Impact of FODMAP Content Restrictions on the Quality of Diet for Patients with Celiac Disease on a Gluten-Free Diet
Impact of FODMAP Content Restrictions on the Quality of Diet for Patients with Celiac Disease on a Gluten-Free Diet
复制标题
DOI：
10.3390/nu11092220
复制
发表时间：
2019-09-01
期刊：
影响因子：
5.9
通讯作者：
Roncoroni, Leda
中科院分区：
文献类型：
--
作者：
Bascunan, Karla A.;Elli, Luca;Roncoroni, Leda
限制性饮食如无麸质（GFD）或减少可发酵、寡糖、二糖、单糖和多元醇（FODMAP）用于改善敏感个体的胃肠道（GI）症状。为了比较常规GFD方案（R-GFD）和低FODMAP GFD（LF-GFD）的营养质量和效果，我们在46例持续GI症状的乳糜泻患者中进行了一项随机、双盲干预对照研究。患者接受个性化饮食，无论是严格的GFD（n = 21）或LF-GFD（n = 25）21天。在干预前，一个有效的食物频率问卷和干预后7天的称重食物记录评估了饮食。患者年龄为41.1 ± 10.1岁（平均值± SD），94%为女性，平均BMI为21.8 ± 2.9 kg/m（2）。在第21天，与膳食建议相比，接受R-GFD的患者仍然显示出较差的营养充足性，能量摄入减少，尽管观察到碳水化合物和叶酸的改善（所有p < 0.025）。在这两组中，铁、钙、维生素D、钠和叶酸的摄入量都没有达到每日推荐量。正如预期的那样，LF-GFD组的豆类和谷物消费量低于R-GFD组，水果消费量高于R-GFD组（所有p < 0.05）。两种饲料的营养质量没有差异。当限制性饮食有助于改善持续的胃肠道症状时，必须进行仔细的营养监测和咨询。
Restrictive diets as gluten-free (GFD) or reduced in Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) are used to improve gastrointestinal (GI) symptoms in sensitive individuals. Aiming at comparing the nutritional quality and effects of a regular GFD regimen (R-GFD) and a low-FODMAP GFD (LF-GFD), in 46 celiac patients with persistent GI symptoms we conducted a randomized, double-blind intervention-controlled study. Patients received a personalized diet, either a strict GFD (n = 21) or a LF-GFD (n = 25) for 21 days. A validated food-frequency questionnaire before intervention and a 7-day weighed-food record after the intervention assessed the diets. Patients were 41.1 +/- 10.1 years (mean +/- SD), 94% women, with mean BMI 21.8 +/- 2.9 kg/m(2). On day 21, patients on R-GFD still showed poor nutritional adequacy compared to dietary recommendations, with decreased energy intake, even though an improvement in carbohydrates and folates was observed (all p < 0.025). In both groups, intake of iron, calcium, vitamin D, sodium and folates did not meet daily recommendations. As expected, consumption of legumes and grains was lower and that of fruits was higher in the LF-GFD group than in the R-GFD one (all p < 0.05). The nutritional quality of both diets was not different. When restrictive diets are useful to improve the persistent GI symptoms, careful nutritional surveillance and counseling is mandatory.