FODMAP modulation as a dietary therapy for IBS: Scientific and market perspective

Compr Rev Food Sci Food Saf. 2022 Mar;21(2):1491-1516. doi: 10.1111/1541-4337.12903. Epub 2022 Feb 4.

Abstract

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is a promising therapeutic approach to reduce gastrointestinal symptoms associated with irritable bowel syndrome (IBS). However, a shift toward a more sustainable, healthy diet with higher inclusion of whole-grain cereals (i.e., wheat, rye, barley) and pulses, naturally rich in FODMAPs, poses a severe challenge for susceptible individuals. Dietary restriction of fermentable carbohydrates (commonly called the "low FODMAP diet") has received significant consideration. Hence, the development of functional low FODMAP products is emerging in food science and the food industry. In this review, we evaluate the most promising yet neglected (bio)-technological strategies adopted for modulating the FODMAP contents in complex food systems and the extent of their uptake in the global food market. We extensively investigated the global low FODMAP market, contrasted with the status quo in food science and discussed the key principles and concomitant challenges of targeted FODMAP reduction strategies. Powerful tools are available which are based either on the use of ingredients where FODMAPs have been physically removed (e.g., by membrane filtration) or biotechnologically reduced during the food processing, mediated by added enzymes, microbial enzymes during a fermentation process, and seed endogenous enzymes. However, <10% of the small market of functional products with a low FODMAP claim (total ∼800 products) used any of the targeted FODMAP reduction techniques. The global market is currently dominated by gluten-free products, which are naturally low in FODMAPs and characterized by inferior sensory attributes.

Keywords: enzymes; germination; gluten-free; sourdough; yeast.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diet
  • Disaccharides / therapeutic use
  • Humans
  • Irritable Bowel Syndrome* / drug therapy
  • Monosaccharides / therapeutic use
  • Oligosaccharides

Substances

  • Disaccharides
  • Monosaccharides
  • Oligosaccharides