Three popular IBS diets went head-to-head in a recent British study from Clinical Gastroenterology and Hepatology — low-FODMAP (LFD), gluten-free (GFD), and traditional dietary advice (TDA). Researchers were surprised to discover that all three eating plans reduced symptoms by roughly 50% among subjects suffering from non-constipated irritable bowel syndrome (IBS).
While all three diets helped ease common IBS symptoms, such as abdominal pain, bloating, and changes in bowel habits, the low-FODMAP diet was the only one that helped alleviate depression and dysphoria. The researchers recommend patients try the TDA first, however, because it’s easier to follow.
“Our study has notable strengths. First, it is amongst the largest studies assessing dietary therapies in IBS. Second, we provided dietary education as per recommended instructions, whereas four-of-five previous randomized trials of TDA have been limited to providing a modified or incomplete version. This could partly explain TDA being ranked inferior to a LFD in a recent network meta-analysis. Our findings shed further clarity on the efficacy of TDA and are in line with a Swedish randomized trial that provided TDA instructions as per guidance and noted no difference versus the LFD.”
What Is the TDA Diet?
Americans may not be as familiar with TDA, which is based on recommendations from the UK National Institute for Health and Care Excellence and the British Dietetic Association. The diet focuses on “sensible eating patterns,” which include controlling portions, drinking enough water, and eating regular meals. Those following the diet are also asked to cut back on alcoholic, caffeinated, and fizzy beverages; fatty, spicy, and processed foods; fruit; and fiber and foods known to cause gas.
TDA, LFD and GFD are effective approaches in non-constipated IBS, but TDA is the most patient-friendly in terms of cost and convenience. We recommend TDA as the first-choice dietary therapy in non-constipated IBS, with a LFD and GFD reserved according to specific patient preferences and specialist dietetic input.