{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:44:49Z","timestamp":1791049489853,"version":"4.1.0"},"reference-count":99,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Functional gastrointestinal disorders (FGIDs) are common in children and adolescents. In recent years, interest in the role of diet in the treatment of FGIDs has increased. Currently, interest focuses on the low-FODMAP diet (LFD), the fructose- or lactose-restricted diet (FRD or LRD), the gluten-free diet (GFD), and the Mediterranean diet (MD). In this review, we focus on the role of these dietary patterns in the FGIDs most commonly diagnosed in clinical practice, namely irritable bowel syndrome (IBS), functional abdominal pain (FAP), functional dyspepsia (FD), and functional constipation (FC). Fifteen clinical trials were systematically reviewed (both RCTs and single-arm clinical trials). We demonstrated the lack of high-quality intervention trials. Based on current evidence, low-FODMAP diet, LRD, FRD, and GFD have no place in daily clinical practice for the management of children and adolescents with FGIDs. Nevertheless, some patients with IBS or RAP may experience some benefit from the use of a low-FODMAP diet or FRD\/LRD. Limited data suggest that MD may be promising in the management of FGIDs, especially in IBS patients, but more data are required to investigate the mechanisms of its protective effects.<\/jats:p>","DOI":"10.3390\/nu15122708","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T01:59:07Z","timestamp":1686535147000},"page":"2708","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy of Different Dietary Patterns in the Treatment of Functional Gastrointestinal Disorders in Children and Adolescents: A Systematic Review of Intervention Studies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4474-328X","authenticated-orcid":false,"given":"Christina N.","family":"Katsagoni","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, Agia Sofia Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki-Maria","family":"Karagianni","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Agia Sofia Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0610-2174","authenticated-orcid":false,"given":"Alexandra","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Agia Sofia Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jpeds.2016.04.008","article-title":"Prevalence of functional gastrointestinal disorders in children and adolescents","volume":"177","author":"Lewis","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11894-020-00760-8","article-title":"The Effects of the Rome IV Criteria on Pediatric Gastrointestinal Practice","volume":"22","author":"Baaleman","year":"2020","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jpeds.2017.12.012","article-title":"Prevalence of pediatric functional gastrointestinal disorders utilizing the Rome IV criteria","volume":"195","author":"Robin","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1053\/j.gastro.2016.02.015","article-title":"Childhood functional gastrointestinal disorders: Child\/adolescent","volume":"150","author":"Hyams","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1053\/j.gastro.2005.11.065","article-title":"Childhood functional gastrointestinal disorders: Neonate\/toddler","volume":"130","author":"Hyman","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1053\/j.gastro.2005.08.063","article-title":"Childhood functional gastrointestinal disorders: Child\/adolescent","volume":"130","author":"Rasquin","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Vernon-Roberts, A., Alexander, I., and Day, A.S. (2021). Systematic Review of Pediatric Functional Gastrointestinal Disorders (Rome IV Criteria). J. Clin. Med., 10.","DOI":"10.3390\/jcm10215087"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3915","DOI":"10.3748\/wjg.v23.i21.3915","article-title":"Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review","volume":"23","author":"Boronat","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Strisciuglio, C., Cenni, S., Serra, M.R., Dolce, P., Kolacek, S., Sila, S., Trivic, I., Bar Lev, M.R., Shamir, R., and Kostovski, A. (2022). Diet and Pediatric Functional Gastrointestinal Disorders in Mediterranean Countries. Nutrients, 14.","DOI":"10.3390\/nu14112335"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"935-e398","DOI":"10.1111\/j.1365-2982.2011.01749.x","article-title":"Genetic susceptibility to inflammation and colonic transit in lower functional gastrointestinal disorders: Preliminary analysis","volume":"23","author":"Camilleri","year":"2011","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1038\/s41380-023-01972-w","article-title":"The neurobiology of irritable bowel syndrome","volume":"28","author":"Mayer","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1365-2982.2006.00875.x","article-title":"Mechanisms of hypersensitivity in IBS and functional disorders","volume":"19","author":"Azpiroz","year":"2007","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5141","DOI":"10.1113\/JP281620","article-title":"Physiological mechanisms of unexplained (functional) gastrointestinal disorders","volume":"599","author":"Burns","year":"2021","journal-title":"J. