Evidence-based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach

Peter R Gibson; Susan J Shepherd

Disclosures

J Gastroenterol Hepatol. 2010;25(2):252-258. 

In This Article

Limitations of Tables of the FODMAP Content of Foods

There are limitations in developing tables of FODMAP-rich and FODMAP-poor foods. This review paper provides a summary that is incomplete and is useful as a guide only.

  • Published lists of foods are generally limited in the description of FODMAP content. This limitation has been assisted by the development of methodologies to measure FODMAP content, together with a systematic examination of fruits, vegetables and cereals.[25,26]

  • The cut-off levels of FODMAP content, which dictates whether it is classified as 'high' or not, are not clearly defined. This is further complicated by the fact that the total of FODMAPs ingested (not the individual FODMAPs) at any one meal is a major factor in determining whether symptoms will be induced or not. In the original description of the diet,[39] cut-off values were based on careful clinical observation, which included obtaining feedback from patients regarding foods that they identified as triggers for symptoms. The foods reported by patients as being troublesome were examined for trends in the pooled food composition table. Foods and beverages containing > 0.5 g fructose in excess of glucose per 100 g, > 3 g fructose in an average serving quantity regardless of glucose intake (termed a 'high fructose load'), and > 0.2 g of fructans per serve were considered at-risk of inducing symptoms. The concept of a 'high fructose load' has not been evaluated in terms of its importance in the success of the diet.

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