are easily fermented by intestinal bacterial. In this study, we estimated the FODMAP contents of commercial medical foods and carbohydrate ingredients. We measured the concentrations of FODMAP in 13 types of different medical foods and five types of carbohydrate ingredients by using high performance liquid chromatography with an evaporative light scattering detector (HPLC-ELSD). The limits of detection of FODMAP were fructose, 0.002; lactose, 0.010; raffinose, 0.003; stachyose, 0.032; 1-kestose, 0.005; nystose, 0.012; and 1-fructofuranosylnystose, 0.003 mg/kg. Limits of quantitation of FODMAP were fructose, 0.008; lactose, 0.033; raffinose, 0.009; stachyose, 0.107; 1-kestose, 0.015; nystose, 0.042; and 1-fructofuranosylnystose, 0.011 mg/kg, respectively. Concentration of FODMAP ranged from 0.428~2.968 g/200 mL. Concentrations of carbohydrate ingredients in FODMAP were chicory fiber, 278.423; soy fiber, 27.467; indigestible maltodextrin, 52.384; maltodextrin (DE10~15), 32.973; and maltodextrin (DE15~20), 50.043 g/kg. Contents of carbohydrates were 19.0~41.0 g/200 mL in commercial medical foods. We expected a correlation between contents of carbohydrates and FODMAP, as carbohydrates included FODMAP. However, we detected a low correlation (r=0.55). Since most commercial medical foods have a similar carbohydrate ingredients and nutritional values, the difference between products was determined by FODMAP contents of carbohydrate ingredients. In this study, we analyzed FODMAP contents of commercial medical foods and carbohydrate ingredients. These results are expected to be utilized as basic data for product development and minimizing maladaptation of medical foods.

• Nutrition Research and Practice
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• v.17 no.6
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• pp.1201-1210
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• 2023

BACKGROUND/OBJECTIVES: The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines. SUBJECTS/METHODS: An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed. RESULTS: Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively. CONCLUSIONS: Fructan was the FODMAP nutrient most consumed by Korean adults. Therefore, given the difference in the dietary habits of each country's population, the dietary guidelines for IBS should be country specific.

• Nutrition Research and Practice
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• v.15 no.6
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• pp.703-714
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• 2021

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.6
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• pp.510-518
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• 2022

Purpose: Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. Methods: This clinical trial included 50 patients aged 3-18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. Results: After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. Conclusion: A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.