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"419","DOI":"10.4161\/gmic.29417","article-title":"The microbiota-gut-brain axis in functional gastrointestinal disorders","volume":"5","author":"Collins","year":"2014","journal-title":"Gut Microbes"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1080\/17474124.2020.1801414","article-title":"Is there a causal link between psychological disorders and functional gastrointestinal disorders?","volume":"14","author":"Koloski","year":"2020","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.pop.2017.07.009","article-title":"Irritable bowel syndrome: Epidemiology, pathophysiology, diagnosis, and treatment","volume":"44","author":"Defrees","year":"2017","journal-title":"Prim. Care Clin. Off. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1097\/MPG.0000000000003030","article-title":"Diagnostic Accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children","volume":"72","author":"Saps","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1159\/000338965","article-title":"Systematic review of randomized controlled trials: Fiber supplements for abdominal pain-related functional gastrointestinal disorders in childhood","volume":"61","author":"Horvath","year":"2012","journal-title":"Ann. Nutr. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"805466","DOI":"10.3389\/fped.2022.805466","article-title":"Probiotics and Functional Gastrointestinal Disorders in Pediatric Age: A Narrative Review","volume":"10","author":"Capozza","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.46439\/gastro.2.014","article-title":"Cognitive behavioral therapy for comorbid pediatric functional gastrointestinal disorders and anxiety: Systematic review and clinical applications","volume":"2","author":"Korte","year":"2023","journal-title":"J. Clin. Exp. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S114","DOI":"10.1097\/j.pain.0000000000001862","article-title":"Pain prevention and management must begin in childhood: The key role of psychological interventions","volume":"161","author":"Palermo","year":"2020","journal-title":"Pain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/nmo.12479","article-title":"Is fecal microbiota transplantation (FMT) an effective treatment for patients with functional gastrointestinal disorders (FGID)?","volume":"27","author":"Pinn","year":"2015","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"365","DOI":"10.2147\/CEG.S146646","article-title":"Focus on the use of antidepressants to treat pediatric functional abdominal pain: Current perspectives","volume":"11","author":"Bonilla","year":"2018","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.jpeds.2014.09.067","article-title":"Pharmacologic treatment in pediatric functional abdominal pain disorders: A systematic review","volume":"166","author":"Korterink","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"808195","DOI":"10.3389\/fphar.2022.808195","article-title":"Current Treatment Options and Therapeutic Insights for Gastrointestinal Dysmotility and Functional Gastrointestinal Disorders","volume":"13","author":"Singh","year":"2022","journal-title":"Front. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e13730","DOI":"10.1111\/nmo.13730","article-title":"Implementation of the low FODMAP diet in functional gastrointestinal symptoms: A real-world experience","volume":"32","author":"Tuck","year":"2020","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1055\/s-0034-1383653","article-title":"Positive or negative fructose breath test results do not predict response to fructose restricted diet in children with recurrent abdominal pain: Results from a prospective randomized trial","volume":"226","author":"Wirth","year":"2014","journal-title":"Klin. P\u00e4diatrie"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rej, A., Avery, A., Aziz, I., Black, C.J., Bowyer, R.K., Buckle, R.L., Seamark, L., Shaw, C.C., Thompson, J., and Trott, N. (2022). Diet and irritable bowel syndrome: An update from a UK consensus meeting. BMC Med., 20.","DOI":"10.1186\/s12916-022-02496-w"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cenni, S., Sesenna, V., Boiardi, G., Casertano, M., Di Nardo, G., Esposito, S., and Strisciuglio, C. (2023). The Mediterranean Diet in Paediatric Gastrointestinal Disorders. Nutrients, 15.","DOI":"10.3390\/nu15071615"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"W-65","DOI":"10.7326\/0003-4819-151-4-200908180-00136","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_33","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2023, May 04). Chapter 25: Assessing risk of bias in a non-randomized study. Available online: www.training.cochrane.org\/handbook."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_35","unstructured":"Higgins, J.P., Li, T., and Sterne, J. (2021). Revised Cochrane risk of bias tool for randomized trials (RoB 2): Additional considerations for crossover trials. Cochrane Methods, 1\u20136."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/apt.13286","article-title":"Randomised clinical trial: Gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome","volume":"42","author":"Chumpitazi","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4161\/gmic.27923","article-title":"Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome","volume":"5","author":"Chumpitazi","year":"2014","journal-title":"Gut Microbes"},{"key":"ref_38","first-page":"433","article-title":"Is low FODMAP diet effective in children with irritable bowel syndrome?","volume":"7","author":"Dogan","year":"2020","journal-title":"North. Clin. Istanb."