Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome

Abstract

BACKGROUND Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder in children and adults, which increased over the past twenty years. The Mediterranean diet is a well-known diet full of antioxidants and anti-inflammatory ingredients. AIM To evaluate the safety, tolerability, and effects of adherence to the Mediterranean diet on disease patterns in children and adolescents with IBS. METHODS This prospective, cross-sectional case-controlled study included 100 consecutive IBS patients diagnosed according to Rome IV criteria, aged 12-18 years. Patients were subdivided into two groups (50 patients each); Group I received a Mediterranean diet, and Group II on their regular diet for six months. Besides IBS scores (IBS-SSS, IBS-QoL, and total score), different clinical and laboratory parameters were evaluated at the start and end of the study. RESULTS The Mediterranean diet was safe and well-tolerated in IBS patients. IBS children and adolescents with good adherence to the Mediterranean diet (KIDMED Score ≥ 8 points); group I showed significant improvement in IBS scores. IBS-SSS in the Mediterranean diet group was 237.2 ± 65 at the beginning of the study and decreased to 163.2 ± 33.8 at the end of the study ( P < 0.001). It did not show a significant improvement in the group with a regular diet (248.3 ± 71.1 at the beginning of the study compared to 228.5 ± 54.3 at the study end with P < 0.05). The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet. Mean IBS-QoL in group I improved from 57.3 ± 12.9 at the start of the study to 72.4 ± 11.2 at the study end ( P < 0.001) and significantly improved when compared to its level in group II at the study end (59.2 ± 12.7 with P < 0.001), while group II showed no significant improvement in IBS-QoL at the study end when compared to the beginning of the study (59.2 ± 11.7 with P >0.05). The mean total IBS score in group I became 28.8 ± 11.2 at the end of our study compared to 24.1 ± 10.4 at the start ( P < 0.05) and significantly improved when compared to its level in group II at the end of the study (22.1 ± 12.5 with P < 0.05), while in group II, non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study (22.8 ± 13.5 with P > 0.05). CONCLUSION The Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.

Mediterranean Diet Adherence Is Associated with Favorable Health-Related Quality of Life, Physical Activity, and Sleep Quality in a Community-Dwelling Greek Older Population

“…In a two-arm, two-site clinical trial, short-term MD compliance was effective in improving some microvascular physiological properties and quality of life domains, suggesting also that further improvement could be obtained in individuals with long-term MD compliance [94]. In a prospective, cross-sectional, case-control study conducted on 100 children and adolescents with irritable bowel syndrome (IBS), MD adherence was associated with considerable improvement in IBS scores, including participants' quality of life [95]. In a 12-weeks, parallel-group, open-label, randomized, controlled trial conducted on 72 young males (18-25 years), an MD intervention resulted in considerable reductions in depression scores and increases in quality-of-life scores compared with befriending [96].…”

The Relationship between Diet, Gut Mycobiome, and Functional Gastrointestinal Disorders: Evidence, Doubts, and Prospects

“…[73] AI-Bilagi et al reported similar results, the compliance with MD for 6 months remarkably elevated symptoms in children and adolescent patients with IBS. [74] This may be because of the high percentage of unsaturated fatty acids and phenolic compounds, and strict calorie limitation, which benefits the defense against bacterial and fungal infections, and chronic inflammation. Based on our previous discussion between dietary nutrients and mycobiome-increased intake of high-quality protein, fresh plant foods, and unsaturated fatty acid-MD may be the most ideal pattern for patients with FGIDs.…”

The Mediterranean Diet in Paediatric Gastrointestinal Disorders

“…Furthermore, this dietary pattern often contemplates foods rich in polyunsaturated fatty acids (PUFA), nitrate/nitrite/NO and polyphenolic agents, which have a vasodilatory effect, anti-inflammatory, immunomodulating, antioxidant properties and improve tissue micro-regulation. [ 48 , 61 , 62 ]. The MD is also effective in increasing gut-beneficial bacterial species, thus creating an anti-inflammatory environment [ 62 ].…”

“…The most promising was the one by Al-Biltagi et al, who aimed to assess the tolerance, security and efficacy of the MD in children and adolescents with IBS. In their 100-people study, half of the patients received a six-month MD with good adherence, while the other half continued their regular diet [ 61 ]. The MD was well-tolerated by the patients, and was free from adverse reactions, as well as proving effective in reducing all IBS scores (IBS-symptoms-severity-score questionnaire, IBS-quality-of-life questionnaire) [ 61 ].…”

“…In their 100-people study, half of the patients received a six-month MD with good adherence, while the other half continued their regular diet [ 61 ]. The MD was well-tolerated by the patients, and was free from adverse reactions, as well as proving effective in reducing all IBS scores (IBS-symptoms-severity-score questionnaire, IBS-quality-of-life questionnaire) [ 61 ]. Table 2 shows the main studies regarding the impact of the MD on IBS.…”