Implementing a Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet in Asia: Addressing Cultural, Clinical and Practical Challenges

The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is an evidence-based diet therapy for irritable bowel syndrome that is recommended in multiple clinical guidelines worldwide. While in Western countries, this diet is well accepted among health professionals and widely applied in clinical practice, uptake of the diet is more limited in Asian countries, likely due to research, clinical, practical, and cultural barriers. This review explores the challenges of implementing a FODMAP diet in Asian countries, including the lack of local efficacy studies, the limited availability of specialist dietitians, the lack of FODMAP composition data for local foods, language barriers and traditional dietary practices that are at odds with the principles of the FODMAP diet. Potential solutions include building local capacity in dietary research and clinical practice; expanding the analysis of Asian foods for FODMAP content; fostering interdisciplinary training opportunities for health professionals using a train-the-trainer approach; adapting educational resources so they are linguistically and culturally appropriate; and developing practical resources for patients to facilitate recipe adaptation and meal planning. Addressing these barriers will improve access to the FODMAP diet for patients in Asia and may provide a framework to adapt other dietary therapies to suit culturally diverse groups.