Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome
Summary Background Grains are high in FODMAPs (Fermentable Oligo‐, Di‐, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms. Aim To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS. Methods The study was conducted as...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2016-09, Vol.44 (5), p.460-470 |
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| creator | Laatikainen, R. Koskenpato, J. Hongisto, S.‐M. Loponen, J. Poussa, T. Hillilä, M. Korpela, R. |
| description | Summary
Background
Grains are high in FODMAPs (Fermentable Oligo‐, Di‐, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms.
Aim
To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS.
Methods
The study was conducted as a randomised double blind controlled cross‐over study (n = 87). Participants were supplied with both regular rye bread and low‐FODMAP rye bread for 4 weeks. Symptoms were measured with a symptom severity scoring system (IBS‐SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.
Results
Dietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low‐FODMAP rye bread (P‐values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [−3 (95% CI): −6 to −1, P = 0.02] but no differences were detected in IBS‐SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low‐FODMAP bread period (median 52.9 vs. 72.6; P = 0.01).
Conclusions
Low‐FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low‐FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS‐SSS. Nonetheless, inclusion of low‐FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake. |
| doi_str_mv | 10.1111/apt.13726 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5113694</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1809051038</sourcerecordid><originalsourceid>FETCH-LOGICAL-c7056-b1e162d3714e090fd23d206a67a7a68c208350e48eab3b5f4e54ae540dbd1c723</originalsourceid><addsrcrecordid>eNp1kc1q3DAQx0VoSTZpD3mBoGNz8EYftuTtobDkoy2kJJT0LMbWOFGRra3k3WXJpY_QZ-yTVO2mITlEIAQzP34a5k_IIWdTns8JLMYpl1qoHTLhUlWFYFK9IhMm1KwQNZd7ZD-l74wxpZnYJXtCl1xLWU_I_VcYbOhdQktb7wbXgqdjdODfUx_Wv3_-urg6-zK_pnGDtIkIlq7SlEa8XXqIT6pjyEXvcIV0vEOaNv1iDH2ioaMuRjdC4zMa1uhzb7Ax9PiGvO7AJ3z78B6QbxfnN6efisurj59P55dFq1mlioYjV8JKzUtkM9ZZIa1gCpQGDapuBatlxbCsERrZVF2JVQn5MttY3mohD8iHrXexbHq0LQ5jBG8W0fUQNyaAM887g7szt2FlKp63OSuz4N2DIIYfS0yjyQtr0XsYMCyT4XWeq-JM1hk93qJtDClF7B6_4cz8DcvksMy_sDJ79HSuR_J_Ohk42QJr53HzssnMr2-2yj-FG6Ff</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1809051038</pqid></control><display><type>article</type><title>Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Laatikainen, R. ; Koskenpato, J. ; Hongisto, S.‐M. ; Loponen, J. ; Poussa, T. ; Hillilä, M. ; Korpela, R.</creator><creatorcontrib>Laatikainen, R. ; Koskenpato, J. ; Hongisto, S.‐M. ; Loponen, J. ; Poussa, T. ; Hillilä, M. ; Korpela, R.</creatorcontrib><description>Summary
Background
Grains are high in FODMAPs (Fermentable Oligo‐, Di‐, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms.
Aim
To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS.
Methods
The study was conducted as a randomised double blind controlled cross‐over study (n = 87). Participants were supplied with both regular rye bread and low‐FODMAP rye bread for 4 weeks. Symptoms were measured with a symptom severity scoring system (IBS‐SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.
Results
Dietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low‐FODMAP rye bread (P‐values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [−3 (95% CI): −6 to −1, P = 0.02] but no differences were detected in IBS‐SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low‐FODMAP bread period (median 52.9 vs. 72.6; P = 0.01).
