The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome

Ellie Y Chen; Swapna Mahurkar-Joshi; Cathy Liu; Nancee Jaffe; Jennifer S Labus; Tien S Dong; Arpana Gupta; Shravya Patel; Emeran A Mayer; Lin Chang

doi:10.1016/j.cgh.2023.07.012

The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome

Clin Gastroenterol Hepatol. 2024 Jan;22(1):164-172.e6. doi: 10.1016/j.cgh.2023.07.012. Epub 2023 Jul 29.

Authors

Affiliations

¹ Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California.
² Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, Los Angeles, California; UCLA Goodman-Luskin Microbiome Center, Los Angeles, California.
³ Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; UCLA Goodman-Luskin Microbiome Center, Los Angeles, California.
⁴ University of California, Los Angeles, Los Angeles, California.
⁵ Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, Los Angeles, California; UCLA Goodman-Luskin Microbiome Center, Los Angeles, California. Electronic address: linchang@mednet.ucla.edu.

Abstract

Background & aims: Low adherence to Mediterranean diet (MD) has been shown to be associated with a higher prevalence of irritable bowel syndrome (IBS), but its association with IBS symptoms is not established. We aim to assess the association between MD and IBS symptoms, identify components of MD associated with IBS symptoms, and determine if a symptom-modified MD is associated with changes in the gut microbiome.

Methods: One hundred and six Rome +IBS and 108 health control participants completed diet history and gastrointestinal symptom questionnaires. Adherence to MD was measured using Alternate Mediterranean Diet and Mediterranean Diet Adherence Screener. Sparse partial least squares analysis identified MD food items associated with IBS symptoms. Stool samples were collected for 16S ribosomal RNA gene sequencing and microbial composition analysis in IBS subjects.

Results: Alternate Mediterranean Diet and Mediterranean Diet Adherence Screener scores were similar between IBS and health control subjects and did not correlate with Irritable Bowel Syndrome Severity Scoring System, abdominal pain, or bloating. Among IBS participants, a higher consumption of fruits, vegetables, sugar, and butter was associated with a greater severity of IBS symptoms. Multivariate analysis identified several MD foods to be associated with increased IBS symptoms. A higher adherence to symptom-modified MD was associated with a lower abundance of potentially harmful Faecalitalea, Streptococcus, and Intestinibacter, and higher abundance of potentially beneficial Holdemanella from the Firmicutes phylum.

Conclusions: A standard MD was not associated with IBS symptom severity, although certain MD foods were associated with increased IBS symptoms. Our study suggests that standard MD may not be suitable for all patients with IBS and likely needs to be personalized in those with increased symptoms.

Keywords: Irritable Bowel Syndrome; Mediterranean Diet; Microbiome; Symptoms.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Diet
Diet, Mediterranean*
Food
Gastrointestinal Diseases*
Gastrointestinal Microbiome*
Humans
Irritable Bowel Syndrome* / diagnosis
Irritable Bowel Syndrome* / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding