背景:FODMAP(可发酵寡糖,二糖,单糖,和多元醇)丰富的食物已被认为是功能性胃肠道疾病(FGID)的可能触发因素。尽管FODMAP含量很高,地中海饮食(MD)似乎对健康有益。我们的目的是评估不同地中海国家的FGID患病率是否可能受到FODMAP消费和坚持MD的影响。方法:以学校为基础,横截面,多中心研究在地中海地区的六个国家进行:克罗地亚,希腊,以色列,意大利,马其顿,塞尔维亚。研究对象4-18年的饮食习惯和FGID的存在。使用罗马四世标准,儿童和青少年的3天食品日记和地中海饮食质量指数(KIDMED)问卷。结果:我们招募了1972名4至9岁的受试者(A组),和2450名10至18岁的受试者(B组)。FGID的总体患病率在A组中为16%,在B组中为26%。FODMAP的摄入量在两个年龄组的国家之间显著不同。在这两组中,FGID和FODMAP之间未发现显著关联.在所有国家/地区,对MD的遵守程度都处于中等水平,除了塞尔维亚,它很低。在这两组中,我们发现FGID与KIDMED评分之间存在统计学显著关联(A组:OR=0.83,p<0.001;B组:OR=0.93,p=0.005).此外,KIDMED评分与功能性便秘(A组:OR=0.89,p=0.008;B组:OR=0.93,p=0.010)和餐后窘迫综合征(A组:OR=0.86,p=0.027;B组:OR=0.88,p=0.004)之间存在显著相关性.结论:我们的数据表明,地中海地区的FGID患病率与FODMAP消费无关,而坚持MD似乎有保护作用。
Background: The increased intake of FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyol) rich foods has been suggested as a possible trigger of functional gastrointestinal disorders (
FGIDs). Despite the high FODMAP content, the Mediterranean diet (MD) appears to have beneficial effects on health. Our aim was to evaluate whether the prevalence of FGIDs in different Mediterranean countries may be influenced by FODMAP consumption and adherence to the MD. Methods: A school-based, cross-sectional, multicenter study was performed in six countries in the Mediterranean area: Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects 4-18 years were examined in relation to their eating habits and the presence of
FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index in Children and Adolescents (KIDMED) questionnaires. Results: We enrolled 1972 subjects between 4 and 9 years old (Group A), and 2450 subjects between 10 and 18 years old (Group B). The overall prevalence of
FGIDs was 16% in Group A and 26% in Group B. FODMAP intake was significantly different among countries for both age groups. In both groups, no significant association was found between
FGIDs and FODMAPs. Adherence to the MD in all countries was intermediate, except for Serbia, where it was low. In both groups, we found a statistically significant association between
FGIDs and the KIDMED score (Group A: OR = 0.83, p < 0.001; Group B: OR = 0.93, p = 0.005). Moreover, a significant association was found between the KIDMED score and functional constipation (Group A: OR = 0.89, p = 0.008; Group B: OR = 0.93, p = 0.010) and postprandial distress syndrome (Group A: OR = 0.86, p = 0.027; Group B: OR = 0.88, p = 0.004). Conclusions: Our data suggest that the prevalence of FGIDs in the Mediterranean area is not related to FODMAP consumption, whereas adherence to the MD seems to have a protective effect.