The Mediterranean Diet for Irritable Bowel Syndrome : A Randomized Clinical Trial

Area of Science:

• Gastroenterology
• Dietary Interventions
• Clinical Trials

Background:

• Irritable bowel syndrome (IBS) management often lacks evidence-based dietary guidelines.
• Traditional dietary advice (TDA) is recommended first-line, with low FODMAP diets as second-line.
• The Mediterranean diet (MD) shows potential for IBS symptom improvement.

Purpose of the Study:

• To evaluate if the Mediterranean diet (MD) is noninferior to traditional dietary advice (TDA) for managing IBS symptoms.

Main Methods:

• A randomized noninferiority clinical trial involving 139 UK IBS patients.
• Participants followed either the MD or TDA for 6 weeks.
• Primary outcome: clinical response (≥50-point reduction in IBS-SSS); secondary outcomes included symptom severity, psychological health, and quality of life.

Main Results:

• The MD group showed a significantly higher clinical response rate (62%) compared to the TDA group (42%).
• MD demonstrated noninferiority and superiority to TDA, with a greater reduction in IBS Symptom Severity Scale (IBS-SSS) scores.
• No significant differences were observed in mood, somatic symptoms, or quality of life, but MD adherence improved.

Conclusions:

• The Mediterranean diet (MD) is noninferior and superior to traditional dietary advice (TDA) for IBS symptom management.
• MD is a potential first-line dietary intervention for individuals with IBS.
• Further research is needed to assess long-term effects.