Conclusions
Low‐FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low‐FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS‐SSS. Nonetheless, inclusion of low‐FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.13726</identifier><identifier>PMID: 27417338</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Abdominal Pain - diet therapy ; Adult ; Bread ; Breath Tests ; Cross-Over Studies ; Diet - methods ; Diet Records ; Disaccharides - administration & dosage ; Double-Blind Method ; Female ; Fermentation ; Humans ; Irritable Bowel Syndrome - diagnosis ; Irritable Bowel Syndrome - diet therapy ; Male ; Middle Aged ; Monosaccharides - administration & dosage ; Oligosaccharides - administration & dosage ; Polymers - administration & dosage ; Quality of Life ; Randomised Clinical Trial ; Randomised Clinical Trials ; Secale</subject><ispartof>Alimentary pharmacology & therapeutics, 2016-09, Vol.44 (5), p.460-470</ispartof><rights>2016 The Authors. published by John Wiley & Sons Ltd</rights><rights>2016 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c7056-b1e162d3714e090fd23d206a67a7a68c208350e48eab3b5f4e54ae540dbd1c723</citedby><cites>FETCH-LOGICAL-c7056-b1e162d3714e090fd23d206a67a7a68c208350e48eab3b5f4e54ae540dbd1c723</cites><orcidid>0000-0003-2907-0291</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.13726$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.13726$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27417338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laatikainen, R.</creatorcontrib><creatorcontrib>Koskenpato, J.</creatorcontrib><creatorcontrib>Hongisto, S.‐M.</creatorcontrib><creatorcontrib>Loponen, J.</creatorcontrib><creatorcontrib>Poussa, T.</creatorcontrib><creatorcontrib>Hillilä, M.</creatorcontrib><creatorcontrib>Korpela, R.</creatorcontrib><title>Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Grains are high in FODMAPs (Fermentable Oligo‐, Di‐, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms.
Aim
To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS.
Methods
The study was conducted as a randomised double blind controlled cross‐over study (n = 87). Participants were supplied with both regular rye bread and low‐FODMAP rye bread for 4 weeks. Symptoms were measured with a symptom severity scoring system (IBS‐SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.
Results
Dietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low‐FODMAP rye bread (P‐values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [−3 (95% CI): −6 to −1, P = 0.02] but no differences were detected in IBS‐SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low‐FODMAP bread period (median 52.9 vs. 72.6; P = 0.01).
Conclusions
Low‐FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low‐FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS‐SSS. Nonetheless, inclusion of low‐FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.</description><subject>Abdominal Pain - diet therapy</subject><subject>Adult</subject><subject>Bread</subject><subject>Breath Tests</subject><subject>Cross-Over Studies</subject><subject>Diet - methods</subject><subject>Diet Records</subject><subject>Disaccharides - administration & dosage</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Fermentation</subject><subject>Humans</subject><subject>Irritable Bowel Syndrome - diagnosis</subject><subject>Irritable Bowel Syndrome - diet therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monosaccharides - administration & dosage</subject><subject>Oligosaccharides - administration & dosage</subject><subject>Polymers - administration & dosage</subject><subject>Quality of Life</subject><subject>Randomised Clinical Trial</subject><subject>Randomised Clinical Trials</subject><subject>Secale</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc1q3DAQx0VoSTZpD3mBoGNz8EYftuTtobDkoy2kJJT0LMbWOFGRra3k3WXJpY_QZ-yTVO2mITlEIAQzP34a5k_IIWdTns8JLMYpl1qoHTLhUlWFYFK9IhMm1KwQNZd7ZD-l74wxpZnYJXtCl1xLWU_I_VcYbOhdQktb7wbXgqdjdODfUx_Wv3_-urg6-zK_pnGDtIkIlq7SlEa8XXqIT6pjyEXvcIV0vEOaNv1iDH2ioaMuRjdC4zMa1uhzb7Ax9PiGvO7AJ3z78B6QbxfnN6efisurj59P55dFq1mlioYjV8JKzUtkM9ZZIa1gCpQGDapuBatlxbCsERrZVF2JVQn5MttY3mohD8iHrXexbHq0LQ5jBG8W0fUQNyaAM887g7szt2FlKp63OSuz4N2DIIYfS0yjyQtr0XsYMCyT4XWeq-JM1hk93qJtDClF7B6_4cz8DcvksMy_sDJ79HSuR_J_Ohk42QJr53HzssnMr2-2yj-FG6Ff</recordid><startdate>201609</startdate><enddate>201609</enddate><creator>Laatikainen, R.