イタリア発：低FODMAP食はIBSの不安を改善する

日本低フォドマップ食推進会

IBSの原因は不安、ストレスか？

IBSの原因は発酵食（FODMAP）か？

ストレスがIBSの原因ならば、FODMAPを抑制する食事でIBSが改善するのは何故か？

ストレス、不安は、IBSのための症状か？

卵が先か？

鶏が先か？

2017年3月、これに関する重要な報告があった。

イタリアの２大学（ピサ大学、ペルージャ医科大）から、

26人のIBS患者に対し、低FODMAP食を8週間おこなったところ、

体液や体脂肪などを測定する人体生体電気インピーダンスや栄養状態に変化はなかったが、IBSの重症度スコア、便通、便の性状、生活の質、不安スコアが改善したことが報告された。

 https://www.ncbi.nlm.nih.gov/pubmed/28567692

Tech Coloproctol. 2017 May 31. doi: 10.1007/s10151-017-1639-3. [Epub ahead of print]

Bioelectrical impedance vector analysis in patients with irritable bowel syndrome on a low FODMAP diet: a pilot study.

Bellini M¹, Gambaccini D², Bazzichi L³, Bassotti G⁴, Mumolo MG², Fani B², Costa F², Ricchiuti A², De Bortoli N², Mosca M³, Marchi S², Rossi A³.

1　Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Via Paradisa no. 2, 56100, Pisa, Italy. mbellini@med.unipi.it.

2　Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Via Paradisa no. 2, 56100, Pisa, Italy.

3　Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

4　Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.

Abstract

BACKGROUND:

The aim of this study was to determine the effects of a low fermentable oligo-, di- and monosaccharides and polyols (FODMAP) diet on the nutritional status and body composition, abdominal symptoms, quality of life, anxiety/depression and sleep quality of patients with irritable bowel syndrome (IBS).

METHODS:

Consecutive patients were given a low FODMAP diet for 8 weeks. At baseline and after 8 weeks, blood tests were taken to evaluate nutritional status and a bioelectrical impedance analysis was performed to assess body composition. Anthropometric data, IBS Symptom Severity Score, results of a bowel habits questionnaire, Bristol Stool Chart classification, SF36, Hamilton Depression Anxiety Scale outcome and Pittsburgh Sleep Quality Index were also recorded. During the 8-week diet period, the patients were phoned periodically by the nutritionist to verify their compliance.

RESULTS:

Twenty-six IBS patients with a mean age of 46.2 ± 13.8 years were studied. After 8 weeks, there were no abnormalities in anthropometric data, bioelectrical impedance parameters and blood tests. The patients' IBS Symptom Severity Score improved (305.2 ± 84.1 vs 156.3 ± 106.4; p < 0.0001), as did bowel habits, Bristol Stool Chart classification, quality of life and HADS anxiety score, whereas sleeping quality and depression were unchanged. The degree of relief from symptoms and satisfaction with the diet was high.

CONCLUSIONS:

A low FODMAP diet improved IBS symptoms without effects on nutritional status and body composition.

References

人体生体電気インピーダンス

Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C, Composition of the EWG (2004) Bioelectrical impedance analysis—part I: review of principles and methods. Clinical nutrition 23(5):1226–1243.

Kyle UG, Genton L, Pichard C (2013) Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission. Clin Nutr 32(2):294–299. 

Alves FD, Souza GC, Aliti GB, Rabelo-Silva ER, Clausell N, Biolo A (2015) Dynamic changes in bioelectrical impedance vector analysis and phase angle in acute decompensated heart failure. Nutrition 31(1):84–89. 

不安スコア：HADS anxiety score

Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

ハミルトンスコア

http://healthnet.umassmed.edu/mhealth/HAMD.pdf

http://dcf.psychiatry.ufl.edu/files/2011/05/HAMILTON-ANXIETY.pdf

抑うつ気分、罪業、自殺企図、入眠障害、熟眠障害、早朝覚醒、精神運動抑制、激越（落着き状況）、精神不安（恐怖、緊張）、身体不安、消化器症状、身体症状（頭重感、背部痛など）、生殖器症状、心気症、体重減少、病識

・・・・・・・・・・・・・・・・・・