Nutrition Undergraduate Program, Department of Nutrition, Health Sciences Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Department of Nutrition, Health Sciences Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Br J Nutr. 2023 Jun 28;129(12):2067-2075. doi: 10.1017/S0007114522002884. Epub 2022 Nov 3.
Non-celiac gluten sensitivity is characterised by the presence of gastrointestinal and extraintestinal symptoms following gluten ingestion. Recent studies suggested an association between non-celiac gluten sensitivity and the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP). This systematic review aimed to examine literature evidence on the relationship between non-celiac gluten sensitivity and FODMAP intake. A comprehensive search was carried out for randomised clinical trials addressing gastrointestinal symptoms as the primary outcome, published between 2010 and 2020 in Portuguese, English or Spanish, and indexed in Scopus, PubMed, SciELO, Cochrane Library, CINAHL, Embase or VHL (LILACS) databases. The systematic review was performed using the population, intervention, comparison and outcome (PICO) framework. A total of 1133 articles were retrieved for further assessment. Three articles were selected for systematic review, one of which included two interventions with different periods and assessments. Quality of evidence was assessed according to the GRADE protocol. The selected articles used different instruments to measure gastrointestinal symptoms and quality of life, hindering comparison of data. Clinical trials identified an association between decreased gastrointestinal symptoms and FODMAP restriction. There are few studies on the topic, and those available used different instruments to assess gastrointestinal symptoms and quality of life. Nevertheless, current evidence supports the gluten-free diet still represents first-line therapy. However, a FODMAP restriction can decrease gastrointestinal symptoms in individuals with non-celiac gluten sensitivity. Further research is needed to confirm this finding.
非乳糜泻麸质敏感性的特征是在摄入麸质后出现胃肠道和肠外症状。最近的研究表明,非乳糜泻麸质敏感性与可发酵寡糖、双糖、单糖和多元醇(FODMAP)的摄入之间存在关联。本系统评价旨在研究非乳糜泻麸质敏感性与 FODMAP 摄入之间关系的文献证据。对 2010 年至 2020 年期间以胃肠道症状为主要结局、发表于葡萄牙语、英语或西班牙语并在 Scopus、PubMed、SciELO、Cochrane 图书馆、CINAHL、Embase 或 VHL(LILACS)数据库中索引的随机临床试验进行了全面检索。系统评价使用了人群、干预、比较和结局(PICO)框架。共检索到 1133 篇文章进行进一步评估。选择了 3 篇文章进行系统评价,其中 1 篇包括两个不同时期和评估的干预措施。根据 GRADE 协议评估证据质量。所选文章使用不同的仪器来测量胃肠道症状和生活质量,这阻碍了数据的比较。临床试验确定了胃肠道症状减少与 FODMAP 限制之间的关联。关于这个主题的研究很少,而且现有的研究使用不同的仪器来评估胃肠道症状和生活质量。然而,目前的证据支持无麸质饮食仍然是一线治疗方法。然而,FODMAP 限制可以减少非乳糜泻麸质敏感性个体的胃肠道症状。需要进一步的研究来证实这一发现。
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