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Improved lipid and glycemic profile and vitamin D levels after a dietary intervention with SSRD and low FODMAP in IBS patients : A randomized controlled trial

Roth, Bodil LU ; D’Amato, Mauro and Ohlsson, Bodil LU (2026) In Nutrition 142.
Abstract

Background Irritable bowel syndrome (IBS) is the most common disorder of gut-brain interaction and associated with overweight. Low content of fermentable oligo-, di-, and monosaccharides and polyols (FODMAP) and a starch- and sucrose-reduced diet (SSRD) alleviate IBS symptoms, but restrictive diets may lead to malnutrition. The aim of the present clinical trial was to randomize IBS patients to either SSRD or low FODMAP and compare circulating metabolic and nutritional status over time. Methods Of 155 included patients, 77 received SSRD and 78 low FODMAP for 4 weeks, with a follow-up at 6 months. Study and Rome IV questionnaires, food diary, IBS-severity scoring system, and visual analog scale for IBS were completed, along with blood... (More)

Background Irritable bowel syndrome (IBS) is the most common disorder of gut-brain interaction and associated with overweight. Low content of fermentable oligo-, di-, and monosaccharides and polyols (FODMAP) and a starch- and sucrose-reduced diet (SSRD) alleviate IBS symptoms, but restrictive diets may lead to malnutrition. The aim of the present clinical trial was to randomize IBS patients to either SSRD or low FODMAP and compare circulating metabolic and nutritional status over time. Methods Of 155 included patients, 77 received SSRD and 78 low FODMAP for 4 weeks, with a follow-up at 6 months. Study and Rome IV questionnaires, food diary, IBS-severity scoring system, and visual analog scale for IBS were completed, along with blood sampling and anthropometric measurements. Albumin, C-reactive peptide, glycosylated hemoglobin A1c (HbA1c) (mmol/mol), lipid profile (mmol/L), and micronutrients were analyzed in plasma/serum. Results Both diets improved gastrointestinal and extraintestinal symptoms. The weight reduction was most pronounced in SSRD (−1.6(−2.4 to [−0.4] kg vs. −0.8(−1.6 to [−0.1] kg; P = 0.006). Cholesterol (−0.1(−0.5 to 0.1), P = 0.007; −0.2(−0.4 to 0.1), P = 0.009), low-density lipoprotein (LDL) (−0.2(−0.4 to 0.1), P = 0.004; −0.1(−0.4 to 0.1), P = 0.017), and non-high-density lipoprotein (non-HDL) (−0.1(−0.4 to 0.1), P = 0.015; −0.1(−0.4 to 0.1), P = 0.008) decreased at week 4 and month 6 in the SSRD group, but only after 4 weeks in the low FODMAP group (−0.2(−0.5 to 0.2), P = 0.003; −0.1(−0.3 to 0.1), P = 0.036; and −0.2(−0.4 to 0.1), P = 0.002, respectively). At week 4, HbA1c decreased (0(−1.0 to 0), P = 0.010 and (0(−1.0 to 0), P = 0.009) and vitamin D increased (6(−3 to 16) nmol/L, P = 0.004 and 4(−5 to 14) nmol/L, P = 0.017) in both groups, with continued elevated vitamin D levels after SSRD. Folate increased and iron decreased in the SSRD group. Lower calcium and ferritin levels were found after low FODMAP. At 6 months, cobalamin was lower in both groups. Conclusions SSRD and low FODMAP improve symptoms and the lipid, glycemic, and vitamin D profiles. The improved lipid and vitamin D profiles remained at follow-up in the SSRD group.

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type
Contribution to journal
publication status
published
subject
keywords
Dietary habits, HbA1c, Irritable bowel syndrome, Lipid profile, Low FODMAP, Starch- and sucrose-reduced diet (SSRD, Randomized controlled trial (RCT)
in
Nutrition
volume
142
article number
112964
publisher
Elsevier
external identifiers
  • scopus:105020885874
  • pmid:41138567
ISSN
0899-9007
DOI
10.1016/j.nut.2025.112964
language
English
LU publication?
yes
id
cd44ad7a-d1e9-42fa-9b7f-36b0305e1e1c
date added to LUP
2026-01-29 15:36:26
date last changed
2026-01-29 15:37:09
@article{cd44ad7a-d1e9-42fa-9b7f-36b0305e1e1c,
  abstract     = {{<p>Background Irritable bowel syndrome (IBS) is the most common disorder of gut-brain interaction and associated with overweight. Low content of fermentable oligo-, di-, and monosaccharides and polyols (FODMAP) and a starch- and sucrose-reduced diet (SSRD) alleviate IBS symptoms, but restrictive diets may lead to malnutrition. The aim of the present clinical trial was to randomize IBS patients to either SSRD or low FODMAP and compare circulating metabolic and nutritional status over time. Methods Of 155 included patients, 77 received SSRD and 78 low FODMAP for 4 weeks, with a follow-up at 6 months. Study and Rome IV questionnaires, food diary, IBS-severity scoring system, and visual analog scale for IBS were completed, along with blood sampling and anthropometric measurements. Albumin, C-reactive peptide, glycosylated hemoglobin A1c (HbA1c) (mmol/mol), lipid profile (mmol/L), and micronutrients were analyzed in plasma/serum. Results Both diets improved gastrointestinal and extraintestinal symptoms. The weight reduction was most pronounced in SSRD (−1.6(−2.4 to [−0.4] kg vs. −0.8(−1.6 to [−0.1] kg; P = 0.006). Cholesterol (−0.1(−0.5 to 0.1), P = 0.007; −0.2(−0.4 to 0.1), P = 0.009), low-density lipoprotein (LDL) (−0.2(−0.4 to 0.1), P = 0.004; −0.1(−0.4 to 0.1), P = 0.017), and non-high-density lipoprotein (non-HDL) (−0.1(−0.4 to 0.1), P = 0.015; −0.1(−0.4 to 0.1), P = 0.008) decreased at week 4 and month 6 in the SSRD group, but only after 4 weeks in the low FODMAP group (−0.2(−0.5 to 0.2), P = 0.003; −0.1(−0.3 to 0.1), P = 0.036; and −0.2(−0.4 to 0.1), P = 0.002, respectively). At week 4, HbA1c decreased (0(−1.0 to 0), P = 0.010 and (0(−1.0 to 0), P = 0.009) and vitamin D increased (6(−3 to 16) nmol/L, P = 0.004 and 4(−5 to 14) nmol/L, P = 0.017) in both groups, with continued elevated vitamin D levels after SSRD. Folate increased and iron decreased in the SSRD group. Lower calcium and ferritin levels were found after low FODMAP. At 6 months, cobalamin was lower in both groups. Conclusions SSRD and low FODMAP improve symptoms and the lipid, glycemic, and vitamin D profiles. The improved lipid and vitamin D profiles remained at follow-up in the SSRD group.</p>}},
  author       = {{Roth, Bodil and D’Amato, Mauro and Ohlsson, Bodil}},
  issn         = {{0899-9007}},
  keywords     = {{Dietary habits; HbA1c; Irritable bowel syndrome; Lipid profile; Low FODMAP; Starch- and sucrose-reduced diet (SSRD, Randomized controlled trial (RCT)}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Nutrition}},
  title        = {{Improved lipid and glycemic profile and vitamin D levels after a dietary intervention with SSRD and low FODMAP in IBS patients : A randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1016/j.nut.2025.112964}},
  doi          = {{10.1016/j.nut.2025.112964}},
  volume       = {{142}},
  year         = {{2026}},
}