Habitual intake of macronutrients and fermentable oligo-, di-, monosaccharides and polyols is not associated with irritable bowel syndrome-like symptoms in inflammatory bowel disease

Insaf Zerouga¹, Jørgen Valeur², Christine Sommer³, Monica Hauger Carlsen⁴, Milada Hagen⁵, Marte Lie Høivik⁶, Vendel Ailin Kristensen⁶, Randi Opheim⁷, Laila Arnesdatter Hopstock⁸, Vibeke Strande⁹, Charlotte Lund⁶, Raziye Boyar¹⁰, Øivind Asak¹¹, May-Bente Bengtson¹², Tone Bergene Aabrekk¹³, Øistein Hovde¹⁴, Gert Huppertz-Hauss¹⁵, Trond Espen Detlie¹⁶, Petr Ricanek¹⁷, Svein Oskar Frigstad¹⁸, Audun Stubhaug¹⁹, Anne-Marie Aas²⁰

Affiliations

¹ Section of Nutrition and Dietetics, Department of Clinical Service, Division of Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: insaf.zerouga@studmed.uio.no.
² Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.
³ Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
⁴ Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
⁵ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; Department of Public Health, Oslo Metropolitan University, Oslo, Norway.
⁶ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
⁷ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; Department of Public Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
⁸ Department of Health and Care Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway.
¹⁰ Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway.
¹¹ Medical Department, Innlandet Hospital Trust, Lillehammer, Norway.
¹² Department of Gastroenterology, Vestfold Hospital Trust, Tønsberg, Norway.
¹³ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Vestfold Hospital Trust, Tønsberg, Norway.
¹⁴ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Gastrointestinal Department, Innlandet Hospital Trust, Gjøvik, Norway.
¹⁵ Department of Gastroenterology, Telemark Hospital Trust, Skien, Norway.
¹⁶ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.
¹⁷ Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway.
¹⁸ Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.
¹⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.
²⁰ Section of Nutrition and Dietetics, Department of Clinical Service, Division of Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

PMID: 40064237
DOI: 10.1016/j.clnesp.2025.03.005

Free article

Habitual intake of macronutrients and fermentable oligo-, di-, monosaccharides and polyols is not associated with irritable bowel syndrome-like symptoms in inflammatory bowel disease

Insaf Zerouga et al. Clin Nutr ESPEN. 2025 Jun.

Free article

. 2025 Jun:67:105-113.

doi: 10.1016/j.clnesp.2025.03.005. Epub 2025 Mar 8.

Authors

Affiliations

¹ Section of Nutrition and Dietetics, Department of Clinical Service, Division of Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: insaf.zerouga@studmed.uio.no.
² Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.
³ Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
⁴ Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
⁵ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; Department of Public Health, Oslo Metropolitan University, Oslo, Norway.
⁶ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
⁷ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; Department of Public Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
⁸ Department of Health and Care Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway.
¹⁰ Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway.
¹¹ Medical Department, Innlandet Hospital Trust, Lillehammer, Norway.
¹² Department of Gastroenterology, Vestfold Hospital Trust, Tønsberg, Norway.
¹³ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Vestfold Hospital Trust, Tønsberg, Norway.
¹⁴ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Gastrointestinal Department, Innlandet Hospital Trust, Gjøvik, Norway.
¹⁵ Department of Gastroenterology, Telemark Hospital Trust, Skien, Norway.
¹⁶ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.
¹⁷ Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway.
¹⁸ Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.
¹⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.
²⁰ Section of Nutrition and Dietetics, Department of Clinical Service, Division of Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

PMID: 40064237
DOI: 10.1016/j.clnesp.2025.03.005

Abstract

Purpose: Almost a third of patients with inactive inflammatory bowel disease (IBD) suffer from symptoms compatible with irritable bowel syndrome (IBS-like symptoms). The relation between these symptoms and diet in patients with IBD is not fully established. We aimed to assess associations between IBS-like symptoms and intake of macronutrients and fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) in patients with inactive IBD compared to an IBD-free background population.

Methods: Patients with IBD at one-year follow-up from the IBSEN III (Inflammatory bowel disease in South-Eastern Norway) study were compared to an IBD-free Norwegian background population (Tromsø7). A food frequency questionnaire (FFQ) was used to collect dietary data including FODMAP intake, which was compiled as gram/100 g of food and assessed in patients with active versus inactive IBD. Rome IV criteria were applied to define IBS-like symptoms in patients with inactive IBD.

Results: A sample of 154 patients ≥40 years with inactive IBD was compared to 11078 adults from the IBD-free background population (Tromsø7). There were no significant associations between IBS-like symptoms and FODMAP and macronutrient intake, neither in patients with inactive IBD nor in the IBD-free background population. Patients with IBD ≥40 years had higher intake of fructans and total FODMAPs compared to the Tromsø7 sample. Intake of nutrients and FODMAPs was similar in patients with active IBD (n = 105), inactive IBD with IBS-like symptoms (n = 55), and without IBS-like symptoms (n = 197).

Conclusion: FODMAP and macronutrient intake were not associated with IBS-like symptoms in patients with inactive IBD one-year after diagnosis.

Keywords: Dietary intake; FFQ; FODMAPs; Inflammatory bowel disease; Irritable bowel syndrome-like symptoms.

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Conflict of interest statement

Declaration of competing interest ØH has received personal fees from AbbVie, Janssen-Cilag AS, Takeda and Ferring. VAK reported advisory boards from Takeda and Tillotts Pharma, consultant fees from Janssen-Cilag and Takeda, and speaker fees from Thermo Fischer Scientific. VS has been sponsored by funds from Takeda. TED has served as a speaker, consultant or advisory board member for AbbVie, Ferring, Pfizer, Pharmacosmos, Takeda, Tillotts, and Vifor Pharma. He received unrestricted research grants from AbbVie, and Pharmacosmos. MLH received investigator-initiated research grants from Takeda, Pfizer, Tilllotts Pharma, Ferring and Janssen-Cilag, speaker honoraria from Takeda, Tillotts, Ferring, AbbVie, Galapagos, MSD and Meda, advisory board from Takeda, Galapagos, MSD, Lilly, Janssen-Cilag, Pfizer and AbbVie. SOF reported personal fees from Takeda, Galapagos, Jansen-Cilag, Abbvie, Pharmacosmos, Norgine and Bristol-Myers-Squibb.

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Habitual intake of macronutrients and fermentable oligo-, di-, monosaccharides and polyols is not associated with irritable bowel syndrome-like symptoms in inflammatory bowel disease

Affiliations

Habitual intake of macronutrients and fermentable oligo-, di-, monosaccharides and polyols is not associated with irritable bowel syndrome-like symptoms in inflammatory bowel disease

Authors

Affiliations

Abstract

Conflict of interest statement

MeSH terms

Substances

LinkOut - more resources

Full Text Sources