Top

Published in:

01-06-2017 | Original Article

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

Authors: M. Bellini, D. Gambaccini, L. Bazzichi, G. Bassotti, M. G. Mumolo, B. Fani, F. Costa, A. Ricchiuti, N. De Bortoli, M. Mosca, S. Marchi, A. Rossi

Published in: Techniques in Coloproctology | Issue 6/2017

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.

Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R (2016) Bowel disorders. Gastroenterology. doi:10.1053/j.gastro.2016.02.031 PubMedCentral

Bellini M, Tosetti C, Costa F, Biagi S, Stasi C, Del Punta A, Monicelli P, Mumolo MG, Ricchiuti A, Bruzzi P, Marchi S (2005) The general practitioner’s approach to irritable bowel syndrome: from intention to practice. Dig Liver Dis 37(12):934–939. doi:10.1016/j.dld.2005.06.011 CrossRefPubMed

Thomas A, Quigley EM (2015) Diet and irritable bowel syndrome. Curr Opin Gastroenterol 31(2):166–171. doi:10.1097/MOG.0000000000000158 CrossRefPubMed

Gibson PR, Shepherd SJ (2010) Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach. J Gastroenterol Hepatol 25(2):252–258. doi:10.1111/j.1440-1746.2009.06149.x CrossRefPubMed

Barrett JS, Gearry RB, Muir JG, Irving PM, Rose R, Rosella O, Haines ML, Shepherd SJ, Gibson PR (2010) Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 31(8):874–882. doi:10.1111/j.1365-2036.2010.04237.x PubMed

Magge S, Lembo A (2012) Low-FODMAP Diet for treatment of irritable bowel syndrome. Gastroenterol Hepatol 8(11):739–745

Mansueto P, Seidita A, D’Alcamo A, Carroccio A (2015) Role of FODMAPs in patients with irritable bowel syndrome. Nutr Clin Pract 30(5):665–682. doi:10.1177/0884533615569886 CrossRefPubMed

Marsh A, Eslick EM, Eslick GD (2016) Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr 55(3):897–906. doi:10.1007/s00394-015-0922-1 CrossRefPubMed

Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Gibson PR, Muir JG (2015) Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut 64(1):93–100. doi:10.1136/gutjnl-2014-307264 CrossRefPubMed

10.

Gibson PR, Muir JG (2013) Non-nutritional effects of food: an underutilized and understudied therapeutic tool in chronic gastrointestinal diseases. J Gastroenterol Hepatol 28(Suppl 4):37–40. doi:10.1111/jgh.12253 CrossRefPubMed

11.

Barrett JS (2013) Extending our knowledge of fermentable, short-chain carbohydrates for managing gastrointestinal symptoms. Nutr Clin Pract 28(3):300–306. doi:10.1177/0884533613485790 CrossRefPubMed

12.

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. doi:10.1016/j.clnu.2004.06.004 CrossRefPubMed

13.

Piccoli A, Nigrelli S, Caberlotto A, Bottazzo S, Rossi B, Pillon L, Maggiore Q (1995) Bivariate normal values of the bioelectrical impedance vector in adult and elderly populations. Am J Clin Nutr 61(2):269–270PubMed

14.

Piccoli A, Rossi B, Pillon L, Bucciante G (1994) A new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph. Kidney Int 46(2):534–539CrossRefPubMed

15.

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. doi:10.1016/j.clnu.2012.08.001 CrossRefPubMed

16.

Kyle UG, Soundar EP, Genton L, Pichard C (2012) Can phase angle determined by bioelectrical impedance analysis assess nutritional risk? A comparison between healthy and hospitalized subjects. Clin Nutr 31(6):875–881. doi:10.1016/j.clnu.2012.04.002 CrossRefPubMed

17.

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. doi:10.1016/j.nut.2014.05.004 CrossRefPubMed

18.

Caccialanza R, Cereda E, Klersy C, Bonardi C, Cappello S, Quarleri L, Turri A, Montagna E, Iacona I, Valentino F, Pedrazzoli P (2015) Phase angle and handgrip strength are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. Nutrients 7(3):1828–1840. doi:10.3390/nu7031828 CrossRefPubMedPubMedCentral

19.

Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006) Functional bowel disorders. Gastroenterology 130(5):1480–1491. doi:10.1053/j.gastro.2005.11.061 CrossRefPubMed

20.