},{"key":"ref_39","first-page":"180","article-title":"Implementation of a low FODMAP diet for functional abdominal pain","volume":"90","year":"2019","journal-title":"An. Pediatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1159\/000510795","article-title":"Low FODMAP diet is not effective in children with functional abdominal pain: A randomized controlled trial","volume":"76","author":"Boradyn","year":"2020","journal-title":"Ann. Nutr. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1080\/09637486.2021.1880553","article-title":"FODMAP intake in children with coeliac disease influences diet quality and health-related quality of life and has no impact on gastrointestinal symptoms","volume":"72","author":"Cyrkot","year":"2021","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2800","DOI":"10.1007\/s10803-020-04717-8","article-title":"The effect of the low FODMAP diet on gastrointestinal symptoms, behavioral problems and nutrient intake in children with autism spectrum disorder: A randomized controlled pilot trial","volume":"51","author":"Nogay","year":"2021","journal-title":"J. Autism Dev. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1055\/s-0031-1279747","article-title":"Fructose malabsorption in children with recurrent abdominal pain: Positive effects of dietary treatment","volume":"224","author":"Wintermeyer","year":"2012","journal-title":"Klin. Padiatr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/MPG.0000000000000232","article-title":"Fructose intolerance\/malabsorption and recurrent abdominal pain in children","volume":"58","author":"Lustig","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e411","DOI":"10.1111\/j.1651-2227.2012.02721.x","article-title":"Lactose and fructose malabsorption in children with recurrent abdominal pain: Results of double-blinded testing","volume":"101","author":"Gijsbers","year":"2012","journal-title":"Acta. Paediatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1177\/000992280304200406","article-title":"Abdominal Pain Associated with Lactose Ingestion in Children with Lactose Intolerance","volume":"42","author":"Gremse","year":"2003","journal-title":"Clin. Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1038\/ajg.2017.483","article-title":"Randomized double-blind placebo-controlled crossover trial for the diagnosis of non-celiac gluten sensitivity in children","volume":"113","author":"Francavilla","year":"2018","journal-title":"Off. J. Am. Coll. Gastroenterol.|ACG"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s10803-019-04266-9","article-title":"Gluten-free diet in children with autism spectrum disorders: A randomized, controlled, single-blinded trial","volume":"50","author":"Piwowarczyk","year":"2020","journal-title":"J. Autism Dev. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1007\/s12519-016-0040-z","article-title":"Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: A randomized clinical trial","volume":"12","author":"Ghalichi","year":"2016","journal-title":"World J. Pediatr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"330","DOI":"10.5409\/wjcp.v11.i4.330","article-title":"Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome","volume":"11","author":"Maher","year":"2022","journal-title":"World J. Clin. Pediatr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1136\/gutjnl-2021-325214","article-title":"Efficacy of a low FODMAP diet in irritable bowel syndrome: Systematic review and network meta-analysis","volume":"71","author":"Black","year":"2022","journal-title":"Gut"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1038\/ajg.2014.187","article-title":"American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation","volume":"109","author":"Ford","year":"2014","journal-title":"Off. J. Am. Coll. Gastroenterol.|ACG"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Moayyedi, P., Marsiglio, M., Andrews, C.N., Graff, L.A., Korownyk, C., Kvern, B., Lazarescu, A., Liu, L., MacQueen, G., and Paterson, W.G. (2019). Patient Engagement and Multidisciplinary Involvement has an Impact on Clinical Guideline Development and Decisions: A Comparison of Two Irritable Bowel Syndrome Guidelines Using the Same Data, Oxford University Press US.","DOI":"10.1093\/jcag\/gwy072"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1177\/0148607114545329","article-title":"Irritable bowel syndrome: Contemporary nutrition management strategies","volume":"38","author":"Mullin","year":"2014","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.gastro.2013.09.046","article-title":"A diet low in FODMAPs reduces symptoms of irritable bowel syndrome","volume":"146","author":"Halmos","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_56","first-page":"3505","article-title":"Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: A systematic review and meta-analysis","volume":"60","author":"Greyling","year":"2021","journal-title":"Eur. J. