Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia.
Department of Nutritional Sciences, King's College London, London, UK.
Aliment Pharmacol Ther. 2024 Feb;59(4):492-503. doi: 10.1111/apt.17791. Epub 2023 Nov 15.
Diet is fundamental to the care of irritable bowel syndrome (IBS). However, some approaches are not appropriate for individuals experiencing psychological symptoms.
To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms.
We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing.
We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups.
A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
饮食对于肠易激综合征（IBS）的治疗至关重要。然而，对于一些伴有心理症状的患者，某些方法并不适用。
评估地中海饮食在 IBS 中的可行性及其对胃肠道和心理症状的影响。
我们招募了罗马 IV 型 IBS 伴有轻度或中度焦虑和/或抑郁症状的成年人，进行了一项为期 6 周的非盲随机对照试验。患者被随机分配到地中海饮食咨询组或习惯性饮食组。我们收集了胃肠道和心理症状数据、饮食数据和粪便样本进行宏基因组测序。
我们随机分配了 59 名患者（29 名接受地中海饮食，30 名接受对照组）；48 名患者完成了研究。在第 6 周时，地中海饮食组的地中海饮食依从性筛查评分高于对照组（7.5 [95% CI：6.9-8.0] vs. 5.7 [5.2-6.3]，p<0.001），并且评分增加幅度大于对照组（2.1 [95% CI：1.3-2.9] vs. 0.5 [95% CI：0.1-1.0]，p=0.004），表明地中海饮食具有可行性。在接受地中海饮食的患者中，胃肠道症状缓解者的比例高于对照组（24/29，83% vs. 11/30，37%，p<0.001），抑郁缓解者的比例也高于对照组（15/29，52% vs. 6/30，20%，p=0.015）。第 6 周时，两组的 FODMAP 摄入量无差异（p=0.51）。胃肠道不良事件也相似（p=0.588）。两组间微生物群参数的变化无差异。
地中海饮食在 IBS 中是可行的，可改善胃肠道和心理症状。尽管本研究是非盲的，但这些发现以及地中海饮食的广泛益处，为 IBS 的进一步研究提供了有力的动力。澳大利亚新西兰临床试验注册中心：ACTRN12620001362987。
