Dietary Fructose Intolerance, Fructan Intolerance and FODMAPs

Amy Fedewa1, Satish S.C. Rao2
1Food and Nutrition Department, Georgia Regents University, Augusta, USA
2Department of Medicine, Section of Gastroenterology and Hepatology, Georgia Regents University, Augusta, USA

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Tài liệu tham khảo

Hungin AP, Chang L, Locke GR, Dennis EH, Barghout V. Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact. Aliment Pharmacol Ther. 2005;21:1365–75.

Chang L. Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther. 2004;20 Suppl 7:31–9.

Böhn L, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms of IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108:634–41. This study investigates dietary food triggers using a food questionnaire in patients with IBS and their effects on gastrointestinal and psychological symptoms and quality of life.

Heizer WD, Southern S, McGovern S. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. J Am Diet Assoc. 2009;109:1204–14.

Bray GA, Nielsen SJ, Popkin BM. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am Clin Nutr. 2004;79:537–43.

Economic Research Service, USDA. Table 49–US total estimated deliveries of caloric sweeteners for domestic food and beverage use, by calendar year. 2003.

Choi YK, Johlin Jr FC, Summers RW, Jackson M, Rao SS. Fructose intolerance: an under-recognized problem. Am J Gastroenterol. 2003;98:1348–53.

Choi YK, Kraft N, Zimmerman B, Jackson M, Rao SS. Fructose intolerance in IBS and utility of fructose-restricted diet. J Clin Gastroenterol. 2008;42:233–8. This study provides evidence that fructose intolerance is prevalent in patients with IBS and showed that, with compliance to fructose-restricted diet, symptoms improved despite only moderate impact on lifestyle.

Wilder-Smith CH, Li X, Ho SSY, Leong SM, Wong RK, Koay ESC, et al. Fructose transporters GLUT5 and GLUT2 expression in adult patients with fructose intolerance. United Eur Gastroenterol J. 2013. doi: 10.1177/2050640613505279 .

Riby JE, Fujisawa T, Kretchmer N. Fructose absorption. Am J Clin Nutr. 1993;58:748S–53S.

Putkonen L, Yao CK, Gibson PR. Fructose malabsorption syndrome. Curr Opin Clin Nutr Metab Care. 2013;16:473–7.

DeBosch BJ, Chi M, Moley KH. Glucose transporter 8 (GLUT8) regulates enterocyte fructose transport and global mammalian fructose utilization. Endocrinology. 2012;153:4181–91.

Barrett JS, Gearry RB, Muir JG, Irving PM, Rose R, Rosella O, et al. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther. 2010;31:874–82.

Rao SS, Attaluri A, Anderson L, Stumbo P. Ability of the normal human intestine to absorb fructose: evaluation by breath testing. Clin Gastroenterol Hepatol. 2007;5:959–63. The dose for breath testing of fructose malabsorption is determined in this dose-response study in normal volunteers.

Jones HF, Butler RN, Moore DJ, Brooks DA. Developmental changes and fructose absorption in children: effect on malabsorption testing and dietary management. Nutr Rev. 2013;71:300–9.

Gibson PR, Newnham E, Barrett JS, Shepherd SJ, Muir JG. Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther. 2007;25:349–63.

Barrett JS, Gibson PR. Fructose and lactose testing. Aust Fam Physician. 2012;41:293–6.

Shepherd SJ, Gibson PR. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management. J Am Diet Assoc. 2006;106:1631–9.

Kim Y, Park SC, Wolf BW, Hertzler SR. Combination of erythritol and fructose increases gastrointestinal symptoms in healthy adults. Nutr Res. 2011;31:836–41.

Komericki P, Akkilic-Materna M, Strimitzer T, Weyermair K, Hammer HF, Aberer W. Oral xylose isomerase decreases breath hydrogen excretion and improves gastrointestinal symptoms in fructose malabsorption-a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2012;36:980–7.

Roberfroid MB. Introducing inulin-type fructans. Br J Nutr. 2005;93 Suppl 1:S13–25.

Marcason W. What is the FODMAP diet? J Acad Nutr Diet. 2012;112:1696.

Donahue R, Attaluri A, Schneider M, Valestin J, Rao SS. Absorptive capacity of fructans in healthy humans: a dose response study. Gastroenterology. 2010;138:S709. This preliminary study provides the dose appropriate for fructan breath testing.

Muir JG, Shepherd SJ, Rosella O, Rose R, Barrett JS, Gibson PR. Fructan and free fructose content of common Australian vegetables and fruit. J Agric Food Chem. 2007;55:6619–27.

Moshfegh AJ, Friday JE, Goldman JP, Ahuja JK. Presence of inulin and oligofructose in the diets of Americans. J Nutr. 1999;129:14707S–11S.

Biesiekierski JR, Rosella O, Rose R, Liels K, Barrett JS, Shepherd SJ, et al. Quantification of fructans, galacto-oligosaccharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet. 2011;24:154–76.

Shepherd SJ, Parker FC, Muir JG, Gibson PR. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol. 2008;6:765–71.

Attaluri A, Paulson J, Jackson M, Donahue R, Rao SS. Dietary Fructan intolerance: a new recognized problem in IBS. Neurogastroenterol Motil. 2009;57:150.

Barrett JS, Gibson PR. Clinical ramifications of malabsorption of fructose and other short-chain carbohydrates. Pract Gastroenterol. 2007;31:51–65.

Shepherd SJ, Lomer MC, Gibson PR. Short-chain carbohydrates and functional gastrointestinal disorders. Am J Gastroenterol. 2013;108:707–17. This review provides comprehensive evaluation of FODMAPs in functional gastrointestinal disorders.

Fernández-Bañares F, Esteve M, Viver JM. Fructose-sorbitol malabsorption. Curr Gastroenterol Rep. 2009;11:368–74.

Staudacher HM, Whelan K, Irving PM, Lomer MC. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPS) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet. 2011;24:487–95.

de Roest RH, Dobbs BR, Chapman BA, Batman B, O’Brien LA, Leeper JA, et al. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Pract. 2013;67:895–903.

Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2013;pii: S0016-5085(13):01407–8. doi: 10.1053/j.gastro.2013.09.046 . This randomized controlled trial provides evidence on the efficacy of FODMAPs in IBS.

Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, et al. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1366–73.

Halmos EP, Muir JG, Barrett JS, Deng M, Shepherd SJ, Gibson PR. Diarrhoea during enteral nutrition is predicted by the poorly absorbed short-chain carbohydrate (FODMAP) content of the formula. Aliment Pharmacol Ther. 2010;32:952–33.

Gearry RB, Irving PM, Barrett JS, Nathan DM, Shepherd SJ, Gibson PR. Reduction of dietary poorly absorbed carbohydrates (FODMAPs) improves abdominal symptoms in patients with inflammatory bowel disease-a pilot study. J Crohns Colitis. 2009;3:8–14.

Barrett JS. Expanding our knowledge of fermentable, short-chain carbohydrates for managing gastrointestinal symptoms. Nutr Clin Pract. 2013;28:300–6.

Barrett JS, Gibson PR. Fermentable oligosaccharides disaccharides, monosaccharides and polyols (FODMAPS) and nonallergic food intolerance: FODMAPs or food chemicals? Ther Adv Gastroenterol. 2012;5:261–8.