Good adherence to mediterranean diet can prevent gastrointestinal symptoms: A survey from Southern Italy

Abstract

Aim: To evaluate how different levels of adherence to a mediterranean diet (MD) correlate with the onset of functional gastrointestinal disorders.

Methods: As many as 1134 subjects (598 M and 536 F; age range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms. Patients with relevant chronic organic disease were excluded from the study. The Mediterranean Diet Quality index for children and adolescents (KIDMED) and the Short Mediterranean Diet Questionnaire were administered. All subjects were grouped into five categories according to their ages: 17-24 years; 25-34; 35-49; 50-64; above 64.

Results: On the basis of the Rome III criteria, our population consisted of 719 (63.4%) individuals who did not meet the criteria for any functional disorder and were classified as controls (CNT), 172 (13.3%) patients meeting criteria for prevalent irritable bowel syndrome (IBS), and 243 (23.3%) meeting criteria for prevalent functional dyspepsia (FD). A significantly lower adherence score in IBS (0.57 ± 0.23, P < 0.001) and FD (0.56 ± 0.24, P < 0.05) was found compared to CNT (0.62 ± 0.21). Females with FD and IBS exhibited significantly lower adherence scores (respectively 0.58 ± 0.24, P < 0.05 and 0.56 ± 0.22, P < 0.05) whereas males were significantly lower only for FD (0.53 ± 0.25, P < 0.05). Age cluster analyses showed a significantly lower score in the 17-24 years and 25-34 year categories for FD (17-24 years: 0.44 ± 0.21, P < 0.001; 25-34 years: 0.48 ± 0.22, P < 0.05) and IBS (17-24 years: 0.45 ± 0.20, P < 0.05; 24-34 years: 0.44 ± 0.21, P < 0.001) compared to CNT (17-24 years: 0.56 ± 0.21; 25-34 years: 0.69 ± 0.20).

Conclusion: Low adherence to MD may trigger functional gastrointestinal symptoms, mainly in younger subjects. Moreover, with increasing age, patients tend to adopt dietary regimens closer to MD.

Keywords: Dietary regimen; Functional dyspepsia; Functional gastro-intestinal disorders; Irritable bowel syndrome; Mediterranean diet.

Figure 1

Equalized mean score to mediterranean diet in CNT, functional dyspepsia and irritable bowel syndrome patients. A: All subjects show a significantly lower adherence score in FD and irritable bowel syndrome (IBS) compared to CNT; B: In the male group only FD exhibited significantly lower adherence scores compared to CNT; C: In females a significant difference for FD and IBS compared to CNT was confirmed.

Figure 2

Distribution of equalized mean adherence score to mediterranean diet in CNT, functional dyspepsia and irritable bowel syndrome stratifying for age clusters. In the 17-24 years and 25-34 years groups both FD and IBS exhibited significantly lower mean adherence score compared to CNT. In the 35-49 years group only IBS patients exhibited a significantly lower mean score compared to CNT. No differences were observed in other age categories (data ± SEM are shown). FD: Functional dyspepsia; IBS: Irritable bowel syndrome.

Figure 3

Multivariate analysis shows a pairwise comparison of the phenotypes (body mass index category, age category, clinical pattern and sex) as follows: A: Comparison between high vs intermediate adherence to MD: only IBS was significantly associated with Intermediate adherence to MD; B: Comparison between high vs low adherence to MD: both IBS and FD as well as the youngest age category were significantly associated with low adherence to MD. The oldest group, controls, individuals presenting with third grade obesity and females are used as reference category in the multinomial regression model. MD: Mediterranean diet; IBS: Irritable bowel syndrome; FD: Functional dyspepsia.