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Gut. 2018 May;67(5):872-881. doi: 10.1136/gutjnl-2016-313128. Epub 2017 Apr 17.

Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs.

Author information

1
Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
2
Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
3
Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
4
Department of Nutrition, Karolinska University Hospital, Stockholm, Sweden.
5
Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden.
6
Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
7
School of Health and Education, University of Skövde, Skövde, Sweden.

Abstract

OBJECTIVE:

The effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.

DESIGN:

Sixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.

RESULTS:

Responders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption.

CONCLUSIONS:

A low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.

TRIAL REGISTRATION NUMBER:

NCT02107625.

KEYWORDS:

DIET; INTESTINAL BACTERIA; IRRITABLE BOWEL SYNDROME

PMID:
28416515
DOI:
10.1136/gutjnl-2016-313128
[Indexed for MEDLINE]

Conflict of interest statement

Competing interests: MS has received unrestricted research grants from Danone, and Ferring Pharmaceuticals and served as a Consultant/Advisory Board member for AstraZeneca, Danone, Nestlé, Chr Hansen, Almirall, Allergan, Albireo, Glycom and Shire, and as a speaker for Tillotts, Takeda, Menarini, Allergan, Shire and Almirall. HT has served as Consultant/Advisory Board member for Almirall, Allergan, Danone and Shire. LÖ has served as Consultant/Advisory Board member for Genetic Analysis, has received unrestricted research grants from AstraZeneca, and as a speaker for Takeda, AbbVie and Meda. PL has served as Consultant/Advisory Board member for Almirall, Allergan, Abbvie and Shire.

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