Mediterranean diet better than TDA in reducing IBS symptoms

The Mediterranean diet (MD) appears to be more effective than traditional dietary advice (TDA) in the management of irritable bowel syndrome (IBS) symptoms, suggests a study.

A randomized clinical trial was conducted via online virtual platform to determine if MD is noninferior to TDA in managing IBS symptoms. Overall, 139 individuals with IBS from across the UK were randomly assigned to receive 6 weeks of MD (n=68) or TDA (n=71).

The proportion achieving clinical response, the primary endpoint, was defined as 50-point or greater decrease in the IBS Symptom Severity Scale (IBS-SSS). Other outcomes included changes in IBS-SSS scores, psychological health, somatic symptom reporting, quality of life, diet satisfaction, and Mediterranean Diet Adherence Screener (MEDAS).

The two groups had similar baseline characteristics (mean age 40.4 years, 80 percent women) and IBS-SSS (mean 309).

Of the participants, 62 percent (95 percent confidence interval [CI], 50–73) in the MD group met the primary endpoint compared with 42 percent (95 percent CI, 31–55) in the TDA group on modified intention-to-treat analysis.

The difference in clinical response was favourable to MD (difference, 20 percentage points, 95 percent CI, 4–36; p=0.017), indicating both noninferiority and superiority. Furthermore, a greater decrease in the mean IBS-SSS was noted following MD than TDA (–101.2 vs –64.5; difference, –36.7, 95 percent CI, –70.5 to –2.8; p=0.034).

No significant between-group differences were noted in change in mood, somatic symptoms, quality of life, or diet satisfaction. Moreover, the MEDAS rose significantly following MD vs TDA (p<0.001).

“The MD showed noninferiority and superiority to TDA in managing IBS symptoms,” the investigators said. “It represents a viable first-line dietary intervention for IBS.”