Effects of a low FODMAP diet on the symptom management of patients with irritable bowel syndrome: a systematic umbrella review with the meta-analysis of clinical trials

Khalighi Sikaroudi, Masoumeh; Soltani, Sepideh; Ghoreishy, Seyed Mojtaba; Ebrahimi, Zohreh; Shidfar, Farzad; Dehnad, Afsaneh

doi:10.1039/d3fo03717g

Cited by 3 publications

References 90 publications

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Characterizing Highly Fermentable Carbohydrate Foods in the Diets of Children with Disorders of Gut-Brain Interaction and Healthy Children

Narayana,

Chang,

McMeans

et al. 2024

Preprint

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Objectives Restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) intake can alleviate symptoms in children with gut-brain interaction disorders (DGBI). Due to the restrictive nature of the low FODMAP diet (LFD), the less restrictive FODMAP Gentle diet (FGD) has been suggested. However, the types of high FODMAP foods and carbohydrates commonly consumed by US children are unknown, as is the impact of the FGD on a typical diet. This project aimed to identify the high FODMAP foods and proportions of FODMAP carbohydrates consumed by children with DGBI and healthy children (HC), and to determine which usually ingested FODMAPs would be restricted on the FGD. Methods Three-day diet records from both HC and children with DGBI were analyzed to assess the type of high FODMAP foods and carbohydrates ingested. Results were compared between the groups. The ingested FODMAPs that would be restricted on the FGD was determined. Results The number of foods ingested daily was similar between children with DGBI and HC (12.3 ± 4.2 vs 12.9 ± 3.4, respectively); high FODMAP foods comprised most foods eaten in both groups. Children with DGBI (vs HC) ate less high FODMAP foods per day (6.5 ± 2.3 vs 8.7 ± 2.4, P<0.0001, respectively). Fructans were the most consumed FODMAP carbohydrate in both groups and children with DGBI (vs HC) consumed fewer fructans, lactose, fructose, and polyols (all P<0.0001). The top 3 food categories consumed in both groups were wheat-containing foods, dairy, and fruits and 100% fruit juices. In children with DGBI, 80.9% of the high FODMAP foods consumed would be limited on the FGD. Discussion Children with DGBI consume significantly fewer high FODMAP foods and carbohydrates than HC. In both groups, the top consumed FODMAP carbohydrates are fructans, lactose, and fructose. A FODMAP Gentle diet would restrict a large majority of high FODMAP foods consumed by children with DGBI.

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Characterizing Highly Fermentable Carbohydrate Foods in the Diets of Children with Disorders of Gut-Brain Interaction and Healthy Children

Narayana,

Chang,

McMeans

et al. 2024

Preprint

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Efficacy of Dietary Interventions for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis

Haghbin,

Hasan,

Gangwani

et al. 2024

JCM

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Introduction: Irritable bowel syndrome (IBS) is a common condition that alters the quality of life of patients. A variety of dietary interventions have been introduced to address this debilitating condition. The low-FODMAP diet (LFD), gluten-free diet (GFD), and Mediterranean diet are examples showing efficacy. The aim of this network meta-analysis was to compare these interventions to find the best approach. Methods: We performed a systematic review of the available literature through 14 March 2024 in the following databases: Embase, PubMed, MEDLINE OVID, Web of Science, CINAHL Plus, and Cochrane Central. We only included randomized controlled trials (RCTs). We used a random effects model and conducted a direct meta-analysis based on the DerSimonian–Laird approach and a network meta-analysis based on the frequentist approach. Mean differences (MDs) with 95% confidence interval (CI) were calculated. The primary outcomes included IBS quality of life (IBS QOL) and IBS symptom severity scale (IBS-SSS). Results: We finalized 23 studies including 1689 IBS patients. In the direct meta-analysis, there was no statistically significant difference in any IBS score between GFD and either LFD or standard diet. Meanwhile, the LFD was statistically superior to the standard diet in the IBS-SSS (MD: −46.29, CI: −63.72–−28.86, p < 0.01) and IBS QOL (MD: 4.06, CI: 0.72–7.41, p = 0.02). On ranking, the Mediterranean diet showed the greatest improvement in IBS-SSS, IBS-QOL, distension, dissatisfaction, and general life interference, followed by the LFD alone or in combination with the GFD. Conclusions: We demonstrated the efficacy of dietary interventions such as the LFD and Mediterranean diet in improving IBS. There is a need for large RCTs with head-to-head comparisons, particularly for the Mediterranean diet.

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Assessing the Nutrient Composition of a Carnivore Diet: A Case Study Model

Goedeke,

Murphy,

Rush

et al. 2024

Nutrients

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Background/Objectives: The rise in chronic metabolic diseases has led to the exploration of alternative diets. The carnivore diet, consisting exclusively of animal products, has gained attention, anecdotally, for imparting benefit for inflammatory conditions beyond that possible by other restrictive dietary approaches. The aim was to assess the micronutrient adequacy of four versions of the carnivore diet against national nutrient reference values (NRVs). Methods: This study assessed the nutrient adequacy of the carnivore diet against national NRVs from the Australian National Health and Medical Research Council (NHMRC) and New Zealand Ministry of Health. Four meal plans for hypothetical average Australian adults were developed and analysed using Foodworks.online (Version 1, Xyris Pty Ltd., Brisbane, Australia, 2024), dietary software. Two female and two male plans were included; one set including dairy products and the other set including offal. Results: The carnivore diet met several NRV thresholds for nutrients such as riboflavin, niacin, phosphorus, zinc, Vitamin B6, Vitamin B12, selenium, and Vitamin A, and exceeded the sodium threshold. However, it fell short in thiamin, magnesium, calcium, and Vitamin C, and in iron, folate, iodine and potassium in some cases. Fibre intake was significantly below recommended levels. Conclusion: The carnivore diet may offer benefits for managing certain chronic conditions. Whether the metabolic contexts from consuming such a diet facilitates a lower requirement of certain nutrients, or whether it poses risks of micronutrient inadequacies remains to be determined. Tailored nutritional guidance and supplementation strategies are recommended to ensure careful consideration of micronutrient intake to prevent deficiencies.

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Effects of a low FODMAP diet on the symptom management of patients with irritable bowel syndrome: a systematic umbrella review with the meta-analysis of clinical trials

Abstract: Effect of low FODMAPs diet on symptoms of patients with irritable bowel syndrome.

Cited by 3 publications

References 90 publications

Characterizing Highly Fermentable Carbohydrate Foods in the Diets of Children with Disorders of Gut-Brain Interaction and Healthy Children

Characterizing Highly Fermentable Carbohydrate Foods in the Diets of Children with Disorders of Gut-Brain Interaction and Healthy Children

Efficacy of Dietary Interventions for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis

Assessing the Nutrient Composition of a Carnivore Diet: A Case Study Model

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