A starch‐ and sucrose‐reduced dietary intervention in irritable bowel syndrome patients produced a shift in gut microbiota composition along with changes in phylum, genus, and amplicon sequence variant abundances, without affecting the micro‐RNA levels

Abstract

Background/Aim A randomized clinical trial with a starch‐ and sucrose‐reduced diet (SSRD) in irritable bowel syndrome (IBS) patients has shown clear improvement of participants' symptoms. The present study aimed to explore the effects of the SSRD on the gut microbiota and circulating micro‐RNA in relation to nutrient intake and gastrointestinal symptoms. Methods IBS patients were randomized to a 4‐week SSRD intervention (n = 80) or control group (n = 25); habitual diet). At baseline and 4 weeks, blood and fecal samples, 4 day‐dietary records, and symptom questionnaires were collected, that is, Rome IV questionnaires, IBS‐symptom severity score (IBS‐SSS) and visual analog scale for IBS (VAS‐IBS). Micro‐RNA was analyzed in blood and microbiota in faeces by 16S rRNA from regions V1–V2. Results The alpha diversity was unaffected, whereas beta diversity was decreased (p < 0.001) along with increased abundance of Proteobacteria (p = 0.0036) and decreased abundance of Bacteroidetes phyla (p < 0.001) in the intervention group at 4 weeks. Few changes were noted in the controls. The shift in beta diversity and phyla abundance correlated with decreased intakes of carbohydrates, disaccharides, and starch and increased fat and protein intakes. Proteobacteria abundance also correlated positively (R2 = 0.07, p = 0.0016), and Bacteroidetes negatively (R2 = 0.07, p = 0.0017), with reduced total IBS‐SSS. Specific genera, for example, Eubacterium eligens, Lachnospiraceae UCG‐001, Victivallis, and Lachnospira increased significantly in the intervention group (p < 0.001 for all), whereas Marvinbryantia, DTU089 (Ruminoccocaceae family), Enterorhabdus, and Olsenella decreased, together with changes in amplicon sequence variant (ASV) levels. Modest changes of genus and ASV abundance were observed in the control group. No changes were observed in micro‐RNA expression in either group. Conclusion The SSRD induced a shift in beta diversity along with several bacteria at different levels, associated with changes in nutrient intakes and reduced gastrointestinal symptoms. No corresponding changes were observed in the control group. Neither the nutrient intake nor the microbiota changes affected micro‐RNA expression. The study was registered at ClinicalTrials.gov data base (NCT03306381).

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“…Bifidobacterium has a diverse host range and shows several beneficial properties to the host [ 65 ]. Victivallis , a short-chain fatty acids (SCFAs) producer, increased significantly in irritable bowel syndrome patients with a starch- and sucrose-reduced dietary intervention [ 66 ]. Genus ASF356 , also a SCFAs producing bacterium, increased along with the programming of hypertension prevention by maternal resveratrol supplementation [ 67 ] and decreased following Gastritis in mice [ 68 ].…”

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“…Interestingly, Nilholm et al showed that SSRD diet in IBS led to significant changes in the gut microbiota, thus suggesting that SSRD diet may be responsible for improved symptoms in these patients. More interestingly, a relative abundance of proteobacteria correlated positively with reduced GI symptoms 12 . As mentioned, increasing evidence indicates that diet significantly affects manifestation of IBS.…”

“…More interestingly, a relative abundance of proteobacteria correlated positively with reduced GI symptoms. 12 As mentioned, increasing evidence indicates that diet significantly affects manifestation of IBS.…”

“…More interestingly, a relative abundance of proteobacteria correlated positively with reduced GI symptoms. 12 As mentioned, increasing evidence indicates that diet significantly affects manifestation of IBS. In a multicenter, randomized controlled trials, Weerts et al assessed the cost effectiveness of peppermint oil to treat IBS.…”

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“…Nevertheless, inverse correlation between changes of IL-18 and beta diversity during the O-BN reflects a lower degree of inflammation and an improved glycemic and lipid metabolism [ 13 , 61 ]. Other mechanisms than microbiota changes may be involved in symptom development [ 62 ].…”