Department of Gastroenterology, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia Department of Gastroenterology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Food Futures National Research Flagship, Commonwealth Scientific and Industrial Research Organisation, Food, Animal and Health Sciences, Adelaide, South Australia, Australia.
Gut. 2015 Jan;64(1):93-100. doi: 10.1136/gutjnl-2014-307264. Epub 2014 Jul 12.
A low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) diet reduces symptoms of IBS, but reduction of potential prebiotic and fermentative effects might adversely affect the colonic microenvironment. The effects of a low FODMAP diet with a typical Australian diet on biomarkers of colonic health were compared in a single-blinded, randomised, cross-over trial.
Twenty-seven IBS and six healthy subjects were randomly allocated one of two 21-day provided diets, differing only in FODMAP content (mean (95% CI) low 3.05 (1.86 to 4.25) g/day vs Australian 23.7 (16.9 to 30.6) g/day), and then crossed over to the other diet with ≥21-day washout period. Faeces passed over a 5-day run-in on their habitual diet and from day 17 to day 21 of the interventional diets were pooled, and pH, short-chain fatty acid concentrations and bacterial abundance and diversity were assessed.
Faecal indices were similar in IBS and healthy subjects during habitual diets. The low FODMAP diet was associated with higher faecal pH (7.37 (7.23 to 7.51) vs. 7.16 (7.02 to 7.30); p=0.001), similar short-chain fatty acid concentrations, greater microbial diversity and reduced total bacterial abundance (9.63 (9.53 to 9.73) vs. 9.83 (9.72 to 9.93) log10 copies/g; p<0.001) compared with the Australian diet. To indicate direction of change, in comparison with the habitual diet the low FODMAP diet reduced total bacterial abundance and the typical Australian diet increased relative abundance for butyrate-producing Clostridium cluster XIVa (median ratio 6.62; p<0.001) and mucus-associated Akkermansia muciniphila (19.3; p<0.001), and reduced Ruminococcus torques.
Diets differing in FODMAP content have marked effects on gut microbiota composition. The implications of long-term reduction of intake of FODMAPs require elucidation.
ACTRN12612001185853.
低 FODMAP（可发酵的寡糖、双糖、单糖和多元醇）饮食可减轻 IBS 症状，但潜在的益生元和发酵作用的减少可能会对结肠微环境产生不利影响。在一项单盲、随机、交叉试验中，比较了低 FODMAP 饮食与典型澳大利亚饮食对结肠健康生物标志物的影响。
27 名 IBS 患者和 6 名健康受试者被随机分配到两种 21 天提供的饮食中，仅在 FODMAP 含量上有所不同（平均（95%CI）低 3.05（1.86 至 4.25）g/天与澳大利亚 23.7（16.9 至 30.6）g/天），然后交叉到另一种饮食，洗脱期至少 21 天。在习惯性饮食的 5 天运行期和干预饮食的第 17 天至第 21 天收集粪便，评估粪便 pH 值、短链脂肪酸浓度以及细菌丰度和多样性。
在习惯性饮食期间，IBS 患者和健康受试者的粪便指数相似。低 FODMAP 饮食与更高的粪便 pH 值（7.37（7.23 至 7.51）与 7.16（7.02 至 7.30）；p=0.001）、相似的短链脂肪酸浓度、更高的微生物多样性和减少的总细菌丰度（9.63（9.53 至 9.73）与 9.83（9.72 至 9.93）log10 拷贝/g；p<0.001）有关。与澳大利亚饮食相比，与习惯性饮食相比，低 FODMAP 饮食减少了总细菌丰度，而典型的澳大利亚饮食增加了产丁酸的梭菌簇 XIVa（中位数比值 6.62；p<0.001）和粘蛋白相关阿克曼氏菌（19.3；p<0.001）的相对丰度，并减少了 Ruminococcus torques。
FODMAP 含量不同的饮食对肠道微生物组成有显著影响。长期减少 FODMAP 摄入量的影响需要阐明。
ACTRN12612001185853。
