The Low-FODMAP Diet, IBS, and BCFAs: Exploring the Positive, Negative, and Less Desirable Aspects-A Literature Review

Microorganisms. 2023 Sep 25;11(10):2387. doi: 10.3390/microorganisms11102387.


Maroulla D Nikolaki 1 2Arezina N Kasti 1Konstantinos Katsas 1 3Konstantinos Petsis 1Sophia Lambrinou 4Vasiliki Patsalidou 1Sophia Stamatopoulou 1Katerina Karlatira 1John Kapolos 5Konstantinos Papadimitriou 6Konstantinos Triantafyllou 7


Author information

1Department of Nutrition and Dietetics, ATTIKON University General Hospital, 12462 Athens, Greece.

2Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University, 72300 Crete, Greece.

3Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Athens, Greece.

4Department of Clinical Nutrition & Dietetics, General Hospital of Karpathos "Aghios Ioannis o Karpathios", 85700 Karpathos, Greece.

5Department of Food Science and Technology, University of Peloponnese, 24100 Kalamata, Greece.

6Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece.

7Hepatogastroenterology Unit, 2nd Department of Internal Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 12462 Athens, Greece.


The literature about the association of branched short-chain fatty acids (BCFAs) and irritable bowel syndrome (IBS) is limited. BCFAs, the bacterial products of the catabolism of branched-chain amino acids, are proposed as markers for colonic protein fermentation. IBS is a gastrointestinal disorder characterized by low-grade inflammation and intestinal dysbiosis. The low-FODMAP diet (LFD) has increasingly been applied as first-line therapy for managing IBS symptoms, although it decreases the production of short-chain fatty acids (SCFA), well known for their anti-inflammatory action. In parallel, high protein consumption increases BCFAs. Protein fermentation alters the colonic microbiome through nitrogenous metabolites production, known for their detrimental effects on the intestinal barrier promoting inflammation. Purpose: This review aims to explore the role of BCFAs on gut inflammation in patients with IBS and the impact of LFD in BCFAs production. Methods: A literature search was carried out using a combination of terms in scientific databases. Results: The included studies have contradictory findings about how BCFAs affect the intestinal health of IBS patients. Conclusions: Although evidence suggests that BCFAs may play a protective role in gut inflammation, other metabolites of protein fermentation are associated with gut inflammation. Further research is needed in order to clarify how diet protein composition and, consequently, the BCFAs are implicated in IBS pathogenesis or in symptoms management with LFD+.

Keywords: branched-chain fatty acids; gut microbiota; inflammation; irritable bowel syndrome; low-FODMAP diet; short-chain fatty acids.

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