ResearchOriginal ResearchNutrient Intake, Diet Quality, and Diet Diversity in Irritable Bowel Syndrome and the Impact of the Low FODMAP Diet
Section snippets
Experimental Design, Treatments, and Participants
Data from individuals with IBS referred to a tertiary center in London, UK, that were recruited to two previously published randomized controlled trials were included in this secondary analysis.26, 27 Participants were recruited between January 2010 to June 2011 and January 2013 to November 2014. Participants were diagnosed with IBS using Rome III criteria,28 were aged 18 to 65 years, and had no other major gastrointestinal conditions or organ dysfunction, recent weight loss, or other specific
Results
Diet records for 130 participants were included in the analysis of habitual diet in individuals with IBS. Most participants were female with a diarrhea-predominant IBS subtype and most did not take IBS medications (Table 3).
Discussion
This is the most comprehensive evaluation of the habitual energy and nutrient intake of individuals with IBS, including an assessment of diet quality and diet diversity. Many individuals reported dietary intakes that did not meet recommendation for various nutrients; however, overall nutrient intake was comparable to the general population. For example, mean fiber intake was 18 g/day, which is the same as that found in a national survey of the UK general population,44 which contrasts with
Conclusions
This study demonstrates that many individuals with IBS fail to meet the DRV for a number of nutrients and overall diet quality is low. Furthermore, a 4-week low FODMAP diet, when delivered by a specialist dietitian, does not significantly impact overall nutrient intake or measures of diet diversity, but leads to a lower diet quality compared with control diets. Overall diet quality should be assessed and considered throughout the dietetic consultation process, with specific emphasis on
H. M. Staudacher is an Alfred Deakin Postdoctoral Research Fellow, Food and Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Deakin University, Melbourne, Australia; at the time of the study, she was a clinical doctoral research fellow, Department of Nutritional Sciences, King's College London, London, UK
References (48)
- et al.
Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis
Clin Gastroenterol Hepatol
(2012) - et al.
The impact of irritable bowel syndrome on health-related quality of life
Gastroenterology
(2000) - et al.
Low intake of vitamin B6 is associated with irritable bowel syndrome symptoms
Nutr Res
(2011) - et al.
Colon hypersensitivity to distension, rather than excessive gas production, produces carbohydrate-related symptoms in individuals with irritable bowel syndrome
Gastroenterology
(2017) - et al.
Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: The Dietary Patterns Methods Project
Am J Clin Nutr
(2015) - et al.
Diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and probiotic restores Bifidobacterium species: A randomized controlled trial
Gastroenterology
(2017) - et al.
Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome
J Nutr
(2012) - et al.
Functional bowel disorders Gastroenterology
(2006) - et al.
The Diet Quality Index revised: A measurement instrument for populations
J Am Diet Assoc
(1999) - et al.
Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study
Am J Clin Nutr
(1993)
Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: A randomized controlled trial
Gastroenterology
Perceived food intolerance in subjects with irritable bowel syndrome—etiology, prevalence and consequences
Eur J Clin Nutr
A dietary survey of patients with irritable bowel syndrome
J Hum Nutr Diet
Are food constituents relevant to the irritable bowel syndrome in young adults? A Rome III based prevalence study of the Korean medical students
J Neurogastroenterol Motil
Diet and functional gastrointestinal disorders: A population-based case-control study
Am J Gastroenterol
Dietary intakes in people with irritable bowel syndrome
BMC Gastroenterol
Habitual diet and diet quality in irritable bowel syndrome: A case-control study
Neurogastroenterol Motil
Diet in subjects with irritable bowel syndrome: A cross-sectional study in the general population
BMC Gastroenterol
Nutrient intake in patients with irritable bowel syndrome compared with the general population
Neurogastroenterol Motil
Comparison of dietary assessment methods in nutritional epidemiology: Weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records
Br J Nutr
IBS patients have a poorer quality diet and exercise less than organic GI disease patients or normal controls
Gastroenterology
The low FODMAP diet: Recent advances in understanding its mechanisms and efficacy in IBS
Gut
The low FODMAP diet in the management of irritable bowel syndrome: An evidence-based review of FODMAP restriction, reintroduction and personalisation in clinical practice
J Hum Nutr Diet
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H. M. Staudacher is an Alfred Deakin Postdoctoral Research Fellow, Food and Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Deakin University, Melbourne, Australia; at the time of the study, she was a clinical doctoral research fellow, Department of Nutritional Sciences, King's College London, London, UK
F. S. E. Ralph is a dietitian, Department of Nutrition and Dietetics, Berkshire Healthcare NHS Foundation Trust, Reading, London, UK; at the time of the study, she was a dietetics student, Department of Nutritional Sciences, King's College London, London, UK
P. M. Irving is a lecturer, Department of Nutritional Sciences, King’s College London, and a consultant gastroenterologist, Department of Gastroenterology, Guys and St Thomas’ NHS Foundation Trust, London, UK
K. Whelan is a professor of dietetics, Department of Nutritional Sciences, King's College London, London, UK.
M. C. E. Lomer is a reader in dietetics, Department of Nutritional Sciences, King’s College London, and a senior consultant dietitian, Departments of Gastroenterology and Nutrition and Dietetics, Guys and St Thomas’ NHS Foundation Trust, London, UK
STATEMENT OF POTENTIAL CONFLICT OF INTEREST M. C. E. Lomer and K. Whelan are co-inventors of a mobile application relating to the low FODMAP diet. No potential conflict of interest was reported by the remaining authors.
FUNDING/SUPPORT This study/project is funded by the National Institute for Health Research (NIHR) [CDRF-2012-03-060]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
ACKNOWLEDGEMENTS The authors thank professor Peter Gibson, MD, FRACP, and Jane Muir, PhD (Monash University, Melbourne, Australia) for providing analysis of total and individual FODMAP intake data.
AUTHOR CONTRIBUTIONS All authors conceived the study and developed the research plan; H. M. Staudacher and F. S. E. Ralph conducted the data collection; H. M. Staudacher, F. S. E. Ralph, M. C. E. Lomer, and K. Whelan developed the analysis plan; F. S. E. Ralph and H. M. Staudacher analyzed the data; H. M. Staudacher and F. S. E. Ralph wrote the paper; M. C. E. Lomer, K. Whelan, and P. M. Irving had primary responsibility for final content. All authors provided critical comment on the intellectual content of the manuscript and approved the final version for submission.
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