Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway.
KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway.
Br J Nutr. 2023 Dec 28;130(12):2061-2075. doi: 10.1017/S0007114523001253. Epub 2023 Jun 5.
Individuals with coeliac disease (CeD) often experience gastrointestinal symptoms despite adherence to a gluten-free diet (GFD). While we recently showed that a diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAP) successfully provided symptom relief in GFD-treated CeD patients, there have been concerns that the low FODMAP diet (LFD) could adversely affect the gut microbiota. Our main objective was therefore to investigate whether the LFD affects the faecal microbiota and related variables of gut health. In a randomised controlled trial GFD-treated CeD adults, having persistent gastrointestinal symptoms, were randomised to either consume a combined LFD and GFD ( 39) for 4 weeks or continue with GFD (controls, 36). Compared with the control group, the LFD group displayed greater changes in the overall faecal microbiota profile (16S rRNA gene sequencing) from baseline to follow-up (within-subject -diversity, < 0·001), characterised by lower and higher follow-up abundances (%) of genus ( < 0·001) and class Erysipelotrichia ( = 0·02), respectively. Compared with the control group, the LFD led to lower follow-up concentrations of faecal propionic and valeric acid (GC-FID) in participants with high concentrations at baseline ( ≤ 0·009). No differences were found in faecal bacterial -diversity ( ≥ 0·20) or in faecal neutrophil gelatinase-associated lipocalin (ELISA), a biomarker of gut integrity and inflammation ( = 0·74), between the groups at follow-up. The modest effects of the LFD on the gut microbiota and related variables in the CeD patients of the present study are encouraging given the beneficial effects of the LFD strategy to treat functional GI symptoms (Registered at clinicaltrials.gov as NCT03678935).
尽管遵循无麸质饮食(GFD),但乳糜泻(CeD)患者常出现胃肠道症状。我们最近表明,低发酵寡糖、二糖、单糖和多元醇(FODMAP)饮食可成功缓解 GFD 治疗的 CeD 患者的症状,但有人担心低 FODMAP 饮食(LFD)可能对肠道微生物群产生不利影响。因此,我们的主要目标是研究 LFD 是否会影响粪便微生物群和肠道健康的相关变量。在一项随机对照试验中,我们将接受 GFD 治疗且持续存在胃肠道症状的 CeD 成年患者随机分为两组,一组在 4 周内同时摄入 LFD 和 GFD(39 例),另一组继续接受 GFD(对照组,36 例)。与对照组相比,LFD 组粪便微生物群整体特征(16S rRNA 基因测序)从基线到随访时的变化更大(个体内多样性,<0.001),特征为属的丰度在随访时降低(<0.001)和类红螺菌科(=0.02)升高。与对照组相比,LFD 导致基线时高浓度(≤0.009)参与者的粪便丙酸和戊酸(GC-FID)浓度在随访时降低。两组间粪便细菌多样性(≥0.20)或粪便中性粒细胞明胶酶相关脂质运载蛋白(ELISA)(一种肠道完整性和炎症的生物标志物)无差异(=0.74)。鉴于 LFD 治疗功能性 GI 症状的有益作用(在 clinicaltrials.gov 上注册为 NCT03678935),本研究中 CeD 患者的 LFD 对肠道微生物群和相关变量的适度影响令人鼓舞。
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