Relationship Between the Fermentable Oligo-Di-Mono-Saccharides and Polyols Diet and Gastrointestinal Distress in Adult Athletes

Abstract

the benefits of a low FODMAP diet (LFOD) in athletes experiencing exercise-related GI distress. Athletes commonly experience GI distress when exercising. It has been hypothesized that reducing the intake of short-chain carbohydrates such as Fermentable Oligo-Di-Mono-Saccharides and Polyols (FODMAPs), which are not easily digested may improve the amount and/or severity of exercise-induced GI distress. We searched PubMed, CINAHL, EBSCOhost, and The Cochrane Library during May-June 2020. Inclusion criteria were: male and female athletes >18 years old with GI distress, >10 participants, dropout rate <20%, English language, and published between 2010-2020. After screening, assessing for eligibility, and eliminating duplicates, a total of four studies were included: three randomized crossover studies and one cross-sectional study. Two studies found that a low FODMAP diet (LFOD) (range of 1.3-17.7 g/day for one week) improved pain and bloating in endurance athletes. One study observed that a LFOD was associated with lower incidences of flatulence, loose stools, diarrhea, and urge to defecate. Participants on a high FODMAP diet (HFOD) reported more GI discomfort and overall GI symptoms compared to a LFOD in three out of the four studies. Finally, one study showed that about 93% of athletes report FODMAPs as a contributor to GI symptoms when exercising and found relief when eliminating those foods from their diet. A LFOD for less than seven days has shown to be more effective than a HFOD in reducing symptoms of GI distress in otherwise healthy adult athletes. However, more studies with longer durations and larger sample sizes are needed before a recommendation can be made by a Registered Dietitian.