Marum Ana Paula, Moreira Cátia, Tomas-Carus Pablo, Saraiva Fernando, Guerreiro Catarina Sousa
Faculdade de Medicina de Lisboa, Universidade de Lisboa.
Nutr Hosp. 2017 Jun 5;34(3):667-674. doi: 10.20960/nh.703.
Fibromyalgia is a chronic rheumatic disease producing widespread pain, associated to a major comorbidity -irritable bowel syndrome. Low FODMAPS diet (low fermentable oligo-di-mono-saccharides and polyols diet) has been effective in controlling irritable bowel syndrome symptoms. Overweight is an aggravating factor for fibromyalgia. We studied effects of low fermentable oligo-di-mono-saccharides and polyols diets on fibromyalgia symptoms and weight status.
A longitudinal study was performed on 38 fibromyalgia patients using a four-week, repeated assessment as follow: M1 = first assessments/presentation of individual low fermentable oligo-di-mono-saccharides and polyols diet; M2 = second assessments/reintroduction of FODMAPs; M3 = final assessments/nutritional counselling. The assessment instruments applied were: Fibromyalgia Survey Questionnaire (FSQ); Severity Score System (IBS-SSS); visual analogic scale (VAS). Body mass-index/composition and waist circumference (WC) were also measured. Daily macro-micronutrients and FODMAP intake were quantified at each moment of the study.
The studied cohort was 37% overweight, 34% obese (average body mass-index 27.4 ± 4.6; excess fat mass 39.4 ± 7%). Weight, body mass-index and waist circumference decreased significantly (p < 0.01) with low fermentable oligo-di-mono-saccharides and polyols diet, but no significant effect on body composition was observed. All fibromyalgiasymptoms, including somatic pain, declined significantly post-LFD (p < 0.01); as well for severity of fibromyalgia [Fibromyalgia survey questionnaire: M1 = 21.8; M2 = 16.9; M3 = 17.0 (p < 0.01)]. The intake of essential nutrients (fiber, calcium, magnesium and vitamin D) showed no significant difference. The significant reduction in FODMAP intake (M1 = 24.4 g; M2 = 2.6g; p < 0.01) reflected the "Diet adherence" (85%). "Satisfaction with improvement of symptoms" (76%), showed correlating with "diet adherence" (r = 0.65; p < 0.01).
Results are highly encouraging, showing low fermentable oligo-di-mono-saccharides and polyols diets as a nutritionally balanced approach, contributing to weight loss and reducing the severity of FM fibromyalgiasymptoms.
纤维肌痛是一种慢性风湿性疾病，会产生广泛疼痛，并伴有主要合并症——肠易激综合征。低FODMAP饮食（低可发酵寡糖-双糖-单糖和多元醇饮食）已被证明对控制肠易激综合征症状有效。超重是纤维肌痛的一个加重因素。我们研究了低可发酵寡糖-双糖-单糖和多元醇饮食对纤维肌痛症状和体重状况的影响。
对38名纤维肌痛患者进行了一项纵向研究，采用为期四周的重复评估，具体如下：M1 = 首次评估/开始个人低可发酵寡糖-双糖-单糖和多元醇饮食；M2 = 第二次评估/重新引入FODMAPs；M3 = 最终评估/营养咨询。所应用的评估工具包括：纤维肌痛调查问卷（FSQ）；严重程度评分系统（IBS-SSS）；视觉模拟量表（VAS）。还测量了体重指数/身体成分和腰围（WC）。在研究的每个阶段都对每日的常量营养素、微量营养素和FODMAP摄入量进行了量化。
研究队列中37%超重，34%肥胖（平均体重指数27.4±4.6；多余脂肪量39.4±7%）。低可发酵寡糖-双糖-单糖和多元醇饮食使体重、体重指数和腰围显著下降（p < 0.01），但对身体成分未观察到显著影响。所有纤维肌痛症状，包括躯体疼痛，在低FODMAP饮食后均显著下降（p < 0.01）；纤维肌痛的严重程度也是如此[纤维肌痛调查问卷：M1 = 21.8；M2 = 16.9；M3 = 17.0（p < 0.01）]。必需营养素（纤维、钙、镁和维生素D）的摄入量没有显著差异。FODMAP摄入量显著降低（M1 = 24.4克；M2 = 2.6克；p < 0.01）反映了“饮食依从性”（85%）。“对症状改善的满意度”（76%）与“饮食依从性”相关（r = 0.65；p < 0.01）。
结果非常令人鼓舞，表明低可发酵寡糖-双糖-单糖和多元醇饮食是一种营养均衡的方法，有助于减轻体重并降低纤维肌痛症状的严重程度。
