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Published on: November 30, 2016
The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome
Ellie Y Chen1, Swapna Mahurkar-Joshi2, Cathy Liu2
1Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California.
Background & Aims:
Low adherence to Mediterranean diet (MD) has been shown to be associated with a higher prevalence of irritable bowel syndrome (IBS), but its association with IBS symptoms is not established. We aim to assess the association between MD and IBS symptoms, identify components of MD associated with IBS symptoms, and determine if a symptom-modified MD is associated with changes in the gut microbiome.
Methods:
One hundred and six Rome +IBS and 108 health control participants completed diet history and gastrointestinal symptom questionnaires. Adherence to MD was measured using Alternate Mediterranean Diet and Mediterranean Diet Adherence Screener. Sparse partial least squares analysis identified MD food items associated with IBS symptoms. Stool samples were collected for 16S ribosomal RNA gene sequencing and microbial composition analysis in IBS subjects.
Results:
Alternate Mediterranean Diet and Mediterranean Diet Adherence Screener scores were similar between IBS and health control subjects and did not correlate with Irritable Bowel Syndrome Severity Scoring System, abdominal pain, or bloating. Among IBS participants, a higher consumption of fruits, vegetables, sugar, and butter was associated with a greater severity of IBS symptoms. Multivariate analysis identified several MD foods to be associated with increased IBS symptoms. A higher adherence to symptom-modified MD was associated with a lower abundance of potentially harmful Faecalitalea, Streptococcus, and Intestinibacter, and higher abundance of potentially beneficial Holdemanella from the Firmicutes phylum.
Conclusions:
A standard MD was not associated with IBS symptom severity, although certain MD foods were associated with increased IBS symptoms. Our study suggests that standard MD may not be suitable for all patients with IBS and likely needs to be personalized in those with increased symptoms.
Insights
A standard Mediterranean diet (MD) did not improve irritable bowel syndrome (IBS) symptoms. Personalizing the MD based on individual symptoms may be more effective for managing IBS and its gut microbiome.
Area of Science:
- Gastroenterology
- Nutritional Science
- Microbiome Research
Background:
- Low adherence to the Mediterranean diet (MD) is linked to higher irritable bowel syndrome (IBS) prevalence.
- The association between MD adherence and specific IBS symptoms remains unclear.
Purpose of the Study:
- To assess the link between MD and IBS symptoms.
- To identify specific MD components associated with IBS symptom severity.
- To determine if a symptom-modified MD impacts the gut microbiome.
Main Methods:
- Dietary intake and gastrointestinal symptoms were assessed in 106 IBS patients and 108 controls.
- Mediterranean diet adherence was measured using standardized questionnaires.
- Gut microbial composition was analyzed via 16S rRNA gene sequencing in IBS subjects.
Main Results:
- Standard MD adherence scores did not correlate with IBS symptom severity.
- Increased consumption of fruits, vegetables, sugar, and butter was associated with more severe IBS symptoms.
- A symptom-modified MD correlated with reduced harmful gut bacteria (Faecalitalea, Streptococcus, Intestinibacter) and increased beneficial bacteria (Holdemanella).
Conclusions:
- A standard MD is not universally beneficial for all IBS patients.
- Personalizing the MD based on individual symptom profiles is crucial for managing IBS.
- Symptom-guided dietary modifications show potential for altering the gut microbiome in IBS.
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