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优化肠-脑相互作用障碍患者低 FODMAP 饮食的教育方法:一项可行性随机对照试验。

Optimizing educational methods for the low FODMAP diet in disorders of gut-brain interaction: A feasibility randomized controlled trial.

机构信息

Department of Nutritional Sciences, King's College London, London, UK.

Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK.

出版信息

Neurogastroenterol Motil. 2023 Oct;35(10):e14640. doi: 10.1111/nmo.14640. Epub 2023 Jul 21.


DOI:10.1111/nmo.14640
PMID:37480191
Abstract

BACKGROUND: A diet low in fermentable oligo-saccharides, di-saccharides, mono-saccharides and polyols (low FODMAP diet) is complex and clinical effectiveness is achieved with dietitian-led education, although dietitian availability in clinical practice varies. This study aimed to assess the feasibility of undertaking a trial to investigate the clinical and cost-effectiveness of different education delivery methods of the low FODMAP diet in patients with disorders of gut-brain interaction (DGBI). METHODS: In this feasibility randomized controlled trial, patients with DGBI requiring the low FODMAP diet were randomized to receive one of the following education delivery methods: booklet, app, or dietitian. Recruitment and retention rates, acceptability, symptoms, stool output, quality of life, and dietary intake were assessed. KEY RESULTS: Fifty-one patients were randomized with a recruitment rate of 2.4 patients/month and retention of 48 of 51 (94%). Nobody in the booklet group strongly agreed that this education delivery method enabled them to self-manage symptoms without further support, compared to 7 of 14 (50%) in the dietitian group (p = 0.013). More patients reported adequate relief of symptoms in the dietitian group (12, 80%) compared with the booklet group (7, 39%; p = 0.026), but not when compared to the app group (10, 63%, p > 0.05). There was a greater decrease in the IBS-SSS score in the dietitian group (mean -153, SD 90) compared with the booklet group (mean -90, SD 56; p = 0.043), but not when compared with the app group (mean -120, SD 62; p = 0.595). CONCLUSIONS & INFERENCES: Booklets were the least acceptable education delivery methods. Dietitian-led consultations led to high levels of clinical effectiveness, followed by the app, while the dietitian was superior to booklets alone. However, an adequately powered clinical trial is needed to confirm clinical effectiveness of these education delivery methods.

摘要

背景:低发酵寡糖、双糖、单糖和多元醇饮食(低 FODMAP 饮食)较为复杂,通过营养师主导的教育可实现临床疗效,但营养师在临床实践中的可及性存在差异。本研究旨在评估开展一项试验的可行性,以调查不同低 FODMAP 饮食教育方法在肠-脑互动障碍(DGBI)患者中的临床和成本效益。

方法:在这项可行性随机对照试验中,需要低 FODMAP 饮食的 DGBI 患者被随机分配接受以下一种教育方法:手册、应用程序或营养师。评估招募和保留率、可接受性、症状、粪便排出量、生活质量和饮食摄入。

主要结果:51 例患者被随机分组,每月招募率为 2.4 例,保留率为 51 例中的 48 例(94%)。与营养师组的 7 例(50%)相比,手册组没有患者强烈认为这种教育方法可以使他们无需进一步支持即可自我管理症状(p=0.013)。营养师组(12 例,80%)报告症状缓解充分的患者多于手册组(7 例,39%;p=0.026),但与应用程序组(10 例,63%)相比则没有差异(p>0.05)。营养师组的 IBS-SSS 评分下降幅度更大(平均-153,SD 90),而手册组(平均-90,SD 56;p=0.043)和应用程序组(平均-120,SD 62;p=0.595)则没有差异。

结论:手册是最不受欢迎的教育方法。营养师主导的咨询可带来较高的临床疗效,其次是应用程序,而营养师优于单独使用手册。然而,需要一项充分有力的临床试验来证实这些教育方法的临床疗效。

相似文献

[1]
Optimizing educational methods for the low FODMAP diet in disorders of gut-brain interaction: A feasibility randomized controlled trial.

Neurogastroenterol Motil. 2023-10

[2]
Clinical effectiveness of adding probiotics to a low FODMAP diet: Randomized double-blind placebo-controlled study.

World J Clin Cases. 2021-9-6

[3]
A dietitian-led low-FODMAP diet webinar: a pre-post study evaluating its impact on symptoms of irritable bowel syndrome.

J Hum Nutr Diet. 2024-4

[4]
The low FODMAP diet in clinical practice: where are we and what are the long-term considerations?

Proc Nutr Soc. 2024-2

[5]
Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies.

PLoS One. 2017-8-14

[6]
Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome.

Neurogastroenterol Motil. 2017-7-14

[7]
Low fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial.

J Gastroenterol Hepatol. 2018-2-21

[8]
Comparison of 4-week versus 8-week dietitian-led FODMAP diet group education sessions in tertiary care clinical practice for irritable bowel syndrome: A service evaluation.

J Hum Nutr Diet. 2024-12

[9]
DOMINO trial analysis: evaluation of the diet effects on symptoms in IBS subtypes.

Therap Adv Gastroenterol. 2024-7-30

[10]
Group education on the low FODMAP diet improves gastrointestinal symptoms but neither anxiety or depression in irritable bowel syndrome.

J Hum Nutr Diet. 2022-6

引用本文的文献

[1]
Efficacy of a Low-FODMAP Diet on the Severity of Gastrointestinal Symptoms and Quality of Life in the Treatment of Gastrointestinal Disorders-A Systematic Review of Randomized Controlled Trials.

Nutrients. 2025-6-19

[2]
The burden of irritable bowel syndrome and functional dyspepsia in Poland: a cross-sectional study from West Pomeranian Voivodship.

BMC Gastroenterol. 2025-1-9

[3]
Dietary management of irritable bowel syndrome: considerations, challenges, and solutions.

Lancet Gastroenterol Hepatol. 2024-12

[4]
Treating disorders of brain-gut interaction with multidisciplinary integrated care. Moving towards a new standard of care.

JGH Open. 2024-5-20

[5]
The Role of the FODMAP Diet in IBS.

Nutrients. 2024-1-26

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