A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome

Background: The low FODMAP diet (LFD) has been shown to alleviate gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). However, the impact of the LFD on coexisting symptoms of fatigue, anxiety, depression, and cognitive functions remains unclear. Objectives: This study aims to...

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Main Authors: Sol Maja G Bjørkevoll, Eline M Randulff Hillestad, Gülen A Lied, Erica S Teige, Elisabeth K Steinsvik, Birgitte Berentsen, Astri J Lundervold
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Current Developments in Nutrition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475299125029440
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author Sol Maja G Bjørkevoll
Eline M Randulff Hillestad
Gülen A Lied
Erica S Teige
Elisabeth K Steinsvik
Birgitte Berentsen
Astri J Lundervold
author_facet Sol Maja G Bjørkevoll
Eline M Randulff Hillestad
Gülen A Lied
Erica S Teige
Elisabeth K Steinsvik
Birgitte Berentsen
Astri J Lundervold
author_sort Sol Maja G Bjørkevoll
collection DOAJ
description Background: The low FODMAP diet (LFD) has been shown to alleviate gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). However, the impact of the LFD on coexisting symptoms of fatigue, anxiety, depression, and cognitive functions remains unclear. Objectives: This study aims to investigate the effects of a 12-wk strict LFD on symptoms of fatigue, depression, anxiety, and inattention in patients with moderate-to-severe IBS-D (diarrhea-predominant), and IBS-M (mixed diarrhea and constipation). Methods: Participants with IBS were included in an open-label, single-center, 12-wk dietary intervention conducted at Haukeland University Hospital in Bergen, Norway. They followed a strict LFD guided by a registered dietitian and completed questionnaires assessing fatigue [Chalder Fatigue Scale (CFQ-11)] and anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] and performed a test of attention [the third edition of the Connors’ continuous performance test (CPT-3)] at baseline and 12-wk follow-up. Data were analyzed using Wilcoxon signed-rank tests to evaluate changes from baseline to post intervention. Results: Thirty-six participants completed the intervention. Statistically significant reductions were observed in symptoms of fatigue (CFQ-11, P < 0.013) and symptoms of anxiety (HADS-A, P < 0.006). Most of the patients were defined as noncases of fatigue and anxiety following the intervention. Performance on the CPT-3 revealed improvements in measures of inattention. Conclusions: A 12-wk strict LFD intervention significantly alleviated coexisting symptoms of fatigue, anxiety, and depression, and improved performance on a psychometric test of attention. These findings suggest that dietary management plays a crucial role in improving both physical and mental health in patients with IBS.This study was registered at clinical trial as NCT04296552 (https://clinicaltrials.gov/study/NCT04296552?term=NCT04296552&rank=1).
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spelling doaj-art-bc62893b69fc4099bc4db89bf268aba52025-08-20T03:35:44ZengElsevierCurrent Developments in Nutrition2475-29912025-07-019710748310.1016/j.cdnut.2025.107483A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel SyndromeSol Maja G Bjørkevoll0Eline M Randulff Hillestad1Gülen A Lied2Erica S Teige3Elisabeth K Steinsvik4Birgitte Berentsen5Astri J Lundervold6Department of Pediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway; Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, NorwayCenter for Nutrition, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Division of Gastroenterology, Department of Medicine, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, NorwayCenter for Nutrition, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Division of Gastroenterology, Department of Medicine, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, NorwayCenter for Nutrition, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Division of Gastroenterology, Department of Medicine, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, NorwayDivision of Gastroenterology, Department of Medicine, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, NorwayDivision of Gastroenterology, Department of Medicine, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, NorwayDepartment of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Corresponding author.Background: The low FODMAP diet (LFD) has been shown to alleviate gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). However, the impact of the LFD on coexisting symptoms of fatigue, anxiety, depression, and cognitive functions remains unclear. Objectives: This study aims to investigate the effects of a 12-wk strict LFD on symptoms of fatigue, depression, anxiety, and inattention in patients with moderate-to-severe IBS-D (diarrhea-predominant), and IBS-M (mixed diarrhea and constipation). Methods: Participants with IBS were included in an open-label, single-center, 12-wk dietary intervention conducted at Haukeland University Hospital in Bergen, Norway. They followed a strict LFD guided by a registered dietitian and completed questionnaires assessing fatigue [Chalder Fatigue Scale (CFQ-11)] and anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] and performed a test of attention [the third edition of the Connors’ continuous performance test (CPT-3)] at baseline and 12-wk follow-up. Data were analyzed using Wilcoxon signed-rank tests to evaluate changes from baseline to post intervention. Results: Thirty-six participants completed the intervention. Statistically significant reductions were observed in symptoms of fatigue (CFQ-11, P < 0.013) and symptoms of anxiety (HADS-A, P < 0.006). Most of the patients were defined as noncases of fatigue and anxiety following the intervention. Performance on the CPT-3 revealed improvements in measures of inattention. Conclusions: A 12-wk strict LFD intervention significantly alleviated coexisting symptoms of fatigue, anxiety, and depression, and improved performance on a psychometric test of attention. These findings suggest that dietary management plays a crucial role in improving both physical and mental health in patients with IBS.This study was registered at clinical trial as NCT04296552 (https://clinicaltrials.gov/study/NCT04296552?term=NCT04296552&rank=1).http://www.sciencedirect.com/science/article/pii/S2475299125029440irritable bowel syndromeFODMAPgut–brain axisfatiguedepressionattention
spellingShingle Sol Maja G Bjørkevoll
Eline M Randulff Hillestad
Gülen A Lied
Erica S Teige
Elisabeth K Steinsvik
Birgitte Berentsen
Astri J Lundervold
A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
Current Developments in Nutrition
irritable bowel syndrome
FODMAP
gut–brain axis
fatigue
depression
attention
title A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
title_full A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
title_fullStr A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
title_full_unstemmed A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
title_short A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome
title_sort 12 week strict low fodmap diet reduces the severity levels of fatigue depression anxiety and inattention in patients with irritable bowel syndrome
topic irritable bowel syndrome
FODMAP
gut–brain axis
fatigue
depression
attention
url http://www.sciencedirect.com/science/article/pii/S2475299125029440
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