CHARACTERIZING HIGH FODMAP FOODS IN THE DIETS OF AMERICAN CHILDREN WITH PAIN-RELATED DISORDERS OF GUT-BRAIN INTERACTION

Background: The low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet, which restricts FODMAP intake, currently is used as a treatment for pain-related disorders of gut-brain interaction (DGBI). A FODMAP Gentle diet, which is less restrictive, has been proposed as a pediatric-friendly alternative to a complete low FODMAP diet (PMID: 36297053).
Objectives: In a clinical sample of children with DGBI from the US to: 1) Characterize the high FODMAP foods consumed; and 2) Determine the degree to which a FODMAP Gentle diet would restrict commonly consumed high FODMAP foods
Methods: Children ages 7-13 years with DGBI enrolled in an ongoing randomized controlled trial based in the US completed 3-day baseline food records. High FODMAP foods in the participants’ diets were identified. The foods were characterized further by the food groups/categories to which the FODMAPs belonged. Whether the FODMAP Gentle diet would restrict the consumed food also was determined.
Results: Eighty-six participants (53, 61.6% female) with a median (IQR) age of 10.5 (9.1-12) years were studied. A total of 1609 high FODMAP foods were consumed by the participants and each participant consumed a median (IQR) of 6 (4.7-7.9) high FODMAP foods per day. High FODMAP foods containing fructans were most prevalent in the diet, followed by those containing lactose and fructose (Table 1). Wheat-based high FODMAP foods were the most prevalent food category consumed, followed by dairy, fruits/fruit juices, beverages, and condiments (Table 1). 1078 (67%) of the high FODMAP foods consumed were ultra-processed and 274 (17%) contained high fructose corn syrup as a major ingredient. High FODMAP foods were categorized into 79 food categories with milk, breaded animal protein, and sodas being the most frequently consumed (Table 2). 1,302 (81%) of consumed high FODMAP foods would be restricted on a FODMAP Gentle diet.
Conclusion: Children with DGBI in the US frequently consume high FODMAP foods. The most consumed FODMAPs are fructans followed by lactose and fructose related to the intake of wheat-based foods, dairy, fruits/fruit juices, and beverages. The vast majority of high FODMAP foods commonly consumed would be restricted on a FODMAP Gentle diet.