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Nutrient Intake, Diet Quality, and Diet Diversity in Irritable Bowel Syndrome and the Impact of the Low FODMAP Diet
Journal of the Academy of Nutrition and Dietetics ( IF 3.5 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.jand.2019.01.017
Heidi M. Staudacher , Frances S.E. Ralph , Peter M. Irving , Kevin Whelan , Miranda C.E. Lomer

BACKGROUND Individuals with irritable bowel syndrome (IBS) may modify their diet, which may pose nutritional risk. Further, some dietary approaches, such as a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), are restrictive and may contribute to nutritional inadequacy. OBJECTIVE Our aim was to evaluate habitual nutrient intake, diet quality, and diversity in IBS and the effect of a 4-week low FODMAP diet on these parameters compared with controls. DESIGN Data from two randomized controlled trials were included for this secondary analysis. Participants were randomized to low FODMAP diet (n=63) or control diet (sham diet n=48, habitual diet n=19). PARTICIPANTS/SETTING Participants included 130 individuals with IBS referred to a tertiary center in London, UK between January 2010 to June 2011 and January 2013 to November 2014. INTERVENTION Participants in one trial were randomized to receive either low FODMAP dietary counseling or sham control dietary counseling. In the other, they were randomized to receive low FODMAP dietary counseling or to continue habitual diet. All advice was provided by a specialist dietitian. MAIN OUTCOME MEASURES Habitual (usual) dietary intake at baseline (n=130) and after a 4-week intervention period was measured using 7-day food records. STATISTICAL ANALYSES PERFORMED Analysis of covariance and χ2 tests evaluated differences across groups at 4 weeks. RESULTS When examining habitual intake of individuals with IBS, fiber intake was low, with only 6 (5%) achieving the target (30 g/day). In those receiving low FODMAP advice, there was no difference in intake of most nutrients compared with controls. However, there was lower intake of starch (109 g/day) vs habitual control diet (128 g/day; P=0.030), and higher intake of vitamin B-12 (6.1 μg/day) vs habitual (3.9 μg/day) and sham control diets (4.7 μg/day; P<0.01). Overall scores for diet quality were lower after low FODMAP advice vs habitual control diet (P<0.01). CONCLUSION This study demonstrates many individuals with IBS fail to meet dietary reference values for multiple nutrients. A 4-week low FODMAP diet, when delivered by a specialist dietitian, does not impact on intake of most nutrients or diet diversity but decreases diet quality compared with control diets.

中文翻译:

肠易激综合征的营养摄入、饮食质量和饮食多样性以及低 FODMAP 饮食的影响

背景 患有肠易激综合征 (IBS) 的个体可能会改变他们的饮食,这可能会带来营养风险。此外,一些饮食方法,例如可发酵寡糖、二糖、单糖和多元醇 (FODMAP) 含量低的饮食,是有限制性的,可能会导致营养不足。目的 我们的目的是评估 IBS 的习惯性营养摄入、饮食质量和多样性,以及与对照组相比 4 周低 FODMAP 饮食对这些参数的影响。设计 来自两项随机对照试验的数据被纳入该次要分析。参与者被随机分配到低 FODMAP 饮食(n=63)或对照饮食(假饮食 n=48,习惯性饮食 n=19)。参与者/环境 参与者包括 130 名被转介到伦敦三级中心的 IBS 患者,2010 年 1 月至 2011 年 6 月和 2013 年 1 月至 2014 年 11 月期间的英国。 干预 一项试验的参与者随机接受低 FODMAP 饮食咨询或假控制饮食咨询。另一方面,他们被随机分配接受低 FODMAP 饮食咨询或继续习惯性饮食。所有建议均由专业营养师提供。主要结果测量使用 7 天的食物记录测量基线(n = 130)和 4 周干预期后的习惯(通常)饮食摄入量。进行的统计分析 协方差分析和 χ2 检验评估了 4 周时各组之间的差异。结果 在检查 IBS 患者的习惯性摄入量时,纤维摄入量较低,只有 6 人(5%)达到了目标(30 克/天)。在那些接受低 FODMAP 建议的人中,与对照组相比,大多数营养素的摄入量没有差异。然而,淀粉摄入量(109 克/天)低于习惯性对照饮食(128 克/天;P=0.030),维生素 B-12 摄入量(6.1 微克/天)高于习惯性饮食(3.9 微克/天) )和假对照饮食(4.7 μg/天;P<0.01)。与习惯性控制饮食相比,低 FODMAP 建议后饮食质量的总体得分较低(P<0.01)。结论 本研究表明,许多 IBS 患者未能满足多种营养素的膳食参考值。由专业营养师提供的 4 周低 FODMAP 饮食不会影响大多数营养素的摄入或饮食多样性,但与对照饮食相比会降低饮食质量。维生素 B-12 的摄入量(6.1 微克/天)高于习惯性(3.9 微克/天)和假对照饮食(4.7 微克/天;P < 0.01)。与习惯性控制饮食相比,低 FODMAP 建议后饮食质量的总体得分较低(P<0.01)。结论 本研究表明,许多 IBS 患者未能满足多种营养素的膳食参考值。由专业营养师提供的 4 周低 FODMAP 饮食不会影响大多数营养素的摄入或饮食多样性,但与对照饮食相比会降低饮食质量。维生素 B-12 的摄入量(6.1 微克/天)高于习惯性(3.9 微克/天)和假对照饮食(4.7 微克/天;P < 0.01)。与习惯性控制饮食相比,低 FODMAP 建议后饮食质量的总体得分较低(P<0.01)。结论 本研究表明,许多 IBS 患者未能满足多种营养素的膳食参考值。由专业营养师提供的 4 周低 FODMAP 饮食不会影响大多数营养素的摄入或饮食多样性,但与对照饮食相比会降低饮食质量。
更新日期:2020-04-01
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