Department of Internal Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden.
Department of Clinical Sciences, Lund University, SE-20502 Malmö, Sweden.
Nutrients. 2021 Jan 28;13(2):416. doi: 10.3390/nu13020416.
Dietary advice constitutes a treatment strategy for irritable bowel syndrome (IBS). We aimed to examine the effect of a starch- and sucrose-reduced diet (SSRD) on gastrointestinal symptoms in IBS patients, in relation to dietary intake and systemic inflammatory parameters. IBS patients ( = 105) were randomized to a 4-week SSRD intervention ( = 80) receiving written and verbal dietary advice focused on starch and sucrose reduction and increased intake of protein, fat and dairy, or control group ( = 25; habitual diet). At baseline and 4 weeks, blood was sampled, and participants filled out IBS-SSS, VAS-IBS, and Rome IV questionnaires and dietary registrations. C-reactive protein and cytokines TNF-α, IFN-γ, IL-6, IL-8, IL-10, and IL-18 were analyzed from plasma. At 4 weeks, the intervention group displayed lower total IBS-SSS, 'abdominal pain', 'bloating/flatulence' and 'intestinal symptoms´ influence on daily life' scores ( ≤ 0.001 for all) compared to controls, and a 74%, responder rate (RR = ΔTotal IBS-SSS ≥ -50; RR = 24%). Median values of sucrose (5.4 vs. 20 g), disaccharides (16 vs. 28 g), starch (22 vs. 82 g) and carbohydrates (88 vs. 182 g) were lower for the intervention group compared to controls ( ≤ 0.002 for all), and energy percentages (E%) of protein (21 vs. 17 E%, = 0.006) and fat (47 vs. 38 E%, = 0.002) were higher. Sugar-, starch- and carbohydrate-reductions correlated weakly-moderately with total IBS-SSS decrease for all participants. Inflammatory parameters were unaffected. IBS patients display high compliance to the SSRD, with improved gastrointestinal symptoms but unaltered inflammatory parameters. In conclusion, the SSRD constitutes a promising dietary treatment for IBS, but needs to be further researched and compared to established dietary treatments before it could be used in a clinical setting.
饮食建议构成了肠易激综合征（IBS）的治疗策略。我们旨在研究淀粉和蔗糖减少饮食（SSRD）对 IBS 患者胃肠道症状的影响，以及饮食摄入和全身炎症参数的关系。将 105 名 IBS 患者随机分为 4 周的 SSRD 干预组（80 名），接受以淀粉和蔗糖减少以及增加蛋白质、脂肪和乳制品摄入为重点的书面和口头饮食建议，或对照组（25 名；习惯性饮食）。在基线和 4 周时，采集血液样本，参与者填写 IBS-SSS、VAS-IBS 和罗马 IV 问卷以及饮食记录。从血浆中分析 C 反应蛋白和细胞因子 TNF-α、IFN-γ、IL-6、IL-8、IL-10 和 IL-18。在 4 周时，与对照组相比，干预组的总 IBS-SSS、“腹痛”、“腹胀/气胀”和“肠道症状对日常生活的影响”评分较低（所有 ≤ 0.001），且应答率（RR = Δ总 IBS-SSS ≥ -50；RR = 24%）为 74%。与对照组相比，干预组的蔗糖（5.4 对 20 克）、二糖（16 对 28 克）、淀粉（22 对 82 克）和碳水化合物（88 对 182 克）中位数较低（所有 ≤ 0.002），蛋白质（21 对 17%E%， = 0.006）和脂肪（47 对 38%E%， = 0.002）的能量百分比较高。所有参与者的总 IBS-SSS 减少与糖、淀粉和碳水化合物的减少呈弱到中度相关。炎症参数不受影响。IBS 患者对 SSRD 具有高度依从性，胃肠道症状得到改善，但炎症参数未改变。总之，SSRD 是一种有前途的 IBS 饮食治疗方法，但在临床应用之前，还需要进一步研究和与既定的饮食治疗方法进行比较。
