In this US trial, 40-50% of patients reported adequate relief of their IBS-D symptoms with the low FODMAP diet or a diet based on modified NICE guidelines. The low FODMAP diet led to significantly greater improvement in individual IBS symptoms, particularly pain and bloating, compared with the mNICE diet.

BACKGROUND & AIMS: We investigated the effects of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) vs traditional dietary recommendations on health-related quality of life (QOL), anxiety and depression, work productivity, and sleep quality in patients with irritable bowel syndrome and diarrhea (IBS-D). METHODS: We conducted a prospective, single-center, single-blind trial of 92 adult patients with IBS-D (65 women; median age, 42.6 years) randomly assigned to groups placed on a diet low in FODMAPs or a modified diet recommended by the National Institute for Health and Care Excellence (mNICE) for 4 weeks. IBS-associated QOL (IBS-QOL), psychosocial distress (based on the Hospital Anxiety and Depression Scale), work productivity (based on the Work Productivity and Activity Impairment), and sleep quality were assessed before and after diet periods. RESULTS: Eighty-four patients completed the study (45 in the low-FODMAP group and 39 in the mNICE group). At 4 weeks, patients on the diet low in FODMAPs had a larger mean increase in IBS-QOL score than did patients on the mNICE diet (15.0 vs 5.0; 95% CI,-17.4 to-4.3). A significantly higher proportion of patients in the low-FODMAP diet group had a meaningful clinical response, based on IBS-QOL score, than in the mNICE group (52% vs 21%; 95% CI,-0.52 to-0.08). Anxiety scores decreased in the low-FODMAP diet group compared with the mNICE group (95% CI, 0.46-2.80). Activity impairment was significantly reduced with the low-FODMAP diet (-22.89) compared with the mNICE diet (-9.44; 95% CI, 2.72-24.20).

Two distinct patterns of sweet taste liking have been described: one showing a peak liking response in the mid-range of sucrose concentrations and the other showing a monotonic liking response at progressively higher sucrose concentrations. Classification of these patterns has been somewhat arbitrary. In this report, we analyzed patterns of sweet taste liking in a pilot study with 26 adults including 14 women and 12 men, 32.6 ± 14.5 years of age with body mass index 26.4 ± 5.1 kg/m2 (mean ± SD). Sweet taste liking was measured for 10 levels of sucrose solutions (0.035 M to 1.346 M). Participants rated their liking of each solution using a visual analog scale with 0 indicating strongly disliking and 100 strongly liking. The cluster analysis demonstrated two distinct groups: 13 liked relatively low sucrose concentrations and liked high sucrose concentrations less, and 13 liked high sucrose concentrations greatly. If we use the 0.598 M sucrose solution alone and a cutoff liking score of 50, we can distinguish the two clusters with high sensitivity (100%) and specificity (100%). If validated in additional studies, this simple tool may help us to better understand eating behaviors and the impact of sweet taste liking on nutrition-related disorders.

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Levels of direct bilirubin were lower in the treated compared with the nontreated group. These findings suggest that cholecystokinin prophylaxis in high-risk neonates may help prevent the development of parenteral nutrition-associated cholestasis.