Impact Of 24-h High And Low Fermentable Oligo-, Di-, Monosaccharide, And Polyol Diets On Markers Of Exercise-induced Gastrointestinal Syndrome In Response To Exertional Heat Stress

Effect Increase
Values There was a significant effect of time and trial on I-FABP (a marker of intestinal permeability); the low FODMAP diet resulted in higher levels of I-FABP after exercise (1429 (872–1987) pg·mL−1; 443% in high FODMAP versus 2068 (1078–3058) pg·mL−1; 710%; p=0.033).
Trial Design Randomized trial
Trial Length 24 hours
Number of Subjects 18
Sex Both Genders
Age Range 18-29, 30-44
Body Types Trained
Notes for this study:
In this randomized, controlled crossover trial, 18 non-heat-acclimatized, recreationally, competitively-trained endurance and ultra-endurance runners were assigned to a 24-hour high or low FODMAP diet (with high FODMAP content adjusted based on prior habitual intake). Participants were provided with prepared diets. On the day of the exercise trial, participants were provided with a high or low FODMAP meal 2 hours prior to a challenging 2-hour treadmill run in a hot room. Participants were provided with water ad lib. After the exercise bout, participants consumed a high or low FODMAP recovery drink and rested for 4 hours.

Heart rate, rate of perceived exertion (RPE), gastrointestinal symptom severity (GIS), rectal temperature, and breath hydrogen were collected at baseline and every 15 minutes during exercise. GIS and breath hydrogen were collected every 15 minutes during the post-exercise rest period, and again 24 hours after the exercise bout. Blood was collected at baseline and after completion of the exercise bout to measure plasma cortisol, blood glucose, endotoxin and cytokine profiles, and markers of intestinal permeability.

There was a significant effect of time and trial on I-FABP (a marker of intestinal permeability); the low FODMAP diet resulted in higher levels of I-FABP after exercise. No significant differences were observed in endotoxin or cytokine profiles between diets.

The high-FODMAP diet resulted in significantly greater breath hydrogen concentration throughout the trial, and a positive correlation existed between breath hydrogen production and total GIS scores.

GIS scores were higher in response to the trial period in the high-FODMAP group.
Funding issues for this study:
One author works in a department which benefits financially from the sales of a digital application and booklets on the low FODMAP diet, but these contribute to research of the Department of Gastroenterology and to the university; the author receives no personal financial gain.

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