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/MPG.0000000000003526","article-title":"An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology","volume":"75","author":"Thomassen","year":"2022","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/ajg.2017.46","article-title":"Hydrogen and methane-based breath testing in gastrointestinal disorders: The North American Consensus","volume":"112","author":"Rezaie","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/S2468-1253(17)30154-1","article-title":"Country, regional, and global estimates for lactose malabsorption in adults: A systematic review and meta-analysis","volume":"2","author":"Storhaug","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1136\/gutjnl-2019-318404","article-title":"Update on lactose malabsorption and intolerance: Pathogenesis, diagnosis and clinical management","volume":"68","author":"Misselwitz","year":"2019","journal-title":"Gut"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kwiecie\u0144, J., Hajzler, W., Kosek, K., Balcerowicz, S., Grzanka, D., Go\u015bciniak, W., and G\u00f3rowska-Kowolik, K. (2021). No Correlation between Positive Fructose Hydrogen Breath Test and Clinical Symptoms in Children with Functional Gastrointestinal Disorders: A Retrospective Single-Centre Study. Nutrients, 13.","DOI":"10.3390\/nu13082891"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1365-2036.2006.03186.x","article-title":"Review article: Fructose malabsorption and the bigger picture","volume":"25","author":"Gibson","year":"2007","journal-title":"Aliment Pharmacol. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1590\/S0004-28032013000200040","article-title":"Fructose malabsorption in children with functional digestive disorders","volume":"50","author":"Lozinsky","year":"2013","journal-title":"Arq Gastroenterol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"863","DOI":"10.17219\/acem\/26337","article-title":"Prevalence of Lactose Malabsorption and Lactose Intolerance in Pediatric Patients with Selected Gastrointestinal Diseases","volume":"24","year":"2015","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.jped.2019.03.004","article-title":"Low FODMAPs diet for functional abdominal pain disorders in children: Critical review of current knowledge","volume":"95","author":"Pensabene","year":"2019","journal-title":"J. Pediatr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/1745-6215-12-264","article-title":"Comparisons against baseline within randomised groups are often used and can be highly misleading","volume":"12","author":"Bland","year":"2011","journal-title":"Trials"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"547","DOI":"10.5056\/jnm16069","article-title":"Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten?","volume":"22","author":"Volta","year":"2016","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"nzaa176","DOI":"10.1093\/cdn\/nzaa176","article-title":"Non-Celiac Gluten Sensitivity and Irritable Bowel Disease: Looking for the Culprits","volume":"4","author":"Koumbi","year":"2020","journal-title":"Curr. Dev. Nutr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1038\/ajg.2010.487","article-title":"Gluten causes gastrointestinal symptoms in subjects without celiac disease: A double-blind randomized placebo-controlled trial","volume":"106","author":"Biesiekierski","year":"2011","journal-title":"Off. J. Am. Coll. Gastroenterol.|ACG"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1038\/ajg.2012.236","article-title":"Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: Exploring a new clinical entity","volume":"107","author":"Carroccio","year":"2012","journal-title":"Off. J. Am. Coll. Gastroenterol.|ACG"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1080\/17474124.2022.2055547","article-title":"Dietary interventions for functional abdominal pain disorders in children: A systematic review and meta-analysis","volume":"16","author":"Rexwinkel","year":"2022","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Barbaro, M.R., Cremon, C., Wrona, D., Fuschi, D., Marasco, G., Stanghellini, V., and Barbara, G. (2020). Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders. Nutrients, 12.","DOI":"10.3390\/nu12123735"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1136\/archdischild-2020-319678","article-title":"Gluten-free diet in children: A fad or necessity?","volume":"106","author":"Devulapalli","year":"2021","journal-title":"Arch. Dis. Child."},{"key":"ref_74","unstructured":"Devulapalli, C.S. (2020). Non-coeliac gluten sensitivity in children. Tidsskr Nor Laegeforen, 140."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"4966","DOI":"10.3390\/nu7064966","article-title":"Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts\u2019 Criteria","volume":"7","author":"Catassi","year":"2015","journal-title":"Nutrients"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1402S","DOI":"10.1093\/ajcn\/61.6.1402S","article-title":"Mediterranean diet pyramid: A cultural model for healthy eating","volume":"61","author":"Willett","year":"1995","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/ejcn.2017.58","article-title":"Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials","volume":"72","author":"Dinu","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1111\/bph.14778","article-title":"Mediterranean diet and health status: Active ingredients and pharmacological mechanisms","volume":"177","author":"Schwingshackl","year":"2020","journal-title":"Br. J. Pharmacol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"564","DOI":"10.4292\/wjgpt.v7.i4.564","article-title":"Good adherence to mediterranean diet can prevent gastrointestinal symptoms: A survey from Southern Italy","volume":"7","author":"Zito","year":"2016","journal-title":"World J. Gastrointest. Pharmacol. Ther."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Elmaliklis, I.