Medically reviewed by Onikepe Adegbola, MD, PhD
The treatment of irritable bowel syndrome (IBS) is quite challenging. One of the most effective treatment options is to change dietary patterns. Dietary interventions that reduce IBS symptoms include the low FODMAP diets (LFD). But recent studies have shown that the Mediterranean Diet can also be effective against IBS.
In this study, researchers reviewed the immunomodulatory effect of the Mediterranean Diet combined with the LFD on IBS symptoms. This review was published in the Journal of Microorganisms in March 2022.
IBS is a chronic functional gastrointestinal disorder that affects millions of people worldwide. No biochemical patterns or structural abnormalities are detected, but there are symptoms such as abdominal pain, flatulence, bloating, and changes in bowel habits.
IBS is divided into four subgroups. IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unclassified IBS (IBS-U) are the types of IBS.
Researchers looked at the immunomodulatory effects of the MedDiet and saw if combining the two diets would be effective in treating this functional impairment.
Effects Of LFD On IBS
The LFD diet restricts carbohydrate intake. Hence, incomplete carbohydrate absorption causes gas and water retention. Long-term use of the LFD is expected to have a deleterious impact on the gut microbiota due to the reduction in prebiotic consumption.
The LFD relieves symptoms in IBS-C patients to a lower extent than in other subtypes, although it may be a helpful treatment regardless of IBS categorization.
The subgroups were tiny, according to some researchers, and further research is needed to determine whether the LFD is equally helpful for all IBS subtypes.
Many studies recommend taking probiotics along with LFDs to help replace the beneficial bacteria lost. Probiotics improved bowel function and symptoms in over 80 studies involving over 10,000 participants.
Irritable bowel syndrome patients were randomly assigned to one of three low-FODMAP diets, which differed only in the quantity of fiber they contained. According to the findings, a low-FODMAP diet paired with dietary fiber is good for treating IBS symptoms.
Effects of the Mediterranean Diet on IBS
The Mediterranean Diet has several antioxidants and anti-inflammatory components. The anti-inflammatory elements in this diet include omega-3 fatty acids, olive oil, phenolic compounds, and fiber.
The LFD helps with IBS symptoms but doesn’t help with inflammation. The Mediterranean Diet, on the other hand, contains anti-inflammatory and immunomodulatory qualities, as well as the ability to boost the number of beneficial bacteria in the intestines.
Thus, the Mediterranean Diet is a sensible dietary pattern and scientifically validated means of treating various ailments, whereas the LFD can detect food intolerances. Mediterranean diets, on the other hand, are suggested for chronic inflammation-related disorders.
IBS patients haven’t been the subject of any research on the Mediterranean Diet, which is full of fruits, vegetables, and legumes, which are high in FODMAPs. Patients with IBS have low-grade inflammation of the bowels. The LFD helps with IBS symptoms, but it doesn’t help manage the inflammatory response. The Mediterranean Diet has anti-inflammatory and immunomodulating properties, and it increases beneficial bacteria in the intestines. The LFD could be used to find out what foods people are intolerant to.
The authors suggest combining the LFD and the Mediterranean Diet as a dietary treatment for IBS. They suggest adding the Med Mediterranean Diet’s anti-inflammatory and prebiotic ingredients to the LFD could make the LFD more effective and eliminate its downsides.
This new dietary combination of the LFD and the Mediterranean Diet is being tested in a clinical trial called NCT03997708. In this study, the effectiveness of the Mediterranean Diet and the LFD will be compared with the nutritional recommendations of NICE in managing IBS, as well as how well the Mediterranean Diet and the LFD work alone. In addition, the trial will look at how each dietary intervention affects the gut microbiota so as to understand how the two dietary interventions work together.
Kasti, A., Petsis, K., Lambrinou, S., Katsas, K., Nikolaki, M., Papanikolaou, I. S., Hatziagelaki, E., & Triantafyllou, K. (2022). A Combination of Mediterranean and Low-FODMAP Diets for Managing IBS Symptoms? Ask Your Gut!. Microorganisms, 10(4), 751. https://doi.org/10.3390/microorganisms10040751