Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inrae U1125, Cnam, Université Sorbonne Paris Nord University, 93017 Bobigny, France.
Department of Hepatology and Gastroenterology, Avicenne Hospital (AP-HP), 93017 Bobigny, France.
Nutrients. 2021 Nov 19;13(11):4147. doi: 10.3390/nu13114147.
Self-management of irritable bowel syndrome (IBS) is increasingly focusing on exclusion diets. In particular; patients are showing a significant interest in the gluten-free diet for the treatment of IBS. However; the lack of scientific evidence prevents the establishment of clear dietary guidelines and attention is needed as dietary restriction can lead to potentially adverse effects. This cross-sectional study aims to explore the practice of gluten avoidance in participants identified with IBS in a large cohort of non-celiac French adults. The population included 15,103 participants of the NutriNet-Santé study who completed a functional gastrointestinal disorder questionnaire based on the Rome III criteria to identify IBS in 2013 and a food avoidance questionnaire in 2016. Data on diet and anthropometric and sociodemographic characteristics were collected. Multivariate logistic regression models were used to compare the avoidance of gluten between IBS and non-IBS participants. Participants were mainly women (73.4%) and the mean age in this population was 55.8 ± 13.2 years. Among these individuals, 804 (5.4%) participants were identified as IBS cases. Among them, the prevalence of gluten avoidance was estimated at 14.8%, of which 3.0% reported total avoidance; versus 8.8% and 1.6% in non-IBS participants. After adjustments; gluten avoidance was higher in IBS participants compared to their non-IBS counterparts: (OR = 1.86; 95%CI = 1.21, 2.85) for total and (OR = 1.71; 95%CI = 1.36, 2.14) for partial avoidance. Participants identified with IBS were more associated with gluten avoidance than non-IBS participants. Further studies are needed to explore the long-term consequences of dietary interventions and to provide consistent dietary guidance connected to patient perception.
肠易激综合征（IBS）的自我管理越来越注重排除饮食。特别是；患者对无麸质饮食治疗 IBS 表现出极大的兴趣。然而；缺乏科学证据阻止了明确饮食指南的确立，需要注意的是，饮食限制可能会导致潜在的不良影响。这项横断面研究旨在探索在法国一项大型非乳糜泻成年人队列中，识别出的 IBS 参与者中避免食用麸质的实践。该人群包括参加 2013 年基于罗马 III 标准的功能性胃肠疾病问卷识别出的 IBS 和 2016 年的食物回避问卷的 NutriNet-Santé 研究的 15103 名参与者。收集了有关饮食和人体测量及社会人口统计学特征的数据。使用多变量逻辑回归模型比较 IBS 和非 IBS 参与者之间的麸质回避情况。参与者主要为女性（73.4%），该人群的平均年龄为 55.8 ± 13.2 岁。在这些人中，有 804 名（5.4%）参与者被确定为 IBS 病例。其中，估计麸质回避的患病率为 14.8%，其中 3.0%报告完全回避；而非 IBS 参与者为 8.8%和 1.6%。调整后；与非 IBS 参与者相比，IBS 参与者更倾向于避免食用麸质：（OR = 1.86；95%CI = 1.21，2.85）为完全回避和（OR = 1.71；95%CI = 1.36，2.14）为部分回避。与非 IBS 参与者相比，识别出的 IBS 参与者更倾向于避免食用麸质。需要进一步研究来探索饮食干预的长期后果，并为与患者感知相关的一致饮食指导提供依据。
