@article{006a8e2e579949c781046a60cb16a6a0,
title = "Long-term personalised low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome",
abstract = "Background: Short-term trials demonstrate the low FODMAP diet improves symptoms of irritable bowel syndrome (IBS) but impacts nutrient intake and the gastrointestinal microbiota. The aim of this study was to investigate clinical symptoms, nutrient intake and microbiota of patients with IBS 12 months after starting a low FODMAP diet. Methods: Participants enrolled in a previous short-term clinical trial and who had been through structured FODMAP restriction, reintroduction and personalisation were invited to participate in a follow-up study at one time point at 12months. Gastrointestinal symptoms, stool output, dietary intake and quality of life were recorded. Stool samples were collected and analysed for microbiota (qPCR) and short-chain fatty acids (SCFA). Data were compared with baseline (prior to any intervention in the original clinical trial) using non-parametric statistics. Key results: Eighteen participants were included in the study. Adequate relief of symptoms occurred in 5/18 (28%) at baseline and increased to 12/18 (67%) following long-term personalised low FODMAP diet (p=0.039). There was a reduction in IBS-SSS total score between baseline (median 227, IQR 99) and long term (154, 89; p<0.001). Bifidobacteria abundance was not different between baseline (median 9.29, IQR 1.45) and long term (9.20, 1.41; p=0.766, q=0.906), however there were lower concentrations of total SCFA, acetate, propionate and butyrate. Conclusions: In this long-term analysis, two thirds of patients reported adequate relief of symptoms after 12 months of personalised low FODMAP diet, that did not result in differences from baseline in Bifidobacteria. FODMAP reintroduction and personalisation may normalise some of the effects of short-term FODMAP restriction. ",
keywords = "bifidobacteria, diet, FODMAP, fructans, irritable bowel syndrome, microbiome",
author = "Staudacher, {Heidi M.} and Megan Rossi and Thomas Kaminski and Eirini Dimidi and Ralph, {Frances S.E.} and Bridgette Wilson and Martin, {Lee D.} and Petra Louis and Lomer, {Miranda C.E.} and Irving, {Peter M.} and Kevin Whelan",
note = "Funding Information: HMS reports non‐financial support from CD Investments VSL Pharmaceuticals. MR is the owner of a breakfast cereal and yoghurt range. MCL is the coinventor of a mobile app with FoodMaestro to support patients following the low FODMAP diet. ED has received research funding from Almond Board of California. BW has received research funding from Clasado Biosciences. LDM has published a book regarding the low FODMAP diet. PL has received grants from Scottish Government Rural and Environment Sciences and Analytical Services (RESAS). KW is the coinventor of a mobile app with FoodMaestro to support patients following the low FODMAP diet, has received research funding from Almond Board of California, Clasado Biosciences, Danone, International Nut and Dried Fruit Council, and has received consultancy fees from Danone. The remaining authors have nothing to disclose. Funding Information: The authors thank the patients who agreed to participate in this long‐term follow‐up study. We are grateful to Monash University, Melbourne, Australia, for access to their FODMAP food composition database for analysis of FODMAP intake. The initial study was funded by the National Institute for Health Research and the long‐term follow‐up was funded by King{\textquoteright}s College London, neither of whom played a role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jul,
day = "17",
doi = "10.1111/nmo.14241",
language = "English",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley",
}