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: NARAYANA, VISHNU - Baylor College Of Medicine; MCMEANS, ANN - Baylor College Of Medicine; LEVY, RONA - University Of Washington; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC); CHUMPITAZI, BRUNO - Children'S Nutrition Research Center (CNRC)

Submitted to: Neurogastroenterology & Motility
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/25/2022
Publication Date: 5/9/2022
Citation: Narayana, V., McMeans, A.R., Levy, R.L., Shulman, R.J., Chumpitazi, B.P. 2022. 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. Neurogastroenterology & Motility. https://doi.org/10.1111/nmo.14392.
DOI: https://doi.org/10.1111/nmo.14392

Interpretive Summary: Approximately 10% of children and adults have abdominal pain when they eat certain foods that are poorly digestible (so-called FODMAP foods). The recommended treatment is reducing the amount of these foods in the diet. However, it is unclear if this is easily done. In this study we found that children can reduce their intake of FODMAP foods, and equally important, the quality of their diet improved when doing so.

Technical Abstract: 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). 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. 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. 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.