Characterizing Highly Fermentable Carbohydrate Foods in the Diets of Children with Disorders of Gut-Brain Interaction and Healthy Children

ObjectivesRestricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) intake can alleviate symptoms in children with gut-brain interaction disorders (DGBI). Due to the restrictive nature of the low FODMAP diet (LFD), the less restrictive FODMAP Gentle diet (FGD) has been suggested. However, the types of high FODMAP foods and carbohydrates commonly consumed by US children are unknown, as is the impact of the FGD on a typical diet. This project aimed to identify the high FODMAP foods and proportions of FODMAP carbohydrates consumed by children with DGBI and healthy children (HC), and to determine which usually ingested FODMAPs would be restricted on the FGD. MethodsThree-day diet records from both HC and children with DGBI were analyzed to assess the type of high FODMAP foods and carbohydrates ingested. Results were compared between the groups. The ingested FODMAPs that would be restricted on the FGD was determined. ResultsThe number of foods ingested daily was similar between children with DGBI and HC (12.3 {+/-} 4.2 vs 12.9 {+/-} 3.4, respectively); high FODMAP foods comprised most foods eaten in both groups. Children with DGBI (vs HC) ate less high FODMAP foods per day (6.5 {+/-} 2.3 vs 8.7 {+/-} 2.4, P<0.0001, respectively). Fructans were the most consumed FODMAP carbohydrate in both groups and children with DGBI (vs HC) consumed fewer fructans, lactose, fructose, and polyols (all P<0.0001). The top 3 food categories consumed in both groups were wheat-containing foods, dairy, and fruits and 100% fruit juices. In children with DGBI, 80.9% of the high FODMAP foods consumed would be limited on the FGD. DiscussionChildren with DGBI consume significantly fewer high FODMAP foods and carbohydrates than HC. In both groups, the top consumed FODMAP carbohydrates are fructans, lactose, and fructose. A FODMAP Gentle diet would restrict a large majority of high FODMAP foods consumed by children with DGBI.