Uno Y

 

 

低FODMAP食について

ロイターは、

過敏性腸症候群の食事療法である低FODMAP食は、栄養素の欠乏にはつながらないが、

食事の質を低下させると発信した。

 

 

https://www.medscape.com/viewarticle/913435?src=wnl_edit_tpal&uac=231753EV&impID=1974866&faf=1

Overall Diet Quality in Many With IBS Is Poor

By Lorraine L. Janeczko

May 24, 2019

 

NEW YORK (Reuters Health) - Many people with irritable bowel syndrome (IBS) don't get the nutrition they need, according to new research from the United Kingdom.

 

"The study demonstrates that a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet does not significantly impact the quality of nutrient intake or the diversity of one's diet but it can lead to lower diet quality, meaning lower intake of suitable fruits, vegetables, and whole grains," said Dr. M. Elizabeth Swenor, a physician specializing in metabolic and nutritional medicine at the Henry Ford Center for Integrative Medicine in Northville, Michigan, who was not involved in the study.

 

"Poor diet - high saturated fats, processed foods, and high added sugars - is one of the causes of IBS," she told Reuters Health by email.

 

For the study, online April 24 in the Journal of the Academy of Nutrition and Dietetics, Dr. Miranda C. E. Lomer of King's College London and colleagues analyzed data from two randomized controlled trials involving 130 adults with diarrhea-predominant (IBS-D), mixed, or unsubtyped IBS, at one academic medical center.

 

Patients in the first study were referred to the center for treatment, including advice from a specialist dietitian, in 2010 and 2011, and those in the second study were referred in 2013 and 2014.

 

In one study, patients received either low FODMAP dietary counseling or sham control dietary counseling. In the other, they received either low FODMAP dietary counseling or advice to continue their usual diet. The usual dietary intake for all participants was recorded at baseline and after a four-week intervention period, using seven-day food records.

 

A total of 63 participants were randomized to a low FODMAP diet, and 67 to a control diet (48 ate a "sham diet" and 19 ate their habitual foods).

 

Among participants in the habitual-diet group, fiber intake was low, with only six (5%) of them reaching the target 30 g/day.

Among participants receiving low-FODMAP advice, intake of most nutrients was similar to the intake of the controls. But they consumed significantly less starch than the habitual controls (109 g/day vs. 128 g/day) and more vitamin B-12 than those on the habitual and sham control diets (6.1 mg/day, 3.9 mg/day and 4.7 mg/day).

 

Overall diet quality scores were significantly lower after low FODMAP advice than after the habitual control diet.

 

Dr. Swenor said she was not surprised by the results as they highlight the habitually poor diet quality of people with IBS-D individuals.

 

The supervision of a specialist dietitian was a limitation, Dr. Swenor said. "Studies of compliance, dietary diversity, nutrient intake, and quality need to be investigated with individuals who are not under close dietitian supervision."

 

"IBS-D is a pervasive medical concern," she explained. "The study of the gut microbiome and IBS-D, and the inclusion and exclusion of specific nutritional intake and its effect on the symptomatology of IBS-D warrant further investigation."

 

The National Institute for Health Research (NIHR) funded the study.

 

Dr. Lomer was unable to comment on the study by press time. She reports be the co-inventor of a mobile application involving the low-FODMAP diet.

 

SOURCE: https://bit.ly/2M6FQpv

 

J Acad Nutr Diet 2019.

 

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＜コメント＞

この記事は、主に、以下の論文を引用している。

Staudacher HM, Ralph FSE, Irving PM, Whelan K, Lomer MCE.

Nutrient Intake, Diet Quality, and Diet Diversity in Irritable Bowel Syndrome and the Impact of the Low FODMAP Diet.

J Acad Nutr Diet. 2019 Apr 24. pii: S2212-2672(18)31829-X

 

この記事の問題は、意見を求めたM. Elizabeth Swenorは、健康食品の専門家ではあるが、過敏性腸症候群に関しての研究についての実績（論文）がひとつもないのである。つまり、医学的には、過敏性腸症候群を語る資格がない、この分野では素人である。そして、困ったことに、食物繊維を摂取して腸内に良い菌を増やすことで、健康になれるという古い概念の持ち主である。そういう古い概念の持ち主にとって、低FODMAP食は、自分が築いてきた地位や立場を脅かすものであることは理解できる。しかし、反論があるならば、それなりに査読過程のある医学雑誌に投稿して、アクセプトされてから話すべきであろう。

しかし、このような人たちの概念を根本的に覆すためには、より重厚な医学的戦略が必要である。