FODMAP intake in children with coeliac disease influences diet quality and health-related quality of life and has no impact on gastrointestinal symptoms

Abstract

Children with coeliac disease (CD) following the gluten-free diet may experience ongoing gastrointestinal symptoms despite strict adherence. The study objective was to evaluate the association between foods high in fermentable oligo/di/monosaccharides, and polyols (FODMAP) and gastrointestinal symptoms, and the potential implications to diet quality and health-related quality of life in CD children. Dietary intake was studied in age-sex matched children 5–18 years (CD, n = 46; non-coeliac mild chronic gastrointestinal complaints [GIC], n = 46; healthy controls [HC], n = 46). CD children consumed fewer foods high in FODMAPs compared to GIC and HC (p < .0001). FODMAP intake was not related to gastrointestinal symptoms in CD children (p > 0.05) but was positively associated with child health-related quality of life (p < 0.05). FODMAP intake from fruits and vegetables was positively associated with diet adequacy and total diet quality in CD children (p < 0.05). FODMAP intake may influence diet quality and health-related quality of life but has no impact on gastrointestinal symptoms in CD children.

Keywords:

• Children
• coeliac disease
• FODMAP
• diet quality
• quality of life

Acknowledgements

The authors would like to acknowledge Poh Hwa Ooi MSc RD, Christine Lirette BSc and Elsa Wong BSc for their assistance with this research study. The authors would also like to gratefully acknowledge the contribution of the children and families who participated in this research.

Author contributions

1. Samantha Cyrkot RD: contributed to data analysis, co-wrote manuscript, contributed to intellectual/scientific interpretation, approved final manuscript.

2. Margaret Marcon MD FRCPC: supervised data collection at the Hospital for Sick Children, intellectual/scientific interpretation, approved final manuscript.

3. Herbert Brill MD FRCPC: supervised data collection at McMaster Children’s Hospital, contributed to intellectual/scientific interpretation of data, approved final manuscript.

4. Heather Mileski RD: collected data at McMaster Children’s Hospital, contributed to intellectual/scientific interpretation, approved final manuscript.

5. Jenna Dowhaniuk MD FRCPC: collected data at McMaster Children’s Hospital, contribute to intellectual/scientific interpretation, approved final manuscript.

6. Alena Frankish BSc: contributed to data analysis, contributed to intellectual/scientific interpretation, approved final manuscript.

7. Matthew W. Carroll MD FRCPC: supervised data collection at Stollery Children’s Hospital, contributed to intellectual/scientific interpretation, approved final manuscript.

8. Rabin Persad MD FRCPC: contributed to study design, supervised data collection at Stollery Children’s Hospital, contributed to intellectual/scientific interpretation, approved final manuscript.

9. Justine M. Turner MD PhD FRCPC: contributed to study design, supervised data collection at Stollery Children’s Hospital, contributed to intellectual/scientific interpretation, approved final manuscript

10. Diana R. Mager PhD RD: responsible for study design/inception, supervision of data collection at all sites, PI on all grants associated with project, data analysis and intellectual/scientific interpretation, co-wrote manuscript, approved final manuscript.

Disclosure statement

The authors declare that they have no conflict of interest.

Transparency declaration

The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported. The reporting of this work is compliant with STROBE guidelines. The lead author affirms that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.

Additional information

Funding

This work was supported by the Canadian Coeliac Association: JA Campbell Award 2012 to DRM. Funders had no role in the design, analysis, or writing of this article.