Comparison of 4-week versus 8-week dietitian-led FODMAP diet group education sessions in tertiary care clinical practice for irritable bowel syndrome: A service evaluation

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS Journal of Human Nutrition and Dietetics Pub Date : 2024-10-08 DOI:10.1111/jhn.13381

Lee D. Martin, Pinal S. Patel

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引用次数: 0

Abstract

Background

The implementation of the fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet for irritable bowel syndrome (IBS) can be effectively delivered by dietitians in group settings. The initial FODMAP restriction phase is recommended to be followed for 4 weeks; however, limited efficacy data exist for 4-week FODMAP restriction in group education clinical practice.

Methods

We aimed to compare 4-week versus 8-week FODMAP group treatment pathways on clinical outcomes using a prospective service evaluation design of IBS patients attending FODMAP restriction (baseline) and reintroduction (follow-up) group sessions (between 2015 and 2019). Clinical outcomes included global symptom question (GSQ) measuring satisfactory relief, gastrointestinal symptom rating scale (GSRS), stool frequency (SF), stool consistency using Bristol stool form scale (BSFS), diet acceptability, patient satisfaction with group sessions and dietary adherence. Logistic regression was used to test for differences in treatment effects when clinical outcomes were compared between groups.

Results

Patients (n = 284) included were aged 18 to 86 years (mean ± SD [standard deviation], 44.6 ± 15.5), 80% female, and were split into 4-week (41%, 117/284) versus 8-week (59%, 167/284) pathways with no differences in baseline characteristics. Mean ± SD time gap between baseline and follow-up was 4.6 ± 0.9 weeks in the 4-week pathway and 9.6 ± 3.3 weeks in the 8-week pathway. When groups were compared at follow-up, no statistical differences were observed in any measures (GSQ, GSRS, SF, BSFS, dietary adherence, diet acceptability and patient satisfaction).

Conclusion

A 4-week dietitian-led group FODMAP treatment pathway is as clinically effective and maintains patient acceptability when compared to 8-weeks and should be considered as part of routine clinical practice.

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在治疗肠易激综合征的三级护理临床实践中，由营养师主导的 4 周与 8 周 FODMAP 饮食小组教育课程的比较：服务评估。

背景：可发酵低聚糖、双糖、单糖和多元醇（FODMAP）饮食治疗肠易激综合征（IBS）可由营养师在集体环境中有效实施。最初的 FODMAP 限制阶段建议持续 4 周；但在团体教育临床实践中，4 周 FODMAP 限制的疗效数据有限：我们的目的是采用前瞻性服务评估设计，对参加 FODMAP 限制（基线）和重新引入（后续）小组课程（2015 年至 2019 年）的肠易激综合征患者的临床结果进行 4 周与 8 周 FODMAP 小组治疗路径的比较。临床结果包括衡量满意缓解程度的总体症状问题（GSQ）、胃肠道症状评分量表（GSRS）、大便次数（SF）、使用布里斯托尔大便形态量表（BSFS）的大便一致性、饮食可接受性、患者对小组疗程的满意度以及饮食依从性。在比较各组临床结果时，采用逻辑回归法检验治疗效果的差异：纳入的患者（n = 284）年龄在 18 至 86 岁之间（平均值 ± SD [标准差]，44.6 ± 15.5），80% 为女性，分为 4 周（41%，117/284）和 8 周（59%，167/284）两种路径，基线特征无差异。基线与随访之间的平均（±SD）时间差为：4周（4.6 ± 0.9）周，8周（9.6 ± 3.3）周。在随访时对各组进行比较，未观察到任何测量指标（GSQ、GSRS、SF、BSFS、饮食依从性、饮食可接受性和患者满意度）存在统计学差异：结论：与 8 周治疗相比，由营养师主导的 4 周 FODMAP 集体治疗路径同样有效，并能保持患者的可接受性，应考虑将其作为常规临床实践的一部分。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.