Optimizing Nutritional Balance: Integrating the Mediterranean Diet into Low-FODMAP Nutrition

Irritable Bowel Syndrome (IBS) is a functional disorder of the digestive system. Its global prevalence varies widely, estimated at up to 10%, due to differences in diagnostic criteria, cultural factors, and dietary patterns. Dietary interventions have emerged as first-line strategies for symptom management, with the low-FODMAP (fermentable oligo-, di-, and monosaccharide and polyol) diet demonstrating robust efficacy in reducing gastrointestinal symptoms by minimizing poorly absorbed, fermentable carbohydrates. However, concerns regarding the long-term nutritional adequacy, potential alterations in gut microbiota composition, and sustainability of the low-FODMAP diet have prompted the need for more integrative and nutritionally balanced dietary models. In contrast, the Mediterranean Diet (MD), rich in fruits, vegetables, legumes, whole grains, nuts, olive oil, and omega-3 fatty acids from fish, is widely recognized for its anti-inflammatory, cardiometabolic, and potential anticarcinogenic effects. Notably, adherence to the MD has been associated with favorable gut microbial profiles and reduced risk of colorectal and other gastrointestinal cancers. However, the high FODMAP content of many MD components limits its immediate compatibility with IBS dietary protocols. This review explores the evidence supporting the integration of MD principles into a low-FODMAP framework for the dietary management of IBS. Rather than proposing a new model, we synthesize existing literature, including recent clinical findings, and offer practical, evidence-informed guidance for tailoring a Mediterranean-style low-FODMAP diet that supports both symptom management and long-term nutritional health. Integrating MD principles into the low-FODMAP approach offers a promising strategy to enhance the nutritional quality, sustainability, and long-term efficacy of dietary management in IBS.