一项关于肠易激综合征成人饮食和营养素摄入的系统评价和荟萃分析。
A systematic review and meta-analysis of diet and nutrient intake in adults with irritable bowel syndrome.
机构信息
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
Neurogastroenterol Motil. 2024 Jan;36(1):e14698. doi: 10.1111/nmo.14698. Epub 2023 Oct 27.
BACKGROUND
Numerous individual and environmental factors including diet may play an important role in the pathophysiology of irritable bowel syndrome (IBS). It is unclear to what degree dietary intake is affected in individuals with IBS. We aimed to perform a systematic review and meta-analysis to summarize dietary intake of adults with IBS and to compare dietary intake between adults with IBS and non-IBS controls.
METHODS
Ovid MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched through February 2023 for clinical trials and observational studies measuring usual diet in adults with IBS. Pooled weighted averages were estimated for total energy, macronutrient, and micronutrient data. Mean differences (MD) in nutrient intake were estimated for adults with IBS versus non-IBS controls using a random effects model. Heterogeneity was assessed by the inconsistency index (I2).
KEY RESULTS
Sixty-three full-text articles were included in the review of which 29 studies included both IBS and control subjects. Nutrients not meeting the recommended intake level for any dietary reference values in the IBS population were fiber and vitamin D. Meta-regression by female proportion was positively correlated with total fat intake and negatively correlated with carbohydrate intake. Comparisons between participants with IBS and controls showed significantly lower fiber intake in participants with IBS with high heterogeneity (MD: -1.8; 95% CI: -3.0, -0.6; I2 = 85%).
CONCLUSIONS AND INFERENCES
This review suggests that fiber and vitamin D intake is suboptimal in IBS; however, overall dietary intake does not appear to be comprised. Causes and consequences of reduced fiber in IBS deserve further study. Results of this systematic review and meta-analysis suggest that fiber and vitamin D intake is suboptimal in IBS. However, overall intake of other macro- and micronutrients does not appear to be compromised. Causes and consequences of reduced fiber and Vitamin D intake in IBS deserve further study.
背景
许多个体和环境因素，包括饮食，可能在肠易激综合征（IBS）的病理生理学中发挥重要作用。目前尚不清楚 IBS 患者的饮食摄入受到多大程度的影响。我们旨在进行系统评价和荟萃分析，总结 IBS 成人的饮食摄入情况，并比较 IBS 成人与非 IBS 对照组的饮食摄入情况。
方法
通过 Ovid MEDLINE、Embase、Cochrane、CINAHL 和 Scopus，检索了截至 2023 年 2 月的临床试验和观察性研究，以测量 IBS 成人的常规饮食。对总能量、宏量营养素和微量营养素数据进行了汇总加权平均值估计。使用随机效应模型估计 IBS 成人与非 IBS 对照组之间营养素摄入的平均差异（MD）。使用不一致指数（I2）评估异质性。
主要结果
对 63 篇全文进行了综述，其中 29 项研究纳入了 IBS 和对照组。在 IBS 人群中，未达到任何膳食参考值推荐摄入量的营养素是纤维和维生素 D。按女性比例进行的元回归与总脂肪摄入量呈正相关，与碳水化合物摄入量呈负相关。IBS 患者与对照组之间的比较显示，IBS 患者的纤维摄入量明显较低，且异质性很高（MD：-1.8；95%CI：-3.0，-0.6；I2=85%）。
结论和推断
本综述表明，IBS 患者的纤维和维生素 D 摄入不足；然而，总体饮食摄入似乎没有受到影响。IBS 中纤维减少的原因和后果值得进一步研究。本系统评价和荟萃分析的结果表明，IBS 患者的纤维和维生素 D 摄入不足；然而，其他宏量和微量营养素的总体摄入似乎没有受到影响。IBS 中纤维和维生素 D 摄入减少的原因和后果值得进一步研究。
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