British Dietetic Association systematic review and evidence‐based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)

McKenzie, Yvonne; Bowyer, R. K.; Leach, Heather J.; Gulia, P.; Horobin, J.; O'Sullivan, Niamh-Anna; Pettitt, Claire; Reeves, Liane; Seamark, Leah; Williams, M. J.; Thompson, Julie; Lomer, Miranda

doi:10.1111/jhn.12385

Cited by 257 publications

(351 citation statements)

References 157 publications

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“…There is a lack of evidence regarding the underlying mechanisms by which food provokes symptoms in IBS, which has limited the development of validated diagnostic tests to identify specific food triggers. First-line dietary advice in IBS usually focuses on modification of dietary fibre intake and restriction of potential triggers such as caffeine, alcohol and fat 15. Two recent meta-analyses identified between 1416 and 2217 randomised controlled trials (RCTs) of dietary fibre, and reported moderate quality evidence for fibre supplementation in IBS, with greater global symptom improvement compared with placebo, in particular for soluble fibre.…”

Section: The Role Of Diet In Ibs Managementmentioning

confidence: 99%

“…Two recent meta-analyses identified between 1416 and 2217 randomised controlled trials (RCTs) of dietary fibre, and reported moderate quality evidence for fibre supplementation in IBS, with greater global symptom improvement compared with placebo, in particular for soluble fibre. In contrast, evidence for the effect of caffeine, alcohol and fat has only been reported in cross-sectional studies,13 18 19 and no RCTs investigating the effect of individual restriction of these items have been performed 15…”

Section: The Role Of Diet In Ibs Managementmentioning

confidence: 99%

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The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

265

236

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There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet) is now increasingly used in the clinical setting. Initial research evaluating the efficacy of the low FODMAP diet was limited by retrospective study design and lack of comparator groups, but more recently well-designed clinical trials have been published. There are currently at least 10 randomised controlled trials or randomised comparative trials showing the low FODMAP diet leads to clinical response in 50%-80% of patients with IBS, in particular with improvements in bloating, flatulence, diarrhoea and global symptoms. However, in conjunction with the beneficial clinical impact, recent studies have also demonstrated that the low FODMAP diet leads to profound changes in the microbiota and metabolome, the duration and clinical relevance of which are as yet unknown. This review aims to present recent advances in the understanding of the mechanisms by which the low FODMAP diet impacts on symptoms in IBS, recent evidence for its efficacy, current findings regarding the consequences of the diet on the microbiome and recommendations for areas for future research.

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Section: The Role Of Diet In Ibs Managementmentioning

confidence: 99%

Section: The Role Of Diet In Ibs Managementmentioning

confidence: 99%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

265

236

View full text Add to dashboard Cite

show abstract

“…While challenging, this should provide new avenues for dietary management of those who prefer a gluten-free diet for performance enhancement or health promotion, in the absence of Celiac’s disease, to trial various approaches [192,207,213,214], as opposed to eating a strictly gluten-free diet. A gluten-free diet per se, with a high amount of processed gluten-free foods, may not meet nutritional recommendations, and a gluten-free, vegan diet could pose serious negative health and performance effects (e.g., B-vitamin deficiency).…”

Section: Eat As If You Could Save the Planet And Win!mentioning

confidence: 99%

“Eat as If You Could Save the Planet and Win!” Sustainability Integration into Nutrition for Exercise and Sport

Meyer

Reguant-Closa

2017

Nutrients

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Today’s industrial food production contributes significantly to environmental degradation. Meat production accounts for the largest impact, including greenhouse gas emissions, land and water use. While food production and consumption are important aspects when addressing climate change, this article focuses predominantly on dietary change that promotes both health for planet and people with focus on athletes. Healthy, sustainable eating recommendations begin to appear in various governmental guidelines. However, there remains resistance to the suggested reductions in meat consumption. While food citizens are likely to choose what is good for them and the planet, others may not, unless healthy eating initiatives integrate creative food literacy approaches with experiential learning as a potential vehicle for change. This concept paper is organized in three sections: (1) Environmental impact of food; (2) health and sustainability connections; and (3) application in sports and exercise. For active individuals, this article focuses on the quantity of protein, highlighting meat and dairy, and quality of food, with topics such as organic production and biodiversity. Finally, the timing of when to integrate sustainability principles in sport nutrition is discussed, followed by practical applications for education and inclusion in team, institutional, and event operations.

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“…In recent years the putative role of FODMAPs in IBS has gained wide popularity in the general public and the subject has been addressed in books promoting the low-FODMAP diet and related recipes [4]. The recently revised British Dietetic Association (BDA) guidelines for the dietary management of IBS recommend the low-FODMAP diet as the second-line intervention in IBS patients [5]. A 2016 meta-analysis supports the efficacy of a low-FODMAP diet in the treatment of functional gastrointestinal symptoms [6].…”

Section: Introductionmentioning

confidence: 99%

The Low FODMAP Diet: Many Question Marks for a Catchy Acronym

et al. 2017

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FODMAP, “Fermentable Oligo-, Di- and Mono-saccharides And Polyols”, is a heterogeneous group of highly fermentable but poorly absorbed short-chain carbohydrates and polyols. Dietary FODMAPs might exacerbate intestinal symptoms by increasing small intestinal water volume, colonic gas production, and intestinal motility. In recent years the low-FODMAP diet for treatment of irritable bowel syndrome (IBS) has gained increasing popularity. In the present review we aim to summarize the physiological, clinical, and nutritional issues, suggesting caution in the prolonged use of this dietary treatment on the basis of the existing literature. The criteria for inclusion in the FODMAPs list are not fully defined. Although the low-FODMAP diet can have a positive impact on the symptoms of IBS, particularly bloating and diarrhea, the quality of the evidence is lower than optimal, due to frequent methodological flaws, particularly lack of a proper control group and/or lack of blinding. In particular, it remains to be proven whether this regimen is superior to conventional IBS diets. The drastic reduction of FODMAP intake has physiological consequences, e.g., on the intestinal microbiome and colonocyte metabolism, which are still poorly understood. A low-FODMAP diet imposes an important restriction of dietary choices due to the elimination of some staple foods, such as wheat derivatives, lactose-containing dairy products, many vegetables and pulses, and several types of fruits. For this reason, patients may be at risk of reduced intake of fiber, calcium, iron, zinc, folate, B and D vitamins, and natural antioxidants. The nutritional risk of the low-FODMAP diet may be higher in persons with limited access to the expensive, alternative dietary items included in the low-FODMAP diet.

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British Dietetic Association systematic review and evidence‐based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)

Abstract: These guidelines provide updated comprehensive evidence-based details to achieve the successful dietary management of IBS in adults.

Cited by 257 publications

References 157 publications

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

“Eat as If You Could Save the Planet and Win!” Sustainability Integration into Nutrition for Exercise and Sport

The Low FODMAP Diet: Many Question Marks for a Catchy Acronym

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