Effectiveness of Two Dietary Approaches on the Quality of Life and Gastrointestinal Symptoms of Individuals with Irritable Bowel Syndrome

Abstract

To evaluate the effectiveness of a low FODMAP (fermentable oligosaccharides, monosaccharaides, disaccharides and polyols) diet in the relief of symptoms and an improvement of the quality of life in individuals with irritable bowel syndrome in comparison to a standard diet according to the British Dietetic Association’s guidelines. A non-randomized clinical trial of adult patients with IBS was compared two diet interventions. An assessment of symptoms, quality of life, and nutritional status was performed before and after the four-week mark of intervention. Individuals from the Low FODMAP Diet (LFD) group were evaluated on a third moment, after the controlled reintroduction of FODMAPs. A total of 70 individuals were divided in two groups: Low FODMAP Diet (LFD; n = 47) and Standard Diet (SD; n = 23). 57 individuals completed the four-week intervention (LFD; n = 39; SD; n = 18). At the completion of four weeks, the symptoms improved in both groups (LFD: p < 0.01; DC: p < 0.05) but LFD led to a higher relief (p < 0.05), primarily with respect to abdominal pain and diarrhoea. Quality of life improved significantly in both groups, with no significant differences between SD vs LFD (p > 0.05). In the LFD group, the relief of symptoms observed at the four-week mark remained constant after reintroduction of FODMAPs. Both interventions seem to be effective for the relief of symptoms and quality of life, however LFD had higher effectiveness in the former. The results with LFD suggest it can be a preferred approach in individuals with diarrhoeal profile.

Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis

“…Where no end values were reported, change from baseline data were used instead [ 41 , 42 ]. Where insufficient data were available to calculate or extract the mean and standard deviation, the study was excluded from analysis [ 43 ].…”

Improved Symptom Profiles and Minimal Inflammation in IBS-D Patients Undergoing a Long-Term Low-FODMAP Diet: A Lipidomic Perspective

“…Notwithstanding, these factors represented inevitable consequences of a long-term personalised diet, which introduced a daily lipid intake based on a typical Mediterranean diet. Guerreiro et al [ 44 ] reported that the “elimination phase” of a LFD leads to reduced body weight and BMI, following caloric restriction of some foods high in FODMAPs. Portion control is essential in a LFD, as larger portions can surpass safe thresholds, changing food from low to high FODMAP content [ 31 ].…”

What is the optimal FODMAP threshold in IBS?

“…All of the eligible studies (n = 9) had data on mean total FODMAP intake (strict phase; n = 7, modified phase; n = 2), 3,[5][6][7][8][9][10][11][12] with seven of the articles having data on mean fructan intake (strict phase; n = 5, modified phase; n = 2). 3,5,7,[9][10][11][12] Studies assessing fructan intake in healthy individuals were included for comparison (n = 2). 13,14 Total FODMAPs at baseline or in the control group ranged between 13.0-29.6 g/day, with total FODMAPs ranging between 3.1-22.0 g/day following the short-term phase (n = 7).…”

“…13,14 Total FODMAPs at baseline or in the control group ranged between 13.0-29.6 g/day, with total FODMAPs ranging between 3.1-22.0 g/day following the short-term phase (n = 7). [5][6][7][8][9][10][11] The total FODMAP intake reduction from baseline to the short term phase of the low FODMAP diet varied between 24% to 86% (Fig. 1).…”