</creator><creator>Koskenpato, J.</creator><creator>Hongisto, S.‐M.</creator><creator>Loponen, J.</creator><creator>Poussa, T.</creator><creator>Hillilä, M.</creator><creator>Korpela, R.</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2907-0291</orcidid></search><sort><creationdate>201609</creationdate><title>Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome</title><author>Laatikainen, R. ; Koskenpato, J. ; Hongisto, S.‐M. ; Loponen, J. ; Poussa, T. ; Hillilä, M. ; Korpela, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c7056-b1e162d3714e090fd23d206a67a7a68c208350e48eab3b5f4e54ae540dbd1c723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Pain - diet therapy</topic><topic>Adult</topic><topic>Bread</topic><topic>Breath Tests</topic><topic>Cross-Over Studies</topic><topic>Diet - methods</topic><topic>Diet Records</topic><topic>Disaccharides - administration & dosage</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Fermentation</topic><topic>Humans</topic><topic>Irritable Bowel Syndrome - diagnosis</topic><topic>Irritable Bowel Syndrome - diet therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monosaccharides - administration & dosage</topic><topic>Oligosaccharides - administration & dosage</topic><topic>Polymers - administration & dosage</topic><topic>Quality of Life</topic><topic>Randomised Clinical Trial</topic><topic>Randomised Clinical Trials</topic><topic>Secale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laatikainen, R.</creatorcontrib><creatorcontrib>Koskenpato, J.</creatorcontrib><creatorcontrib>Hongisto, S.‐M.</creatorcontrib><creatorcontrib>Loponen, J.</creatorcontrib><creatorcontrib>Poussa, T.</creatorcontrib><creatorcontrib>Hillilä, M.</creatorcontrib><creatorcontrib>Korpela, R.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laatikainen, R.</au><au>Koskenpato, J.</au><au>Hongisto, S.‐M.</au><au>Loponen, J.</au><au>Poussa, T.</au><au>Hillilä, M.</au><au>Korpela, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2016-09</date><risdate>2016</risdate><volume>44</volume><issue>5</issue><spage>460</spage><epage>470</epage><pages>460-470</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
Grains are high in FODMAPs (Fermentable Oligo‐, Di‐, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms.
Aim
To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS.
Methods
The study was conducted as a randomised double blind controlled cross‐over study (n = 87). Participants were supplied with both regular rye bread and low‐FODMAP rye bread for 4 weeks. Symptoms were measured with a symptom severity scoring system (IBS‐SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.
Results
Dietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low‐FODMAP rye bread (P‐values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [−3 (95% CI): −6 to −1, P = 0.02] but no differences were detected in IBS‐SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low‐FODMAP bread period (median 52.9 vs. 72.6; P = 0.01).
Conclusions
Low‐FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low‐FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS‐SSS. Nonetheless, inclusion of low‐FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>27417338</pmid><doi>10.1111/apt.13726</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2907-0291</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Abdominal Pain - diet therapy Adult Bread Breath Tests Cross-Over Studies Diet - methods Diet Records Disaccharides - administration & dosage Double-Blind Method Female Fermentation Humans Irritable Bowel Syndrome - diagnosis Irritable Bowel Syndrome - diet therapy Male Middle Aged Monosaccharides - administration & dosage Oligosaccharides - administration & dosage Polymers - administration & dosage Quality of Life Randomised Clinical Trial Randomised Clinical Trials Secale |
| title | Randomised clinical trial: low‐FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome |
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