Jent, Sandra; Bez, Natalie Sara; Haddad, Joyce; Catalano, Loan; Egger, Kim Stefanie; Raia, Michela; Tedde, Giulia Simona; Rogler, Gerhard (2024). The efficacy and real-world effectiveness of a diet low in fermentable oligo-, di-, monosaccharides and polyols in irritable bowel syndrome: A systematic review and meta-analysis Clinical Nutrition, 43(6), pp. 1551-1562. Elsevier 10.1016/j.clnu.2024.05.014
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Background & aims A diet low in fermentable oligo-, di-, monosaccharides, and polyols (LFD) has been shown to effectively reduce irritable bowel syndrome (IBS) symptoms. Effects resulting from real-world studies may differ from those seen in efficacy studies because of the diversity of patients in real-world settings. This systematic review and meta-analysis aimed to compare the effect of the LFD on reducing IBS symptoms and improving the quality of life (QoL) in efficacy trials and real-world studies. Methods Major databases, trial registries, dissertations, and journals were systematically searched for studies on the LFD in adults with IBS. Meta-analysis was conducted using a random effects model with standardized mean differences (SMD) and 95% confidence intervals (CI). Outcomes of interest were all patient-reported: stool consistency, stool frequency, abdominal pain, overall symptoms, adequate symptom relief, IBS-specific QoL and adherence to the LFD. Results Eleven efficacy and 19 real-world studies were reviewed. The meta-analysis results for abdominal pain (SMD 0.35, 95% CI 0.16 to 0.54) and QoL (SMD 0.23, 95% CI -0.05 to 0.50) showed the LFD was beneficial in efficacy studies with no statistically significant results for stool frequency (SMD 0.71, 95% CI 0.34 to 1.07). Real-world studies found improvements in abdominal pain and QoL. Due to heterogeneity, no meta-analysis was done for stool consistency and overall symptoms. In these outcomes, results were mostly supportive of the LFD, but they were not always statistically significant. Conclusions The results of this systematic review and meta-analysis suggest the LFD improves outcomes compared to a control diet (efficacy studies) or baseline data (real-world studies). Because of diverse study designs and heterogeneity of results, a clear superiority of the LFD over control diets could not be concluded. There are no indications of an efficacy-effectiveness gap for the LFD in adults with IBS.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
School of Health Professions School of Health Professions > Nutrition and Dietetics |
Name: |
Jent, Sandra 0000-0003-1243-6197; Bez, Natalie Sara 0000-0002-2695-5361; Haddad, Joyce 0000-0002-9774-3817; Catalano, Loan 0000-0003-3926-4778; Egger, Kim Stefanie; Raia, Michela; Tedde, Giulia Simona 0000-0002-8190-7071 and Rogler, Gerhard 0000-0002-1733-9188 |
Subjects: |
R Medicine > R Medicine (General) R Medicine > RS Pharmacy and materia medica |
ISSN: |
0261-5614 |
Publisher: |
Elsevier |
Funders: |
[UNSPECIFIED] Spendenstiftung Bank Vontobel ; [UNSPECIFIED] BFH |
Projects: |
[UNSPECIFIED] EQ-ERB - Ergebnisqualität in der Ernährungsberatung |
Language: |
English |
Submitter: |
Sandra Jent |
Date Deposited: |
24 May 2024 11:32 |
Last Modified: |
24 May 2024 11:32 |
Publisher DOI: |
10.1016/j.clnu.2024.05.014 |
Uncontrolled Keywords: |
FODMAP diet Irritable bowel syndrome Dietetic Efficacy-effectiveness-gap Meta-analysis Systematic review |
ARBOR DOI: |
10.24451/arbor.21907 |
URI: |
https://arbor.bfh.ch/id/eprint/21907 |
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