Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
Unilever, Unilever Foods Innovation Centre, Bronland 14, 6708 WH, Wageningen, The Netherlands.
Eur J Nutr. 2021 Sep;60(6):3505-3522. doi: 10.1007/s00394-020-02473-0. Epub 2021 Feb 14.
This review provides an updated overview of observational and intervention studies investigating the effect of a low-FODMAP (fermentable oligo-, di- and monosaccharides, and polyols) diet (LFD) on gastrointestinal (GI) symptoms, quality of life (QoL), nutritional adequacy, and gut microbiome in irritable bowel syndrome (IBS) patients.
We systematically searched available literature until October 2020 for studies that investigated the effect of LFDs on GI symptoms, QoL, nutritional adequacy, and the gut microbiome in IBS patients. The data were represented as standardized mean differences (SMD) for IBS severity, and as mean differences (MD) for IBS-QoL. Meta-analyses were performed for the quantitative analyses using random effects models with inverse variance weighing.
Twelve papers (nine parallel trials, three crossover studies) were included for the meta-analysis. The LFD reduced IBS severity by a moderate-to-large extent as compared to a control diet (SMD - 0.66, 95% CI - 0.88, - 0.44, I = 54%). When analyzing only studies that used the validated IBS-SSS questionnaire, a mean reduction of 45 points (95% CI - 77, - 14; I = 89%) was observed. Subgroup analyses on adherence, age, intervention duration, IBS subtype, outcome measure, and risk of bias revealed no significantly different results. The LFD also increased IBS-QoL scores, when compared with a control diet (MD 4.93; 95% CI 1.77, 8.08; I = 42%).
The low-FODMAP diet reduces GI symptoms and improves quality of life in IBS subjects as compared to control diets. Future work is required to obtain definitive answers regarding potential long-term effects of such diets on nutritional adequacy and the gut microbiome.
CRD42020175157.
本综述提供了关于观察性和干预性研究的最新概述，这些研究调查了低 FODMAP（可发酵寡糖、二糖和单糖及多元醇）饮食（LFD）对肠易激综合征（IBS）患者胃肠道（GI）症状、生活质量（QoL）、营养充足性和肠道微生物组的影响。
我们系统地检索了截至 2020 年 10 月的可用文献，以寻找调查 LFD 对 IBS 患者 GI 症状、QoL、营养充足性和肠道微生物组影响的研究。使用随机效应模型和倒数方差加权法对 IBS 严重程度的标准化均数差（SMD）和 IBS-QoL 的均数差（MD）进行了定量分析。
共有 12 篇论文（9 项平行试验，3 项交叉研究）纳入了荟萃分析。与对照饮食相比，低 FODMAP 饮食可显著减轻 IBS 严重程度（SMD-0.66，95%CI-0.88，-0.44，I=54%）。当仅分析使用验证的 IBS-SSS 问卷的研究时，观察到平均减少 45 分（95%CI-77，-14；I=89%）。关于依从性、年龄、干预持续时间、IBS 亚型、结局测量和偏倚风险的亚组分析未显示出显著不同的结果。与对照饮食相比，低 FODMAP 饮食还可提高 IBS-QoL 评分（MD 4.93；95%CI 1.77，8.08；I=42%）。
与对照饮食相比，低 FODMAP 饮食可减轻 IBS 患者的 GI 症状并提高其生活质量。需要进一步研究以确定此类饮食对营养充足性和肠道微生物组的潜在长期影响。
PROSPERO 注册号：CRD42020175157。
