Diets that differ in their FODMAP content alter the colonic luminal microenvironment
Open accessAbstract
Objective: A low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) diet reduces symptoms of IBS, but reduction of potential prebiotic and fermentative effects might adversely affect the colonic microenvironment. The effects of a low FODMAP diet with a typical Australian diet on biomarkers of colonic health were compared in a single-blinded, randomised, cross-over trial. Design: Twenty-seven IBS and six healthy subjects were randomly allocated one of two 21-day provided diets, differing only in FODMAP content (mean (95% CI) low 3.05 (1.86 to 4.25) g/day vs Australian 23.7 (16.9 to 30.6) g/day), and then crossed over to the other diet with ≥21-day washout period. Faeces passed over a 5-day run-in on their habitual diet and from day 17 to day 21 of the interventional diets were pooled, and pH, short-chain fatty acid concentrations and bacterial abundance and diversity were assessed. Results: Faecal indices were similar in IBS and healthy subjects during habitual diets. The low FODMAP diet was associated with higher faecal pH (7.37 (7.23 to 7.51) vs 7.16 (7.02 to 7.30); p=0.001), similar short-chain fatty acid concentrations, greater microbial diversity and reduced total bacterial abundance (9.63 (9.53 to 9.73) vs 9.83 (9.72 to 9.93) log 10 copies/g; p<0.001) compared with the Australian diet. To indicate direction of change, in comparison with the habitual diet the low FODMAP diet reduced total bacterial abundance and the typical Australian diet increased relative abundance for butyrate-producing Clostridium cluster XIVa (median ratio 6.62; p<0.001) and mucus-associated Akkermansia muciniphila (19.3; p<0.001), and reduced Ruminococcus torques . Conclusions: Diets differing in FODMAP content have marked effects on gut microbiota composition. The implications of long-term reduction of intake of FODMAPs require elucidation. Trial registration number: ACTRN12612001185853.
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A low FODMAP diet may induce detrimental changes to the gut microbiota, with reductions in Bifidobacteria and total bacterial count.
“Moreover, a low FODMAP diet may induce detrimental changes to the gut microbiota, with reductions in Bifidobacteria and total bacterial count, 212 although the long-term consequences of this are unknown.”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [212]
The long-term consequences of detrimental changes to the gut microbiota from a low FODMAP diet are unknown.
“Moreover, a low FODMAP diet may induce detrimental changes to the gut microbiota, with reductions in Bifidobacteria and total bacterial count, 212 although the long-term consequences of this are unknown.”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [212]
The long-term effects on the gut microbiome of dietary interventions with reported benefit in IBS, such as psyllium fiber and low FODMAP diet, remain unknown.
“the long term consequences of current dietary interventions with reported benefit in IBS, such as supplementation with psyllium fiber and the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet31, 32, on the gut microbiome remain to be seen.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [31]
A low FODMAP diet recommended for reduction of IBS symptoms will have adverse effects on colonic luminal microenvironment and microbiota in healthy populations, reducing the absolute and relative bacterial abundance and diversity.
“low FODMAP diet recommended for reduction of IBS symptoms will have adverse effects on colonic luminal microenvironment and microbiota in healthy populations, reducing the absolute and relative bacterial abundance and diversity [278]”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [278]
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- [1]1. Interventional diets were analysed by Wilcoxon matched-pairs signed rank test. Statistically significant differences are shown in bold and based upon p≤0.05 for bacterial diversity, p≤0.005 for absolute and p≤0.006 for relative bacterial abundance after Bonferroni correction. Differences between habitual diet and interventional diets are indicated with an asterisk. *p<0.001 compared with habitual diet; Wilcoxon matched-pairs signed rank test. †Due to difficulties in microbial analysis for A. muciniphila, three IBS subjects could not be included; n=30. ‡p<0.05 compared with habitual diet; pairwise permanova test. FODMAP, Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Gut microbiota Halmos EP, et al. Gut 2015;64:93-100. doi:10.1136/gutjnl-2014-307264 99 on July 13, 2023 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gutjnl-2014-307264 on 12 July 2014. Downloaded from supported by a scholarship from the Faculty of Medicine, Nursing and Health Sciences, Monash University.
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- Authors
- Halmos, E. P., Christophersen, C. T., Bird, A. R., Shepherd, S. J., Gibson, P. R., & Muir, J. G.
- Affiliations
- The Alfred Hospital (AU)
- Commonwealth Scientific and Industrial Research Organisation (AU)
- Eastern Health (AU)
- Corresponding author
- Halmos, Emma P
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2014-07-12
- Volume
- 64
- Issue
- 1
- Pages
- 93-100
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2167428741
- Cited by
- 681
- References
- 37
- Citations by year
- 2026: 21 · 2025: 31 · 2024: 37 · 2023: 45 · 2022: 56 · 2021: 64 · 2020: 63 · 2019: 76 · 2018: 66 · 2017: 87 · 2016: 79 · 2015: 47 · 2014: 8 · 2013: 1
- FWCI
- 30.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- Research Online (Edith Cowan University) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Commonwealth Scientific and Industrial Research Organisation
- Monash University
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Keywords
- low FODMAP diet, FODMAPs, irritable bowel syndrome, gut microbiota, fecal pH, short-chain fatty acids, butyrate-producing bacteria, Clostridium cluster XIVa, Akkermansia muciniphila, Ruminococcus torques, dietary intervention, prebiotics
- MeSH terms
- Adult, Colon, Diet, Disaccharides, Feces, Female, Fermentation, Humans, Male, Middle Aged, Monosaccharides, Oligosaccharides, Single-Blind Method, Cross-Over Studies, Irritable Bowel Syndrome, Young Adult
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