Ingvarsdottir Ingunn Erla, Engilbertsdottir Svava, Halldorsson Thorhallur Ingi, Bjornsson Einar Stefan, Gunnarsdottir Ingibjorg
Department of Clinical Nutrition, Landspitali National University Hospital.
Faculty of Food Science and Nutrition, University of Iceland.
Laeknabladid. 2024 Jun;110(6):298-306. doi: 10.17992/lbl.2024.05.796.
High FODMAP (fermentable oligo-, di, monosaccharides and polyols) foods have been linked with worsening symptoms of IBS patients. The aim was to compare gastrointestinal symptoms and dietary intake of patients with irritable bowel syndrome following a low FODMAP diet, with or without individual nutrition therapy.
A total of 54 patients that met Rome IV criteria for IBS were randomized into two groups, guided group (individual nutrition therapy, n=28) and self-management group (learned about low FODMAP diet online, n=26). Both groups followed low FODMAP diet for 4 weeks. Four-day food records were used to assess dietary intake. Symptoms were assessed by the IBS-severity scoring system (ISB-SSS).
The number of subjects who did not complete the study was 13, thereof five in the nutrition therapy and eight in the self-management group, leaving 23 and 18 subjects available for analysis, respectively. Symptoms declined from baseline to endpoint in both groups, by 183±101 points on average in the group receiving nutrition therapy (p< 0.001) and 132±110 points in the self-management group (p< 0.001), with no difference between groups. At baseline, about 80% of meals in both groups contained food high in FODMAP's. The corresponding proportion was 9% and 36% in week 3 in the nutrition therapy and self-management group, respectively (p< 0.001).
Both groups experienced relieve of symptoms, but compliance to the low FODMAP diet was better in the group receiving individual nutrition therapy compared with the group who only received instructions on how to learn about low FODMAP diet online.
高FODMAP(可发酵的寡糖、二糖、单糖和多元醇)食物与肠易激综合征(IBS)患者症状加重有关。本研究旨在比较接受低FODMAP饮食的IBS患者在有或无个体营养治疗情况下的胃肠道症状及饮食摄入情况。
共54例符合罗马IV标准的IBS患者被随机分为两组,即指导组(个体营养治疗,n = 28)和自我管理组(在线学习低FODMAP饮食,n = 26)。两组均遵循低FODMAP饮食4周。采用4天食物记录评估饮食摄入情况。通过IBS严重程度评分系统(IBS-SSS)评估症状。
未完成研究的受试者有13例,其中营养治疗组5例,自我管理组8例,分别剩余23例和18例受试者可供分析。两组症状均从基线降至终点,接受营养治疗组平均下降183±101分(p < 0.001),自我管理组下降132±110分(p < 0.001),两组间无差异。基线时,两组约80%的膳食含有高FODMAP食物。在第3周时,营养治疗组和自我管理组的相应比例分别为9%和36%(p < 0.001)。
两组症状均有缓解,但与仅在线接受低FODMAP饮食学习指导的组相比,接受个体营养治疗的组对低FODMAP饮食的依从性更好。