There is now high quality evidence that restriction of dietary FODMAPs in people with IBS leads to symptomatic improvement of gastrointestinal symptoms. However, this dietary approach requires comprehensive data describing the FODMAP composition of food. We have undertaken extensive work over many years to quantify the FODMAP (Fermentable Oligo-, Di-, and Monosaccharides And Polyols) composition of several hundred foods. Fructose, lactose, sorbitol, mannitol, galacto-oligosaccharides (GOS, stachyose, raffinose) were measured using high-performance liquid chromatography (HPLC) with evaporative light scattering detection (ELSD). Total fructans were quantified using a commercially available kit that utilises an enzymatic hydrolysis method. A wide range of foods have now been tested, including cereal and grain products; pulses, nuts and seeds; dairy and dairy alternatives; beverages; fruit and vegetables; confectionary, sugars and sweeteners, and fibre supplements.
This paper draws together FODMAP composition data from the published literature and updates this literature with FODMAP composition data from Australian and international foods, sourced from the USA and Denmark. We describe our method of FODMAP analysis, outline our reference ranges for low FODMAP foods and discuss the effect of serving size and food processing techniques on FODMAP composition. We compare the FODMAP composition of Australian and international foods, noting similarities in the FODMAP composition of fresh foods, but differences in the FODMAP composition of processed foods, probably due to differences in ingredients and food processing techniques. We also discuss specific challenges faced by patients and clinicians when implementing a low FODMAP diet in the USA.
Our extensive database characterising the FODMAP composition of food has enabled us to develop digital tools, such as the Monash University Low FODMAP diet app, that communicate this information with health professionals and patients. Our app is regularly updated with results from FODMAP analysis of foods. This helps to ensure that users have access to the latest and most comprehensive FODMAP composition data, enabling them to implement the least restrictive, low FODMAP diet necessary. This may have implications for patient compliance and nutritional adequacy.