The Mediterranean Diet for Irritable Bowel Syndrome
Joy O. Bamidele, Grace MC Brownlow, Rosie M. Flack, Rachel L Buckle, Christian C Shaw, Mohamed G. Shiha, Imran Aziz
Abstract
BACKGROUND: Patients with irritable bowel syndrome (IBS) frequently seek dietary advice, but few evidence-based options exist. Major societal guidelines recommend traditional dietary advice (TDA) as first-line therapy, with the cumbersome and resource-intensive low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet reserved as second-line therapy. Recent pilot data suggest that the Mediterranean diet (MD), renowned for its general health benefits, improves IBS symptoms, but whether it can be considered another first-line dietary option is unknown. OBJECTIVE: To determine if the MD is noninferior to TDA in managing IBS symptoms. DESIGN: Randomized noninferiority clinical trial. (ClinicalTrials.gov: NCT05985018). SETTING: Online virtual platform. PARTICIPANTS: 139 persons with IBS from across the United Kingdom. INTERVENTION: = 71). MEASUREMENTS: Primary end point was the proportion achieving clinical response, defined as 50-point or greater reduction in IBS Symptom Severity Scale (IBS-SSS). Secondary outcomes included changes in IBS-SSS scores, psychological health, somatic symptom reporting, quality of life, diet satisfaction, and Mediterranean Diet Adherence Screener (MEDAS). RESULTS: < 0.001). LIMITATION: No long-term data. CONCLUSION: The MD showed noninferiority and superiority to TDA in managing IBS symptoms. It represents a viable first-line dietary intervention for IBS. PRIMARY FUNDING SOURCE: None.