Gut microbiota associations with diet in irritable bowel syndrome and the effect of low FODMAP diet and probiotics

TY - JOUR

T1 - Gut microbiota associations with diet in irritable bowel syndrome and the effect of low FODMAP diet and probiotics

AU - Staudacher, Heidi

AU - Scholz, Matthias

AU - Lomer, Miranda

AU - Ralph, Frances S

AU - Irving, Peter M.

AU - Lindsay, James O.

AU - Fava, Francesca

AU - Tuohy, Kieran M.

AU - Whelan, Kevin

PY - 2020/10/12

Y1 - 2020/10/12

N2 - Background and Aims: Diet is both a modulator of the gastrointestinal microbiota and an important therapy in irritable bowel syndrome (IBS). We aimed to comprehensively (i) identify diet-microbiota associations in adults with IBS consuming habitual diet; (ii) assess the impact of two nutritional interventions on the microbiota; and (iii) determine whether baseline microbiota can predict clinical response to diet or probiotic intervention Methods: Data were analyzed from 95 individuals with IBS participating in a previously published 4-week 2x2 factorial design randomized controlled trial investigating the impact of the low FODMAP diet (LFD) and co-administration of a probiotic. Diet was assessed at four hierarchical levels and partial 16S rRNA gene sequencing was used to profile the microbiota. Results: There were numerous diet-microbiota associations especially at the nutrient level, including a negative association between protein and Bifidobacterium abundance (rs= -0.358, p<0.001). After correction for multiple testing, the significance for this association (q=0.237) and all others was lost. Low FODMAP diet led to changes in abundance of major saccharolytic genera compared with sham diet, including higher Bacteroides (LFD 34.1% (15.7%) vs sham 23.3% (15.2%), q=0.01) and lower Bifidobacterium (0.9% (1.0%) vs 2.1%, (2.5%) q=0.029). Compared with placebo, probiotic supplementation led to higher Lactobacillus (Probiotic 0.08% (0.1%) vs placebo 0.03% (0.2%), q<0.001), and Streptococcus abundance (2.0% (2.2%) vs 0.6% (1.2%), q=0.001). The probiotic treatment buffered the impact of the low FODMAP diet on Bifidobacterium. Baseline microbiota did not predict clinical response to either intervention. Conclusions: Although diet modifies the gut microbiota, bivariate correlation analysis may only provide a limited explanation of the complex diet interactions with individual gut bacteria in IBS. Some diet interventions modify the microbiota in IBS. Registered under ISRCTN registry identifier no. ISRCTN02275221

AB - Background and Aims: Diet is both a modulator of the gastrointestinal microbiota and an important therapy in irritable bowel syndrome (IBS). We aimed to comprehensively (i) identify diet-microbiota associations in adults with IBS consuming habitual diet; (ii) assess the impact of two nutritional interventions on the microbiota; and (iii) determine whether baseline microbiota can predict clinical response to diet or probiotic intervention Methods: Data were analyzed from 95 individuals with IBS participating in a previously published 4-week 2x2 factorial design randomized controlled trial investigating the impact of the low FODMAP diet (LFD) and co-administration of a probiotic. Diet was assessed at four hierarchical levels and partial 16S rRNA gene sequencing was used to profile the microbiota. Results: There were numerous diet-microbiota associations especially at the nutrient level, including a negative association between protein and Bifidobacterium abundance (rs= -0.358, p<0.001). After correction for multiple testing, the significance for this association (q=0.237) and all others was lost. Low FODMAP diet led to changes in abundance of major saccharolytic genera compared with sham diet, including higher Bacteroides (LFD 34.1% (15.7%) vs sham 23.3% (15.2%), q=0.01) and lower Bifidobacterium (0.9% (1.0%) vs 2.1%, (2.5%) q=0.029). Compared with placebo, probiotic supplementation led to higher Lactobacillus (Probiotic 0.08% (0.1%) vs placebo 0.03% (0.2%), q<0.001), and Streptococcus abundance (2.0% (2.2%) vs 0.6% (1.2%), q=0.001). The probiotic treatment buffered the impact of the low FODMAP diet on Bifidobacterium. Baseline microbiota did not predict clinical response to either intervention. Conclusions: Although diet modifies the gut microbiota, bivariate correlation analysis may only provide a limited explanation of the complex diet interactions with individual gut bacteria in IBS. Some diet interventions modify the microbiota in IBS. Registered under ISRCTN registry identifier no. ISRCTN02275221

M3 - Article

SN - 0261-5614

JO - CLINICAL NUTRITION

JF - CLINICAL NUTRITION

ER -