-N., Liveri, A., Ntelis, B., Paraskeva, K., Goulis, I., and Koutelidakis, A.E. (2019). Increased functional foods\u2019 consumption and Mediterranean diet adherence may have a protective effect in the appearance of gastrointestinal diseases: A case\u2013control study. Medicines, 6.","DOI":"10.3390\/medicines6020050"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e14345","DOI":"10.1111\/nmo.14345","article-title":"FODMAP dietary restrictions in the management of children with functional abdominal pain disorders: A systematic review","volume":"34","author":"Horvath","year":"2022","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1002\/jgh3.12231","article-title":"Low FODMAP diet in children and adolescents with functional bowel disorder: A clinical case note review","volume":"4","author":"Brown","year":"2020","journal-title":"JGH Open"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13052-018-0495-8","article-title":"Does a low FODMAPs diet reduce symptoms of functional abdominal pain disorders? A systematic review in adult and paediatric population, on behalf of Italian Society of Pediatrics","volume":"44","author":"Turco","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Axelrod, C.H., and Saps, M. (2018). The Role of Fiber in the Treatment of Functional Gastrointestinal Disorders in Children. Nutrients, 10.","DOI":"10.3390\/nu10111650"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"P\u00e4rtty, A., Rautava, S., and Kalliom\u00e4ki, M. (2018). Probiotics on Pediatric Functional Gastrointestinal Disorders. Nutrients, 10.","DOI":"10.3390\/nu10121836"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/apa.12513","article-title":"Probiotics for childhood functional gastrointestinal disorders: A systematic review and meta-analysis","volume":"103","author":"Korterink","year":"2014","journal-title":"Acta Paediatr."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/MPG.0000000000003568","article-title":"Synbiotics in the Management of Pediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications","volume":"76","author":"Hojsak","year":"2023","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13052-019-0606-1","article-title":"Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: A systematic review on behalf of the Italian Society of Paediatrics","volume":"45","author":"Scarpato","year":"2019","journal-title":"Ital. J. Pediatr."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Axelrod, C.H., and Saps, M. (2020). Global Dietary Patterns and Functional Gastrointestinal Disorders. Children, 7.","DOI":"10.3390\/children7100152"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/MPG.0000000000000266","article-title":"Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN","volume":"58","author":"Tabbers","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1002\/jpen.1771","article-title":"Does a Minority of Children with Functional Gastrointestinal Disorders Receive Formal Diet Advice?","volume":"44","author":"Minard","year":"2020","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Gil, J.F., Garc\u00eda-Hermoso, A., Sotos-Prieto, M., Cavero-Redondo, I., Mart\u00ednez-Vizca\u00edno, V., and Kales, S.N. (2023). Mediterranean diet-based interventions to improve anthropometric and obesity indicators in children and adolescents: A systematic review with meta-analysis of randomized controlled trials. Adv. Nutr.","DOI":"10.1016\/j.advnut.2023.04.011"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"680803","DOI":"10.3389\/fped.2021.680803","article-title":"Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension","volume":"9","author":"Bouhanick","year":"2021","journal-title":"Front. Pediatr."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/MPG.0000000000003540","article-title":"ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease","volume":"75","author":"Mearin","year":"2022","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Llanos-Chea, A., and Fasano, A. (2018). Gluten and Functional Abdominal Pain Disorders in Children. Nutrients, 10.","DOI":"10.3390\/nu10101491"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.gastro.2013.04.051","article-title":"No Effects of Gluten in Patients with Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates","volume":"145","author":"Biesiekierski","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Agakidis, C., Kotzakioulafi, E., Petridis, D., Apostolidou, K., and Karagiozoglou-Lampoudi, T. (2019). Mediterranean Diet Adherence is Associated with Lower Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents. Nutrients, 11.","DOI":"10.3390\/nu11061283"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1071\/HC15324","article-title":"The contribution of dietitians to the primary health care workforce","volume":"7","author":"Howatson","year":"2015","journal-title":"J. Prim. Health Care"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/MCG.0000000000001280","article-title":"Literature review: Dietary intervention adherence and adherence barriers in functional gastrointestinal disorder studies","volume":"54","author":"Heitkemper","year":"2020","journal-title":"J. Clin. Gastroenterol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/12\/2708\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:52:26Z","timestamp":1760125946000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/12\/2708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,10]]},"references-count":99,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["nu15122708"],"URL":"https:\/\/doi.org\/10.3390\/nu15122708","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,10]]}}}