FODMAPs & Prebiotics
What are FODMAPs?
FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) is a collective acronym for poorly absorbed complex sugars that are present in the diet and that can cause IBS-like symptoms in some individuals with a sensitive gut. These products are fermented by the majority of gut bacteria, causing a release of intestinal gas which can lead to Gastro-Intestinal (GI) symptoms.
Why are low-FODMAP diets recommended to people with IBS?
In an IBS population, the production of gas can lead to bloating, constipation and abdominal discomfort. FODMAP foods react the same way in everyone but those with IBS will be sensitive to the discomfort caused by the production of gas. A diet low in FODMAPs has been used by dietitians as a useful short-term dietary approach for reducing the symptoms in people with IBS.
Does Bimuno act as a FODMAP in people with IBS?*
Bimuno® is a galactooligosaccharide (the O in FODMAP) but it is important to understand that not all oligosaccharides are the same. Bimuno is specifically fermented by bacteria (bifidobacteria) which are not gas producing. The broad low-FODMAP approach predates a lot of the research on prebiotics on their specific effects on lowering (rather than increasing) IBS symptoms. Not all prebiotics function in the same way and so research on one type of prebiotic may not apply to another type.
In fact a review on the effects of prebiotics and IBS in 2018, concluded that the non-inulin based prebiotics, such as Bimuno, were effective in lowering the symptoms of IBS but inulin based prebiotics increased them.2
So although Bimuno is by definition a FODMAP, it has been found to act differently to other traditional FODMAPs and has been clinically shown to reduce symptoms of bloating, constipation and digestive discomfort for people with functional gut disorders when taken daily. 3 4 5
Why is Bimuno different from other prebiotics?
Bimuno is highly selective towards bifidobacteria down to a species level.1 This is not the same for other prebiotic oligosaccharides, which tend to be less selective and more general in their functionality. Some of them, such as inulin and fructooligosaccharides (FOS) are both defined as and act like FODMAPS. These types of prebiotics occur naturally in certain fruits and vegetables and in food supplements. Unlike Bimuno, when they are fermented in the colon, they generate gas and can cause flatulence, bloating and discomfort in some people.
Do low-FODMAP diets affect the gut microbiome?
Individuals with IBS who are sensitive to FODMAPs are often placed on a short-term low-FODMAP diet to reduce their symptoms. By restricting the intake of FODMAPs you are essentially starving the probiotics in the gut, thereby reducing fermentation, which then reduces the amount of gas that is produced. This reduces flatulence, bloating and abdominal discomfort if it is present. Probiotic bacteria (which are fed by many FODMAP foods) are regarded as beneficial in alleviating IBS symptoms and so ultimately this diet is only a temporary solution.
Are there other potential issues with the long-term use of low-FODMAP diets?
In addition to contributing to a varied microbiome, it’s important to note that the foods in which FODMAPs naturally occur offer many other important nutrients, such as antioxidants, vitamins and fibre and so should only be excluded for medical reasons.
As the diet is very restrictive, patient/client adherence may also be poor which may limit its use as a dietary strategy in IBS patients.
Have the effects of Bimuno and low-FODMAP diets been compared in studies?
Scientific research has shown that at the recommended doses, Bimuno can reduce bloating and abdominal discomfort without the need to make changes to the diet.3 4
A further study directly comparing the effectiveness of Bimuno to a low-FODMAP diet found that both groups had significantly reduced symptoms of abdominal pain, distention and bloating. Unsurprisingly the Bimuno group had raised levels of bifidobacteria and this was not seen in the group on the low FODMAPs diet. In addition, all the positive effects seen in the Bimuno group were still evident two weeks after the end of the study but not in the low-FODMAP group.5
Graph reproduced from Huaman et al ⁴
Therefore, Bimuno could be beneficial to people with symptoms associated with IBS alone or even in combination with a low-FODMAP diet.
- *IBS is used to represent all people with IBS like symptoms, such as bloating, abdominal pain and constipation whether diagnosed or not.
- 1 Depeint el al (2008), Prebiotic evaluation of a novel galactooligosaccharide mixture produced by the enzymatic activity of Bifidobacterium bifidum NCIMB 41171, in healthy humans: a randomized, double-blind, crossover, placebo-controlled intervention studyhttps://www.ncbi.nlm.nih.gov/pubmed/18326619
- 2 Wilson et al 2018, Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials. https://www.ncbi.nlm.nih.gov/pubmed/30949662
- 3 Silk et al (2009) Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome https://www.ncbi.nlm.nih.gov/pubmed/19053980
- 4 Vulevic et al (2018) Effect of a prebiotic galactooligosaccharide mixture (B-GOS®) on gastrointestinal symptoms in adults selected from a general population who suffer with bloating, abdominal pain, or flatulence https://www.ncbi.nlm.nih.gov/pubmed/30109908
- 5 Huaman et al (2019) Effects of Prebiotics vs a Diet Low in FODMAPs in Patients With Functional Gut Disorders https://www.ncbi.nlm.nih.gov/pubmed/29964041
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