Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome
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Preliminary studies indicate that dietary restriction of fermentable short-chain carbohydrates improves symptoms in irritable bowel syndrome (IBS). Prebiotic fructo-oligosaccharides and galacto-oligosaccharides stimulate colonic bifidobacteria. However, the effect of restricting fermentable short-chain carbohydrates on the gastrointestinal (GI) microbiota has never been examined. This randomized controlled trial aimed to investigate the effects of fermentable carbohydrate restriction on luminal microbiota, SCFA, and GI symptoms in patients with IBS. Patients with IBS were randomized to the intervention diet or habitual diet for 4 wk. The incidence and severity of symptoms and stool output were recorded for 7 d at baseline and follow-up. A stool sample was collected and analyzed for bacterial groups using fluorescent in situ hybridization. Of 41 patients randomized, 6 were withdrawn. At follow-up, there was lower intake of total short-chain fermentable carbohydrates in the intervention group compared with controls (P = 0.001). The total luminal bacteria at follow-up did not differ between groups; however, there were lower concentrations (P < 0.001) and proportions (P < 0.001) of bifidobacteria in the intervention group compared with controls when adjusted for baseline. In the intention-to-treat analysis, more patients in the intervention group reported adequate control of symptoms (13/19, 68%) compared with controls (5/22, 23%; P = 0.005). This randomized controlled trial demonstrated a reduction in concentration and proportion of luminal bifidobacteria after 4 wk of fermentable carbohydrate restriction. Although the intervention was effective in managing IBS symptoms, the implications of its effect on the GI microbiota are still to be determined.
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Reducing consumption of carbohydrates and wholegrain cereals lowers the abundance of important butyrate-producing bacteria, including bifidobacteria, as well as SCFAs themselves.
“Numerous intervention studies in humans show that reducing the consumption of carbohydrates and wholegrain cereals lowers the abundance of important butyrate-producing bacteria, including the probiotic bifidobacteria, as well as SCFAs themselves (121-123).”
From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [123]
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Spencer, M., Chey, W. D., & Eswaran, S. (2014) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-014-0031-x · Cited by 34 · see citing works
Murtaza, N., Ó Cuív, P., & Morrison, M. (2017) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2016.09.005 · Cited by 32 · see citing works
Wiffin, M., Smith, L., Antonio, J., Johnstone, J., Beasley, L., & Roberts, J. (2019) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-019-0268-9 · Cited by 27 · see citing works
- Authors
- Staudacher, H. M., Lomer, M. C. E., Anderson, J. L., Barrett, J. S., Muir, J. G., Irving, P. M., & Whelan, K.
- Affiliations
- St Thomas' Hospital (GB)
- Guy's Hospital (GB)
- Eastern Health (AU)
- King's College London (GB)
- Corresponding author
- Whelan, Kevin
- ORCID
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 142
- Issue
- 8
- Pages
- 1510-1518
- ISSN
- 0022-3166 (ISSN-L)
- OpenAlex
- W2113957312
- Cited by
- 590
- References
- 53
- Citations by year
- 2026: 24 · 2025: 30 · 2024: 21 · 2023: 24 · 2022: 45 · 2021: 61 · 2020: 47 · 2019: 61 · 2018: 54 · 2017: 69 · 2016: 62 · 2015: 39 · 2014: 30 · 2013: 20 · 2012: 1
- FWCI
- 27.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- Funders
- King's College London
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Keywords
- irritable bowel syndrome, short-chain carbohydrates, Bifidobacterium, gut microbiota, gastrointestinal symptoms, short-chain fatty acids, dietary intervention, stool output
- MeSH terms
- Adult, Bifidobacterium, Diet, Dietary Carbohydrates, Fatty Acids, Feces, Female, Fermentation, Food Analysis, Humans, Male, Middle Aged, Irritable Bowel Syndrome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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