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Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Richards, Julie Ann
http://orcid.org/0000-0002-5697-7633
http://rave.ohiolink.edu/etdc/view?acc_num=osu1524001442665205

Abstract Details

2018, Master of Science, Ohio State University, Allied Medicine.
Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) that affects 10-20% of adults and adolescents worldwide. A connection has been identified between the consumption of some foods and an exacerbation of IBS symptoms. One nutrition therapy option for IBS is the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet. A lack of data describing the mechanism of action of this dietary pattern has led to insufficient evidence to establish standard clinical guidelines regarding the use of the low-FODMAP diet in IBS. Objective: This study aims to define the duration of the low-FODMAP diet elimination phase for optimal symptom relief and the nutritional adequacy of the low-FODMAP diet. Methods: Subjects attended a low-FODMAP diet group education class and were instructed to follow the low-FODMAP diet for six weeks. Subjects completed an IBS-Symptom Severity Scale questionnaire (IBS-SSS) at baseline and weeks 2, 4, and 6. Subjects completed a three-day diet record at baseline and week 2. Dietary compliance was assessed through daily high-FODMAP food checklists. Results: A total of 35 participants enrolled in this study. Complete data was available for 14 (40%) participants. Incomplete data was available for 2 (6%) participants, and 19 (54%) dropped out of the study. 43% (15/35) participants were responders to the diet (a reduction 50 points in IBS-SSS), and 87% (13/15) of responders saw a clinical response after two weeks of the diet. There was a significant reduction in symptoms seen between baseline and week two (p<0.001). Post initiation of the low-FODMAP diet in those participants with complete data, there was a statistically significant reduction in grams of carbohydrates consumed (p=0.031). Servings from grains and servings from dairy were also significantly reduced (p=0.048, p=0.010). Calcium, iron, folate, vitamin C, and vitamin D intake were below the recommended dietary allowance (RDA) for >75% of participants. 71% of participants reported non-compliance. Conclusion: Our findings support that a low-FODMAP diet elimination phase of two weeks is optimal for achieving symptom relief. The low-FODMAP diet leads to a nutritionally inadequate dietary pattern and must be monitored in future studies. The high dropout rate and poor dietary compliance reported in this study highlight the need to assess dietary compliance in future interventions to determine if a reduction in IBS-SSS is a result of dietary FODMAP concentration or placebo effect.
Marcia Nahikian-Nelms (Advisor)
Kristen Roberts (Committee Member)
Jill Clutter (Committee Member)
196 p.
Nutrition
IBS, low FODMAP, symptom relief, IBS-SSS, diet adequacy, dietary changes, compliance

Recommended Citations

Citations

  • Richards, J. A. (2018). Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1524001442665205

    APA Style (7th edition)

  • Richards, Julie. Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome. 2018. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1524001442665205.

    MLA Style (8th edition)

  • Richards, Julie. "Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome." Master's thesis, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1524001442665205

    Chicago Manual of Style (17th edition)

osu1524001442665205
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This open access ETD is published by The Ohio State University and OhioLINK.