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Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (Fodmaps) and Mortality Among Survivors of Liver Cirrhosis: A Prospective Cohort Study Publisher Pubmed



Fotros D1 ; Hekmatdoost A1 ; Pashayeekhamene F2 ; Karimi S1 ; Ahmadzadeh S1 ; Saberifiroozi M3 ; Hatami B4 ; Yari Z5
Authors

Source: Nutrition Journal Published:2025


Abstract

Background: Cirrhosis is a medical condition marked by persistent liver damage, which leads to the development of fibrous tissue and compromised liver function. In the present study, we decided to investigate the possibility of a connection between the consumption of fermentable olig-, di-, monosaccharides, and polyols (FODMAPs) and mortality rates in cirrhotic patients by utilizing data obtained from a prospective cohort study. Methods: This cohort study enrolled 166 ambulatory patients from two hospitals in Tehran, Iran, between 2016 and 2018, and followed them up for 5 48 months until April 30, 2022. During the 3,955 person-months of follow-up, 43 fatalities were recorded (36 men and 7 women). The study classified participants into three groups based on their FODMAPs consumption and assessed the risk of mortality using Cox proportional hazards regression models. Results: Total FODMAPs intake was associated with increased overall mortality risk (T3 vs. T1, HR = 3.5; 95%CI: 1.05, 11.7; P-trend = 0.036). This significant trend was also observed for total fructans (T3 vs. T1, HR = 5.15; 95% CI: 1.15, 23.2; P-trend = 0.006) and fructose (T3 vs. T1, HR = 5.55; 95% CI: 0.54, 57.14; P-trend = 0.018). Mortality risk was U-shaped with galactooligosaccharide intake, a lower mortality risk was observed with lactose intake and a higher mortality risk with polyols intake, although these associations did not reach statistical significance. Conclusion: In conclusion, this study highlights a higher risk of mortality with higher intake of fructans, excess fructose and total FODMAPs. © The Author(s) 2025.
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