Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Nov 6, 2016; 7(4): 564-571
Published online Nov 6, 2016. doi: 10.4292/wjgpt.v7.i4.564
Good adherence to mediterranean diet can prevent gastrointestinal symptoms: A survey from Southern Italy
Francesco Paolo Zito, Barbara Polese, Letizia Vozzella, Antonietta Gala, Daniela Genovese, Viviana Verlezza, Fabiana Medugno, Antonello Santini, Luigi Barrea, Martina Cargiolli, Paolo Andreozzi, Giovanni Sarnelli, Rosario Cuomo
Francesco Paolo Zito, Barbara Polese, Letizia Vozzella, Antonietta Gala, Daniela Genovese, Viviana Verlezza, Fabiana Medugno, Martina Cargiolli, Paolo Andreozzi, Giovanni Sarnelli, Rosario Cuomo, Department of Surgery, Gastroenterology and Endocrinology, University of Naples “Federico II”, Naples, 80131 Campania, Italy
Antonello Santini, Department of Pharmacy, University of Naples “Federico II”, Naples, 80131 Campania, Italy
Luigi Barrea, IOS s.r.l and COLEMAN S.p.A., Naples, 80131 Campania, Italy
Author contributions: Sarnelli G and Cuomo R ideated the project; Polese B, Gala A, Genovese D, Verlezza V and Medugno F collected the data; Zito FP and Vozzella L wrote the first draft of the manuscript; Santini A, Barrea L, Cargiolli M and Andreozzi P critically reviewed the manuscript; all authors approved the final version of the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rosario Cuomo, MD, Associate Professor, Department of Surgery, Gastroenterology and Endocrinology, University of Naples “Federico II”, Via S. Pansini 5, Building 6, Naples, 80131 Campania, Italy. rcuomo@unina.it
Telephone: +39-81-7463892 Fax: +39-339-7221830
Received: June 1, 2016
Peer-review started: June 2, 2016
First decision: July 4, 2016
Revised: July 19, 2016
Accepted: September 13, 2016
Article in press: September 15, 2016
Published online: November 6, 2016
Abstract
AIM

To evaluate how different levels of adherence to a mediterranean diet (MD) correlate with the onset of functional gastrointestinal disorders.

METHODS

As many as 1134 subjects (598 M and 536 F; age range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms. Patients with relevant chronic organic disease were excluded from the study. The Mediterranean Diet Quality index for children and adolescents (KIDMED) and the Short Mediterranean Diet Questionnaire were administered. All subjects were grouped into five categories according to their ages: 17-24 years; 25-34; 35-49; 50-64; above 64.

RESULTS

On the basis of the Rome III criteria, our population consisted of 719 (63.4%) individuals who did not meet the criteria for any functional disorder and were classified as controls (CNT), 172 (13.3%) patients meeting criteria for prevalent irritable bowel syndrome (IBS), and 243 (23.3%) meeting criteria for prevalent functional dyspepsia (FD). A significantly lower adherence score in IBS (0.57 ± 0.23, P < 0.001) and FD (0.56 ± 0.24, P < 0.05) was found compared to CNT (0.62 ± 0.21). Females with FD and IBS exhibited significantly lower adherence scores (respectively 0.58 ± 0.24, P < 0.05 and 0.56 ± 0.22, P < 0.05) whereas males were significantly lower only for FD (0.53 ± 0.25, P < 0.05). Age cluster analyses showed a significantly lower score in the 17-24 years and 25-34 year categories for FD (17-24 years: 0.44 ± 0.21, P < 0.001; 25-34 years: 0.48 ± 0.22, P < 0.05) and IBS (17-24 years: 0.45 ± 0.20, P < 0.05; 24-34 years: 0.44 ± 0.21, P < 0.001) compared to CNT (17-24 years: 0.56 ± 0.21; 25-34 years: 0.69 ± 0.20).

CONCLUSION

Low adherence to MD may trigger functional gastrointestinal symptoms, mainly in younger subjects. Moreover, with increasing age, patients tend to adopt dietary regimens closer to MD.

Keywords: Mediterranean diet, Irritable bowel syndrome, Dietary regimen, Functional gastro-intestinal disorders, Functional dyspepsia

Core tip: Diet seems to be one of the most important triggering factor for functional gastrointestinal disorders (FGID). In fact, patients suffering from irritable bowel syndrome or functional dyspepsia frequently report the onset of symptoms after a meal or the consumption of certain types of foods. The mediterranean (MD) diet is universally considered a health-promoting dietary regimen, since populations adopting this type of diet exhibit a lower rate of major cardiovascular, neoplastic, metabolic morbidity and mortality. Emerging evidence supports a beneficial effect of MD on the gastrointestinal tract, although the association between a high adherence to MD and FGID symptoms is still unclear.