Factors governing adherence to a low FODMAP diet and subsequent re-introduction of high FODMAP foods: a cross-sectional survey of adults with Irritable Bowel Syndrome
Cardiff Metropolitan University
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Background Evidence supports using low FODMAP (Fermentable Oligo-, Di- & Monosaccharides and Polyols) exclusion diets (LFDs) as a treatment for Irritable Bowel Syndrome (IBS). However to-date there is limited research into factors that influence adherence to the diet or that influence subsequent re-introduction of high FODMAP foods (HFFs). The aim of this study was to identify factors that are associated with LFD adherence and re-introduction of HFFs. Methods An online cross-sectional survey of adult participants in social media (SM) LFD discussion groups was completed to identify factors influencing LFD adherence and HFF reintroduction using questions adapted from previous research studies. Statistical analysis was undertaken to establish whether any of the factors assessed were associated either with self-reported adherence or confidence in ability to successfully re-introduce HFFs as outcome measures. Results 68 respondents completed the questionnaire (0.24% response rate). 96.9% were female, median age range was 41 -50 years, and median time on the diet was 3 – 6 months. 84.8% of respondents felt their symptoms improved on LFDs and 95.3% of participants felt they adhered ‘≥ 50% of the time’, with 72 % rating their current level of LFD knowledge as ‘good’ or ‘excellent’. 18% ‘Strongly agreed/agreed’ that they had successfully re-introduced HFFs. Associations were identified between adherence and; verbal explanations of LFD at outset (p= 0.035); current sources of information (p=0.006); meal preparation (p=0.017). Associations were identified between confidence in HFF re-introduction and; use of smart-phone apps (p=0.003) and the ease of adaptation to LFDs (p=0.002). Conclusions Participants reported high levels of IBS symptom relief despite partial LFD adherence. The type and quality of information received on LFDs influences adherence. Emerging sources of information about LFDs e.g. smart-phone apps are used extensively and may facilitate re-introduction of HFFs.
BSc (Hons) Human Nutrition and Dietetics
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