The Low ‘FODMAP’ diet: A Survey of Food Availability

INTRODUCTION: Irritable Bowel Syndrome (IBS) occurs in ~15% of UK population. Low FODMAP diet is a potentially good dietary treatment for management of IBS symptoms. Low FODMAP diet is only associated with good outcomes when completely adhered too. Food availability can reduce adherence to other dietary interventions and low-FODMAP food availability is not known in current UK eating-out settings. METHODS: A cross-sectional survey of supermarkets, convenience stores, cafes and restaurants in Guildford, UK was administered to collect food quantities of sweet snacks, savoury snacks, meals-to-go, free-from sweet snacks and free-from savoury snacks that were then categorised as low, medium and high-FODMAP foods. Data was collected online and in-store. RESULTS: 7% of all foods (n=4279) were low-FODMAP, 8% were medium-FODMAP, 85% were high-FODMAP (p<0.05). Proportion of suitable foods available (low and medium-FODMAP foods combined) was higher in supermarkets than convenience stores (16.3% vs. 14.6% p<0.05); average count of suitable foods was higher in supermarkets than in cafes (37.9 ±22.4 vs. 5.5 ±1.9, p<0.05). In order, 24% of savoury snacks, 21% of free-from savoury snacks, 20% of sweet snacks, 16% of free from sweet snacks and 2% of meals-to-go were suitable to eat. Restaurants did not have enough data available. Gluten, onion and garlic were the highest occurring high-FODMAP ingredients and significantly affected food availability (p<0.05). CONCLUSION: For patients using the Low-FODMAP-diet, suitable food (Low and Medium-FODMAP) availability is currently very low in eating-out settings in the UK, especially meals-to-go. To improve adherence, low-FODMAP foods or labelling could be developed.