Abstract：
Diet is fundamental to the care of irritable bowel syndrome (IBS). However, some approaches are not appropriate for individuals experiencing psychological symptoms.
To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms.
We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing.
We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups.
A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms.
We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing.
We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups.
A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
摘要：
背景：饮食是治疗肠易激综合征（IBS）的基础。然而,有些方法不适用于出现心理症状的个体。
目的：评估地中海饮食在IBS中的可行性及其对胃肠道和心理症状的影响。
方法：我们招募了患有罗马IV型IBS且有轻度或中度焦虑和/或抑郁症状的成年人参加一项为期6周的非盲法随机对照试验。患者随机接受地中海饮食咨询或习惯性饮食。我们收集了胃肠道和心理症状数据，饮食数据和粪便样本进行宏基因组测序。
结果：我们随机抽取了59个人（29个地中海饮食，30个对照）；48个完成了研究。地中海饮食组的地中海饮食依从性筛选评分在第6周时高于对照组（7.5[95％CI：6.9-8.0]与5.7[5.2-6.3],p<0.001)，并且得分增加比对照组更大（2.1[95％CI：1.3-2.9]vs.0.5[95%CI：0.1-1.0]，p=0.004),证明地中海饮食的可行性。地中海饮食组中胃肠道症状反应者的比例高于对照组（24/29，83％vs.11/30，37%，p<0.001）和抑郁反应者（15/29，52%vs.6/3020%，p=0.015)。在第6周，FODMAP的摄入量没有差异（p=0.51）。胃肠道不良事件相似（p=0.588）。组间微生物组参数的变化没有差异。
结论：在IBS中，地中海饮食是可行的，并且可以改善胃肠道和心理症状。尽管这项研究是不盲目的，这些发现以及地中海饮食的更广泛益处，为未来IBS的研究提供了强大的动力。澳大利亚新西兰临床试验注册：ACTRN12620001362987。
目的：评估地中海饮食在IBS中的可行性及其对胃肠道和心理症状的影响。
方法：我们招募了患有罗马IV型IBS且有轻度或中度焦虑和/或抑郁症状的成年人参加一项为期6周的非盲法随机对照试验。患者随机接受地中海饮食咨询或习惯性饮食。我们收集了胃肠道和心理症状数据，饮食数据和粪便样本进行宏基因组测序。
结果：我们随机抽取了59个人（29个地中海饮食，30个对照）；48个完成了研究。地中海饮食组的地中海饮食依从性筛选评分在第6周时高于对照组（7.5[95％CI：6.9-8.0]与5.7[5.2-6.3],p<0.001)，并且得分增加比对照组更大（2.1[95％CI：1.3-2.9]vs.0.5[95%CI：0.1-1.0]，p=0.004),证明地中海饮食的可行性。地中海饮食组中胃肠道症状反应者的比例高于对照组（24/29，83％vs.11/30，37%，p<0.001）和抑郁反应者（15/29，52%vs.6/3020%，p=0.015)。在第6周，FODMAP的摄入量没有差异（p=0.51）。胃肠道不良事件相似（p=0.588）。组间微生物组参数的变化没有差异。
结论：在IBS中，地中海饮食是可行的，并且可以改善胃肠道和心理症状。尽管这项研究是不盲目的，这些发现以及地中海饮食的更广泛益处，为未来IBS的研究提供了强大的动力。澳大利亚新西兰临床试验注册：ACTRN12620001362987。