Lohman TG, Roche AF, Martorell R (1988) Anthropometric standardization reference manual. Human Kinetics Books, Champaign

21.

Buffa R, Saragat B, Cabras S, Rinaldi AC, Marini E (2013) Accuracy of specific BIVA for the assessment of body composition in the United States population. PLoS ONE 8(3):e58533. doi:10.1371/journal.pone.0058533 CrossRefPubMedPubMedCentral

22.

Ibanez ME, Mereu E, Buffa R, Gualdi-Russo E, Zaccagni L, Cossu S, Rebato E, Marini E (2015) New specific bioelectrical impedance vector reference values for assessing body composition in the Italian-Spanish young adult population. Am J Human Biol 27(6):871–876. doi:10.1002/ajhb.22728 CrossRef

23.

Francis CY, Morris J, Whorwell PJ (1997) The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 11(2):395–402CrossRefPubMed

24.

Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32(9):920–924. doi:10.3109/00365529709011203 CrossRefPubMed

25.

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

26.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213CrossRefPubMed

27.

Varney J, Barrett J, Scarlata K, Catsos P, Gibson PR, Muir JG (2017) FODMAPs: food composition, defining cutoff values and international application. J Gastroenterol Hepatol 32(Suppl 1):53–61. doi:10.1111/jgh.13698 CrossRefPubMed

28.

Muir JG, Shepherd SJ, Rosella O, Rose R, Barrett JS, Gibson PR (2007) Fructan and free fructose content of common Australian vegetables and fruit. J Agric Food Chem 55(16):6619–6627. doi:10.1021/jf070623x CrossRefPubMed

29.

Muir JG, Rose R, Rosella O, Liels K, Barrett JS, Shepherd SJ, Gibson PR (2009) Measurement of short-chain carbohydrates in common Australian vegetables and fruits by high-performance liquid chromatography (HPLC). J Agric Food Chem 57(2):554–565. doi:10.1021/jf802700e CrossRefPubMed

30.

Biesiekierski JR, Rosella O, Rose R, Liels K, Barrett JS, Shepherd SJ, Gibson PR, Muir JG (2011) Quantification of fructans, galacto-oligosaccharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet 24(2):154–176. doi:10.1111/j.1365-277X.2010.01139.x CrossRefPubMed

31.

Catassi G, Lionetti E, Gatti S, Catassi C (2017) The low FODMAP diet: many question marks for a catchy acronym. Nutrients. doi:10.3390/nu9030292

32.

Barbosa-Silva MC, Barros AJ (2005) Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations. Curr Opin Clin Nutr Metab Care 8(3):311–317CrossRefPubMed

33.

Nanayakkara WS, Skidmore PM, O’Brien L, Wilkinson TJ, Gearry RB (2016) Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date. Clin Exp Gastroenterol 9:131–142. doi:10.2147/CEG.S86798 PubMedPubMedCentral

34.

Iacovou M, Tan V, Muir JG, Gibson PR (2015) The low FODMAP diet and its application in East and Southeast Asia. J Neurogastroenterol Motil 21(4):459–470. doi:10.5056/jnm15111 CrossRefPubMedPubMedCentral

Title: Bioelectrical impedance vector analysis in patients with irritable bowel syndrome on a low FODMAP diet: a pilot study
Authors: M. Bellini
D. Gambaccini
L. Bazzichi
G. Bassotti
M. G. Mumolo
B. Fani
F. Costa
A. Ricchiuti
N. De Bortoli
M. Mosca
S. Marchi
A. Rossi
Publication date: 01-06-2017
Publisher: Springer International Publishing
Published in: Techniques in Coloproctology / Issue 6/2017
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-017-1639-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2017

Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review

Dynamic cystocolpoproctography to confirm the efficacy of laparoscopic rectopexy in the treatment of hedrocele associated with full-thickness rectal prolapse

The use of carbon dioxide insufflation to facilitate identification of intestinal injuries in patients undergoing cytoreductive surgery and intraperitoneal chemotherapy

Pelvic exenteration with en bloc resection of the pelvic sidewall and intraoperative electron beam radiotherapy with Mobetron® for locally advanced rectal cancer

Anal fistula surgery: what are the patients expecting from the surgeon?

Anterior rectal duplication treated with transanal endoscopic microsurgery