Irritable bowel syndrome (IBS), a gastrointestinal disease, is a global phenomenon correlated with industrialization. We propose that an evolutionary medicine approach is useful to understand this disease from an ultimate perspective and conducted a scoping literature review to synthesize the IBS literature within this framework. Our review suggests five potential evolutionary hypotheses for the cause of IBS, including (a) a dietary mismatch accompanying a nutritional transition, (b) an early hygienic life environment leading to the immune system and microbiotic changes, (c) an outcome of decreased physical activity, (d) a response to changes in environmental light-dark cycles, and (e) an artifact of an evolved fight or flight response. We find key limitations in the available data needed to understand early life, nutritional, and socioeconomic experiences that would allow us to understand evolutionarily relevant risk factors and identify a need for further empirical research to distinguish potential causes and test evolutionary hypotheses.

The South African Medical Research Council food frequency questionnaire (FFQ) and protocol was used to determine food intake in 83 adolescents from the Birth To Twenty study. The FFQ was piloted on a small group (n=8). Specific problems which resulted in overestimation of energy intake were identified. The protocol was modified and administered to the remainder of the adolescents and their caregivers. Reasonable energy intakes were obtained, and time spent completing the FFQ was reduced. The modified protocol was more successful in determining habitual food intake although it would benefit from validation against other dietary intake techniques.