荟萃分析:低FODMAP饮食干预肠易激综合征,短期有效而安全

截至2016年,共596名受试者参与的9项随机对照试验(RCT)纳入荟萃分析。
与其他饮食相比,短期的低FODMAP饮食可显著改善肠易激综合征(IBS)患者的胃肠道症状、腹痛、健康相关的生活质量。
三项RCT显示,低FODMAP饮食可显著降低luminal双歧杆菌丰度。
只有三项RCT评估了不良反应,而且并非与饮食干预有关的不良反应。
因此,短期低FODMAP饮食是有效而安全,但长期干预的有效性和安全性需进一步研究;之后才能形成科学的初步建议。
延伸阅读

Nutrition [IF:3.591]

Low FODMAP Diet in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

低FODMAP饮食用于肠易激综合征的治疗:一项系统回顾和荟萃分析

10.1016/j.nut.2017.07.004

2018-01-01, Article

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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.

First Authors:
Dania Schumann

Correspondence Authors:
Holger Cramer

All Authors:
Dania Schumann,Petra Klose,Romy Lauche,Gustav Dobos,Jost Langhorst,Holger Cramer