Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
Department of Clinical Sciences, Lund University, Lund, Sweden.
J Gastroenterol Hepatol. 2022 Jul;37(7):1253-1262. doi: 10.1111/jgh.15830. Epub 2022 Apr 5.
Poor food habits with insufficient intake of micronutrients have been described in irritable bowel syndrome (IBS), which could be of importance for development of gastrointestinal and extraintestinal symptoms. The study aims were to examine intake and plasma/serum levels of micronutrients in IBS and whether these factors were associated with symptoms and restrictions and to study the effects of a starch- and sucrose-reduced diet (SSRD).
One hundred five patients with IBS or functional gastrointestinal disorder (FGID) according to Rome IV criteria were included to SSRD/controls for 4 weeks. Patients completed a study questionnaire about lifestyle habits, medical health, IBS-symptom severity score (IBS-SSS), visual analog scale for IBS (VAS-IBS), and diary books before and after study start. Plasma/serum levels of micronutrients were analyzed at baseline.
Intake of micronutrients at baseline was lower than recommended according to national guidelines. Gastrointestinal symptoms were inversely associated with intake and plasma levels of iron. Extraintestinal symptoms and fatigue inversely associated with intake of vitamin B6, phosphorus, magnesium, and iodine, as was plasma levels of iron, and positively associated with plasma iron-binding capacity. Fatigue was also inversely associated with calcium, iron, and zinc intakes. Plasma ferritin was lower in participants on restrictions. SSRD increased the intake of several vitamins, selenium, and fat, whereas sodium intake was decreased, with markedly reduced symptoms.
Irritable bowel syndrome patients had low intake of micronutrients at baseline, which associated inversely with total IBS-SSS, extraintestinal IBS-SSS, and fatigue. SSRD increased the intake of several micronutrients, which correlated weakly with symptom improvement.
肠易激综合征(IBS)患者存在不良饮食习惯和微量营养素摄入不足的情况,这可能与胃肠道和肠外症状的发生发展有关。本研究旨在检测 IBS 患者微量营养素的摄入和血浆/血清水平,以及这些因素是否与症状和限制有关,并研究淀粉和蔗糖减少饮食(SSRD)的影响。
根据罗马 IV 标准,105 例 IBS 或功能性胃肠病(FGID)患者被纳入 SSDR/对照组,进行为期 4 周的研究。患者在研究开始前后完成生活方式习惯、医疗健康、IBS 症状严重程度评分(IBS-SSS)、IBS 视觉模拟评分(VAS-IBS)和日记簿的研究问卷。在基线时分析微量营养素的血浆/血清水平。
基线时的微量营养素摄入低于国家指南推荐量。胃肠道症状与铁的摄入和血浆水平呈负相关。肠外症状和疲劳与维生素 B6、磷、镁和碘的摄入呈负相关,与铁的摄入和血浆铁结合能力呈正相关。疲劳也与钙、铁和锌的摄入呈负相关。限制饮食的患者的血浆铁蛋白水平较低。SSRD 增加了多种维生素、硒和脂肪的摄入,而钠的摄入减少,症状明显改善。
IBS 患者基线时微量营养素摄入较低,与总 IBS-SSS、肠外 IBS-SSS 和疲劳呈负相关。SSRD 增加了多种微量营养素的摄入,与症状改善呈弱相关。