Gut-Brain Axis and Psychopathology: Exploring the Impact of Diet with a Focus on the Low-FODMAP Approach

Overview

Journal Nutrients

Date 2024 Oct 26

PMID 39458509

Authors

Emanuela Ribichini

Giulia Scalese

Chiara Mocci

Carola Severi

Affiliations

Soon will be listed here.

Abstract

Background: The gut-brain axis (GBA) is a bidirectional communication network connecting the central nervous system with the gastrointestinal (GI) tract, influencing both mental and physical health. Recent research has underscored the significant role of diet in modulating this axis, with attention to how specific dietary patterns can impact anxiety and depression, particularly when linked to disorders of gut-brain interaction (DGBIs), like intestinal bowel syndrome (IBS).

Aims And Methods: This narrative review examines the effects of specific diet regimens on the GBA and its potential role in managing psychopathology, focusing on anxiety and depression, IBS, and the low-FODMAP diet. We conducted a search on PubMed and MEDLINE by combining the following key terms: "Gut-Brain Axis", "Irritable Bowel Syndrome", "Low FODMAP diet", "Mediterranean Diet", "Psychopathology", "Anxiety and Depression", and "Gut Microbiota". We applied the following filters: "Clinical Trials", "Randomized Controlled Trials", "Reviews", "Meta-Analyses", and "Systematic Reviews". In total, 59 papers were included.

Results: Low-FODMAP diet, originally developed to alleviate GI symptoms in IBS, may also positively influence mental health by modulating the GBA and improving the gut microbiota (GM) composition. New insights suggest that combining the low-FODMAP diet with the Mediterranean diet could offer a synergistic effect, enhancing both GI and psychological therapeutic outcomes.

Conclusions: Understanding the complex interactions between diet, the GM, and mental health opens new avenues for holistic approaches to managing psychopathology, particularly when linked to GI symptoms.

References

Marx W, Lane M, Hockey M, Aslam H, Berk M, Walder K . Diet and depression: exploring the biological mechanisms of action. Mol Psychiatry. 2020; 26(1):134-150. DOI: 10.1038/s41380-020-00925-x. View

Kelly J, Borre Y, O Brien C, Patterson E, El Aidy S, Deane J . Transferring the blues: Depression-associated gut microbiota induces neurobehavioural changes in the rat. J Psychiatr Res. 2016; 82:109-18. DOI: 10.1016/j.jpsychires.2016.07.019. View

Liu J, Galfalvy H, Cooper T, Oquendo M, Grunebaum M, Mann J . Omega-3 polyunsaturated fatty acid (PUFA) status in major depressive disorder with comorbid anxiety disorders. J Clin Psychiatry. 2013; 74(7):732-8. PMC: 3905735. DOI: 10.4088/JCP.12m07970. View

Ledochowski M, Widner B, BAIR H, Probst T, Fuchs D . Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers. Scand J Gastroenterol. 2000; 35(10):1048-52. DOI: 10.1080/003655200451162. View

Schellekens H, Torres-Fuentes C, van de Wouw M, Long-Smith C, Mitchell A, Strain C . Bifidobacterium longum counters the effects of obesity: Partial successful translation from rodent to human. EBioMedicine. 2020; 63:103176. PMC: 7838052. DOI: 10.1016/j.ebiom.2020.103176. View

Hughes P, Zola H, Penttila I, Blackshaw L, Andrews J, Krumbiegel D . Immune activation in irritable bowel syndrome: can neuroimmune interactions explain symptoms?. Am J Gastroenterol. 2013; 108(7):1066-74. DOI: 10.1038/ajg.2013.120. View

Talley N, Dennis E, Schettler-Duncan V, Lacy B, Olden K, Crowell M . Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003; 98(11):2454-9. DOI: 10.1111/j.1572-0241.2003.07699.x. View

Anand N, Gorantla V, Chidambaram S . The Role of Gut Dysbiosis in the Pathophysiology of Neuropsychiatric Disorders. Cells. 2023; 12(1). PMC: 9818777. DOI: 10.3390/cells12010054. View

Ustaoglu T, Tek N, Yildirim A . Evaluation of the effects of the FODMAP diet and probiotics on irritable bowel syndrome (IBS) symptoms, quality of life and depression in women with IBS. J Hum Nutr Diet. 2023; 37(1):5-17. DOI: 10.1111/jhn.13194. View

10.

Lin P, Huang S, Su K . A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry. 2010; 68(2):140-7. DOI: 10.1016/j.biopsych.2010.03.018. View

11.

Meyer K, Lulla A, Debroy K, Shikany J, Yaffe K, Meirelles O . Association of the Gut Microbiota With Cognitive Function in Midlife. JAMA Netw Open. 2022; 5(2):e2143941. PMC: 8826173. DOI: 10.1001/jamanetworkopen.2021.43941. View

12.

Evrensel A, Unsalver B, Ceylan M . Neuroinflammation, Gut-Brain Axis and Depression. Psychiatry Investig. 2019; 17(1):2-8. PMC: 6992852. DOI: 10.30773/pi.2019.08.09. View

13.

Jent S, Bez N, Haddad J, Catalano L, Egger K, Raia M . The efficacy and real-world effectiveness of a diet low in fermentable oligo-, di-, monosaccharides and polyols in irritable bowel syndrome: A systematic review and meta-analysis. Clin Nutr. 2024; 43(6):1551-1562. DOI: 10.1016/j.clnu.2024.05.014. View

14.

Tiwari P, Dwivedi R, Bansal M, Tripathi M, Dada R . Role of Gut Microbiota in Neurological Disorders and Its Therapeutic Significance. J Clin Med. 2023; 12(4). PMC: 9965848. DOI: 10.3390/jcm12041650. View

15.

Pedersen N, Nyboe Andersen N, Vegh Z, Jensen L, Ankersen D, Felding M . Ehealth: low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol. 2014; 20(43):16215-26. PMC: 4239510. DOI: 10.3748/wjg.v20.i43.16215. View

16.

Balboa A, Mearin F, Badia X, Benavent J, Caballero A, Dominguez-Munoz J . Impact of upper digestive symptoms in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2006; 18(12):1271-7. DOI: 10.1097/01.meg.0000243870.41207.2f. View

17.

Zhao Z, Wang B, Mu L, Wang H, Luo J, Yang Y . Long-Term Exposure to Ceftriaxone Sodium Induces Alteration of Gut Microbiota Accompanied by Abnormal Behaviors in Mice. Front Cell Infect Microbiol. 2020; 10:258. PMC: 7344183. DOI: 10.3389/fcimb.2020.00258. View

18.

Jacka F, ONeil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M . A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). BMC Med. 2017; 15(1):23. PMC: 5282719. DOI: 10.1186/s12916-017-0791-y. View

19.

Harvie R, Chisholm A, Bisanz J, Burton J, Herbison P, Schultz K . Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs. World J Gastroenterol. 2017; 23(25):4632-4643. PMC: 5504379. DOI: 10.3748/wjg.v23.i25.4632. View

20.

Jang S, Choi S, Kim Y, Ryu H, Lee S, Bahk W . Psychological Characteristics and Quality of Life of Patients with Upper and Lower Functional Gastrointestinal Disorders. J Clin Med. 2023; 12(1). PMC: 9821077. DOI: 10.3390/jcm12010124. View