IBS dietary self-management: fiber, micronutrient deficiencies are common

  • Staudacher HM & al.
  • J Acad Nutr Diet
  • 24 Apr 2019

  • International Clinical Digest
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Takeaway

  • Many people with irritable bowel syndrome (IBS) fail to get enough fiber or micronutrients.
  • A 4-week stint of diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) reduced diet quality in this study, but the clinical significance is uncertain.

Why this matters

  • FODMAP restriction improves symptoms in most patients, but few data reflect the quality or diversity of this diet.

Key results

  • At baseline:
    • Only 5% of participants met recommended fiber intake.
    • Many were also not consuming adequate iodine, magnesium, iron, or selenium.
    • Vast majority were consuming too much salt and sugar.
    • Formal diet quality and diversity scores were low.
  • Low-FODMAP diet led to slightly lower diet-quality scores vs habitual diet, but diversity was similar.

Study design

  • Secondary analysis of 2 randomized controlled trials of adults with IBS at a tertiary center (n=130). 
  • Authors evaluated habitual nutrient intake, diet quality, and diversity among IBS patients with low-FODMAP diet (n=63) vs without (sham exclusion diet, n=48; habitual diet, n=19).
  • Outcome: intake at baseline vs 4 weeks.
  • Funding: National Institute for Health Research.

Limitations

  • Short-term study.
  • May not apply to patients who do not receive dietitian counseling.