Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis

Schumann, D; Klose, P; Lauche, R; Dobos, G; Langhorst, J; Cramer, H

Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis

Schumann, D Klose, P Lauche, R

Dobos, G Langhorst, J Cramer, H

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Publication Type:: Journal Article
Citation:: Nutrition, 2018, 45 pp. 24 - 31
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Schumann, D	en_US
dc.contributor.author	Klose, P	en_US
dc.contributor.author	Lauche, R https://orcid.org/0000-0002-4171-7935	en_US
dc.contributor.author	Dobos, G	en_US
dc.contributor.author	Langhorst, J	en_US
dc.contributor.author	Cramer, H	en_US
dc.date.available	2020-05-25T19:27:22Z
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	Nutrition, 2018, 45 pp. 24 - 31	en_US
dc.identifier.issn	0899-9007	en_US
dc.identifier.uri	http://hdl.handle.net/10453/110757
dc.description.abstract	© 2017 Elsevier Inc. Objectives The aim of this review was to systematically assess and meta-analyze the effects of a low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet (LFD) on the severity of symptoms, quality of life, and safety in patients with irritable bowel syndrome (IBS). Methods The MEDLINE/PubMed, Scopus, and Cochrane Library databases were screened through January 19, 2016. Randomized controlled trials (RCTs) that compared LFD to other diets were included if they assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression, and effect on gut microbiota were defined as secondary outcomes. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. Results Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD with a habitual diet, two RCTs provided all meals and compared LFD with a western diet, one RCT each compared LFD with a diet high in FODMAPs or a sham diet, and two RCTs compared with other diet recommendations for IBS. A meta-analysis revealed significant group differences for LFD compared with other diets with regard to gastrointestinal symptoms (SMD = −0.62; 95% CI = −0.93 to −0.31; P = 0.0001), abdominal pain (SMD = −0.50; 95% CI = −0.77 to −0.22; P = 0.008), and health-related quality of life (SMD = 0.36; 95% CI = 0.10–0.62; P = 0.007). Three studies reported a significant reduction in luminal bifidobacteria after LFD. Adverse events were assessed in three RCTs only and no intervention-related adverse events were reported. Conclusions This meta-analysis found evidence of the short-term efficacy and safety of LFD in patients with IBS. However, only a preliminary recommendation for LFD can be made until long-term effects are investigated.	en_US
dc.relation.ispartof	Nutrition	en_US
dc.relation.isbasedon	10.1016/j.nut.2017.07.004	en_US
dc.subject.classification	Nutrition & Dietetics	en_US
dc.subject.mesh	Gastrointestinal Tract	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Irritable Bowel Syndrome	en_US
dc.subject.mesh	Abdominal Pain	en_US
dc.subject.mesh	Polymers	en_US
dc.subject.mesh	Monosaccharides	en_US
dc.subject.mesh	Oligosaccharides	en_US
dc.subject.mesh	Disaccharides	en_US
dc.subject.mesh	Fermentation	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Diet, Carbohydrate-Restricted	en_US
dc.subject.mesh	Randomized Controlled Trials as Topic	en_US
dc.subject.mesh	Gastrointestinal Microbiome	en_US
dc.title	Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis	en_US
dc.type	Journal Article
utslib.citation.volume	45	en_US
utslib.for	1104 Complementary and Alternative Medicine	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.publication-status	Published	en_US
pubs.volume	45	en_US

Abstract:

© 2017 Elsevier Inc. Objectives The aim of this review was to systematically assess and meta-analyze the effects of a low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet (LFD) on the severity of symptoms, quality of life, and safety in patients with irritable bowel syndrome (IBS). Methods The MEDLINE/PubMed, Scopus, and Cochrane Library databases were screened through January 19, 2016. Randomized controlled trials (RCTs) that compared LFD to other diets were included if they assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression, and effect on gut microbiota were defined as secondary outcomes. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. Results Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD with a habitual diet, two RCTs provided all meals and compared LFD with a western diet, one RCT each compared LFD with a diet high in FODMAPs or a sham diet, and two RCTs compared with other diet recommendations for IBS. A meta-analysis revealed significant group differences for LFD compared with other diets with regard to gastrointestinal symptoms (SMD = −0.62; 95% CI = −0.93 to −0.31; P = 0.0001), abdominal pain (SMD = −0.50; 95% CI = −0.77 to −0.22; P = 0.008), and health-related quality of life (SMD = 0.36; 95% CI = 0.10–0.62; P = 0.007). Three studies reported a significant reduction in luminal bifidobacteria after LFD. Adverse events were assessed in three RCTs only and no intervention-related adverse events were reported. Conclusions This meta-analysis found evidence of the short-term efficacy and safety of LFD in patients with IBS. However, only a preliminary recommendation for LFD can be made until long-term effects are investigated.

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http://hdl.handle.net/10453/110757