The Role of Dietary Energy and Macronutrients Intake in Prevalence of Irritable Bowel Syndromes

Abstract

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain and altered bowel habits in the absence of any detectable organic illnesses. Interest in the effect of dietary opponents to the IBS pathogenesis has been increased in recent years. This study aims to review previous studies to determine the relationship between IBS prevalence in community and dietary energy and macronutrients intakes according to the national nutrition surveys.

Methods: A literature search was conducted in PubMed and EMBASE to September, 2018, to identify population-based studies that reported the prevalence of IBS. Daily energy intake, daily carbohydrates, and protein and fat percent contribution to energy intake (%) were obtained from study population-based national nutrition survey. The correlations of prevalence of IBS and dietary intakes were obtained by Spearman coefficient or Pearson coefficient.

Results: Global prevalence of IBS was 11.7%. There was no correlation between overall prevalence of IBS of individual countries and national energy intake (P = 0.785), protein proportion (P = 0.063), carbohydrates proportion (P = 0.505), or fat proportion (P = 0.384) according to the years when the studies were conducted. No correlations were detected between dietary intake and male or female IBS prevalence. Interestingly, protein proportion was positively correlated with the prevalence of IBS in Rome III criteria (r = 0.569).

Conclusion: Our findings demonstrate that dietary energy and macronutrients intake do not play a direct role in prevalence of IBS. However, IBS diagnostic criteria seem to have a bias on the correlation between prevalence of IBS and dietary intake. Further studies are needed to confirm the correlation between prevalence of IBS and specific dietary intake.

Figure 1

Flow diagram of assessment of studies identified in the systematic review and meta-analysis.

Figure 2

Global prevalence of irritable bowel syndrome (IBS) (data were expressed as mean ± standard error). (a) The prevalence of IBS in Asia, North America, Europe, Australia, Africa, and South America. (b) The prevalence of IBS in 1970-1979, 1980-1989, 1990-1999, 2000-2009, and 2010-present. (c) The age distribution of subjects with IBS. (d) The predominant stool pattern in IBS patients (constipation-predominant IBS [IBS-C], diarrhea-predominant [IBS-D], mixed stool pattern [IBS-M], and unclassifiable [IBS-U]).

Figure 3

The scatterplot of prevalence of irritable bowel syndrome (IBS) and dietary factors. (a) The scatterplot of prevalence of IBS and energy intake (r = -0.027, P = 0.785, Spearman correlation). (b) The scatterplot of prevalence of IBS and protein proportion (r = 0.172, P = 0.063, Pearson correlation). (c) The scatterplot of prevalence of IBS and carbohydrates proportion (r = -0.062, P = 0.505, Spearman correlation). (d) The scatterplot of prevalence of IBS and fat proportion (r = 0.081, P = 0.384, Spearman correlation).

Figure 4

Prevalence of IBS according to diagnostic criteria. (a) The prevalence of irritable bowel syndrome (IBS) in Manning, questionnaire, Rome I, Rome II, Rome III, and Rome IV criteria (data were expressed as mean ± standard error). (b) The correlation between prevalence of IBS and protein proportion in Rome III criteria (Pearson correlation: r = 0.569, P ≤ 0.001; linear regression: R = 0.569, adjusted R² = 0.302, F = 15.300, P ≤ 0.001, ANOVA).