Mediterranean Diet Adherence is Associated with Lower Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents

Abstract

Dietary patterns may have a role in the prevention of functional gastrointestinal disorders (FGIDs). The current study aimed at examining the association between FGIDs and adherence to the Mediterranean diet (MD) among elementary school children (ESC), as well as high school students (HSS). In a prospective cohort study, data from 1116 subjects (387 ESC and 448 HSS) aged 6–18 years were collected. FGID identification was based on the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-RIII). Adherence to the MD was assessed using the KIDMED Index. Full data were available on 835/1116 questionnaires. Based on Rome III criteria, 184/835 participants (22%) were identified with FGID (122 (66%) with functional constipation (FC)). The prevalence of FGIDs (p = 0.001) was significantly higher in HSS (13–18 years). The KIDMED score in the cohort was 5.7 ± 2.5. Subjects with FGIDs demonstrated a lower KIDMED score compared to the non-FGID group, both in the cohort, as well as in the ESC and HSS subgroups (FGID vs. non-FGID: p = 0.001, p = 0.007, and p = 0.032, respectively). Multivariate analysis highlighted the KIDMED score as a significant predictor of FGIDs and FC after controlling for the age subgroups. We conclude that good adherence to the MD is associated to lower prevalence of FGIDs, while adolescents display a significantly higher prevalence of FGIDs compared to children.

O que comem as crianças constipadas/What constipated children eat

“…Apesar dos benefícios associados a fibra para a saúde humana, a maioria dos adultos e crianças não atingem às recomendações [13]. Embora a relação de causa e efeito entre dieta e a constipação intestinal funcional ainda seja controversa, os efeitos da dieta no hábito intestinal são cruciais na terapêutica da constipação e a adesão a determinados padrões alimentares pode diminuir significativamente os sintomas dessa condição [5][6][7][8][9][10][11][12][13][14]. da fibra alimentar ingerida foi obtida de produtos ultraprocessados [16].…”

“…A dieta do mediterrâneo é reconhecida por ser saudável, os pratos nessa alimentação são ricos em fibras e antioxidantes, além do baixo teor de gorduras saturadas. A prevalência de FGIDs (Distúrbios Gastrointestinais Funcionais) em crianças e adolescentes é associada a uma menor adesão a dieta do mediterrâneo [27] As crianças, em geral, são mais seletivas nas escolhas dos alimentos e, habitualmente, apresentam um consumo reduzido de fibras alimentares [28]. As crianças com constipação funcional desenvolvem um comportamento alimentar não saudável que por sua vez aumenta o risco da doença caracterizando um ciclo vicioso [29].…”

“…Inquéritos alimentares nacionais e internacionais que investigaram o consumo de fibras por crianças e adolescentes mostram que há alta prevalência de inadequação de consumo do nutriente[14, 15,16]. Dados da última Pesquisa de Orçamentos familiares (POF), realizada nos anos de 2017/18, mostram que o consumo de fibras pelos adolescentes vem caindo ao longo dos anos, com média de consumo entre os meninos de 27,9g em 2008/09 para 24,2 g, e entre as meninasde 22,5g para 19,6g [15] A quantidade média, em gramas, de fibras consumida pelos constipados pesquisados foi correspondente à encontrada no estudo realizado com adolescentes em Campinas, o ISACamp, que identificou o consumo insuficiente de fibras, com ingestão média de 12,6 g/dia, onde, no mínimo 1/4…”

Global Dietary Patterns and Functional Gastrointestinal Disorders

“…In Greece, a school-based, cross-sectional study showed that reduced fish and increased junk food consumption were related to a higher likelihood of developing functional abdominal pain disorders [ 36 ]. Another study concluded that good adherence to the Mediterranean diet is associated with a lower prevalence of FGIDs [ 37 ]. The Mediterranean diet is centered on whole grains, fruits, vegetables, beans, herbs, spices, nuts and healthy fats such as olive oil.…”

Digital Therapeutics Care Utilizing Genetic and Gut Microbiome Signals for the Management of Functional Gastrointestinal Disorders: Results from a Preliminary Retrospective Study

“…Poor nutrition, for example, consumption of highly processed and "fast" foods, has been implicated in FGID etiology [17,18]. Conversely, a Mediterranean diet has been associated with a lower prevalence of FGID [19]. A dietary therapeutics approach, for example a low-FODMAP diet in which rapidly fermentable carbohydrates that are poorly absorbed by the gut are eliminated or avoided as much as possible, is a typical dietary protocol for IBS patients [20].…”