Dietary Intakes of Recipients of Faecal Microbiota Transplantation: An Observational Pilot Study

Abstract

This study reports on the dietary intake of recipients of faecal microbiota transplantation (FMT), comparing this with dietary guidelines, and investigates the relationship between dietary intake and clinical outcomes. Males and females aged ≥ 16 years with irritable bowel syndrome or inflammatory bowel disease undergoing FMT were invited to complete validated symptom and quality of life (QOL) questionnaires and three-day weighed food diaries. Descriptive statistics were calculated for symptom scores, QOL scores, nutrients, and food group servings, and compared to Australian population norms, nutrient reference values, and dietary guidelines. The relationship between dietary intake, symptoms, and QOL was assessed. Participants (n = 18) reported baseline symptoms of urgency, abdominal pain, nausea, and bloating and reduced QOL. Of the participants who completed food diaries, 8/14 met the recommended 30 g of fibre when including supplements. Participants met the recommendations for micronutrients and food groups except calcium, fruit, and dairy/dairy alternatives. There was a non-significant trend towards lower symptom severity scores in participants who met the fibre target. The high degree of variability in participant fibre intakes highlights diet as a key variable that has not been previously controlled for in FMT intervention studies. Future studies examining FMT should include dietary analysis of habitual intake of the recipients and donors.

Fecal Microbiota Transplantation to Prevent and Treat Chronic Disease: Implications for Dietetics Practice

“…For example, as fecal microbiota transplantation (FMT) becomes more widely used, the ability of diet to modify the microbiota has also been appreciated. 17 Registered dietitians (RDs) could play an integral role by working with patients who have undergone FMT to sustain the newly colonized gut and provide education on appropriate foods for an improved outcome. RDs should be aware of FMT and be prepared to provide suitable interventions.…”

“…For example, fiber intake has been identified as a means of managing intestinal diseases and preventing flareups. Clancy and colleagues 17 explored the relevance of dietary intake of fiber, according to the dietary guidelines, to patients with irritable bowel syndrome and inflammatory bowel disease (IBD) who received FMT. RDs assessed participants' food diaries and it was determined that these FMT patients had higher intake of fiber than the population average.…”

Dietary Management for Faecal Microbiota Transplant: An International Survey of Clinical and Research Practice, Knowledge and Attitudes

“…Pilot studies examining the relationship between recipient fibre intake and FMT outcomes have demonstrated a positive trend ( 13 , 14 ), a study by Wei et al compared the outcomes of UC patients receiving FMT and a known prebiotic fibre (pectin) supplement or FMT alone. Their results suggested that supplementation with pectin delayed the loss of diversity of transplanted gut microbiota and enhanced the effects of the FMT ( 15 ).…”