Department of Medicine, University of Otago, Christchurch 8140, New Zealand.
Department of Gastroenterology, Central Clinical School, Monash University, Melbourne 3004, VIC, Australia.
Nutrients. 2020 Sep 30;12(10):3002. doi: 10.3390/nu12103002.
The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)diet has been extensively researched, but not in the management of older adults with functional gastrointestinal symptoms. This study determines the positive and negative impacts of this dietary treatment in older adults with chronic diarrhea. A non-blinded intervention study was conducted with adults over 65 years with chronic diarrhea referred for colonoscopy where no cause was found. Participants followed a dietitian-led low FODMAP diet for six weeks and completed a structured assessment of gastrointestinal symptoms, the Hospital Anxiety and Depression scale, and a four-day food diary before and after the intervention. Twenty participants, mean age 76 years, were recruited. Adherence to the low FODMAP diet was acceptable; mean daily FODMAP intake reduced from 20.82 g to 3.75 g ( < 0.001) during the intervention and no clinically significant changes in macro- or micronutrient intakes were observed. There were clinically significant improvements in total gastrointestinal symptoms (pre diet 21.15/88 (standard deviation SD = 10.99), post diet 9.8/88 (SD = 9.58), < 0.001) including diarrhea (pre diet 9.85 (SD = 3.84), post diet 4.05 (SD = 3.86), < 0.001) and significant reductions in anxiety (pre diet 6.11/21 (SD = 4.31), post diet 4.26/21 (SD = 3.38), < 0.05). In older adults the low FODMAP diet is clinically effective and does not jeopardise nutritional intake when supervised by an experienced dietitian.
低发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食已得到广泛研究，但在治疗有功能性胃肠道症状的老年人方面尚未进行研究。本研究旨在确定这种饮食治疗对慢性腹泻老年患者的积极和消极影响。对因慢性腹泻而行结肠镜检查但未发现病因的 65 岁以上成年人进行了一项非盲干预研究。参与者遵循营养师指导的低 FODMAP 饮食 6 周，并在干预前后完成胃肠道症状的结构化评估、医院焦虑和抑郁量表以及为期 4 天的饮食日记。共招募了 20 名平均年龄为 76 岁的参与者。低 FODMAP 饮食的依从性可以接受；在干预期间，平均每日 FODMAP 摄入量从 20.82 克减少到 3.75 克（<0.001），且未观察到宏量或微量营养素摄入的临床显著变化。胃肠道症状总评分有临床显著改善（饮食前 21.15/88（标准差 SD = 10.99），饮食后 9.8/88（SD = 9.58），<0.001），包括腹泻（饮食前 9.85（SD = 3.84），饮食后 4.05（SD = 3.86），<0.001），焦虑评分显著降低（饮食前 6.11/21（SD = 4.31），饮食后 4.26/21（SD = 3.38），<0.05）。在经验丰富的营养师监督下，低 FODMAP 饮食在老年患者中具有临床疗效，且不会影响营养摄入。
