Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia.
J Hum Nutr Diet. 2018 Jun;31(3):390-407. doi: 10.1111/jhn.12506. Epub 2017 Sep 15.
BACKGROUND: Functional dyspepsia (FD) is a debilitating functional gastrointestinal disorder characterised by early satiety, post-prandial fullness or epigastric pain related to meals, which affects up to 20% of western populations. A high dietary fat intake has been linked to FD and duodenal eosinophilia has been noted in FD. We hypothesised that an allergen such as wheat is a risk factor for FD and that withdrawal will improve symptoms of FD. We aimed to investigate the relationship between food and functional dyspepsia. METHODS: Sixteen out of 6451 studies identified in a database search of six databases met the inclusion criteria of studies examining the effect of nutrients, foods and food components in adults with FD or FD symptoms. RESULTS: Wheat-containing foods were implicated in FD symptom induction in six studies, four of which were not specifically investigating gluten and two that were gluten-specific, with the implementation of a gluten-free diet demonstrating a reduction in symptoms. Dietary fat was associated with FD in all three studies that specifically measured this association. Specific foods reported as inducing symptoms were high in either natural food chemicals, high in fermentable carbohydrates or high in wheat/gluten. Caffeine was associated with FD in four studies, although any association with alcohol was uncertain. CONCLUSIONS: Wheat and dietary fats may play key roles in the generation of FD symptoms and reduction or withdrawal eased symptoms. Randomised trials investigating the roles of gluten, FODMAPs (fermentable oligosaccharide, disaccharide, monosaccharide and polyols) and high fat ingestion and naturally occurring food chemicals in the generation of functional dyspepsia symptoms are warranted and further investigation of the mechanisms is now required.
背景:功能性消化不良(FD)是一种使人虚弱的功能性胃肠道疾病,其特征为早饱、餐后饱胀或与进食相关的上腹痛,影响了多达 20%的西方人群。高膳食脂肪摄入与 FD 有关,并且在 FD 中已注意到十二指肠嗜酸性粒细胞增多。我们假设,像小麦这样的过敏原是 FD 的一个危险因素,并且戒断会改善 FD 的症状。我们旨在研究食物与功能性消化不良之间的关系。
方法:在对六个数据库的数据库搜索中,从 6451 项研究中确定了 16 项符合纳入标准的研究,这些研究检查了成年人 FD 或 FD 症状中营养素、食物和食物成分的影响。
结果:在六项研究中,含小麦的食物与 FD 症状的诱导有关,其中四项研究并非专门研究麸质,两项研究是针对麸质的,实施无麸质饮食可减轻症状。在所有三项专门测量这种关联的研究中,膳食脂肪都与 FD 有关。报告引起症状的特定食物要么富含天然食物化学物质,要么富含可发酵碳水化合物,要么富含小麦/麸质。在四项研究中,咖啡因与 FD 有关,尽管与酒精的任何关联尚不确定。
结论:小麦和膳食脂肪可能在 FD 症状的产生中发挥关键作用,减少或戒断可缓解症状。有必要进行随机试验,以调查麸质、FODMAP(可发酵寡糖、双糖、单糖和多元醇)和高脂肪摄入以及天然食物化学物质在功能性消化不良症状产生中的作用,并且现在需要进一步研究其机制。
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