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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome
Mohammed Al-Biltagi, Doaa El Amrousy, Heba El Ashry, Sara Maher, Mahmoud A Mohammed, Samir Hasan
Mohammed Al-Biltagi, Department of Pediatrics, University Medical center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
Mohammed Al-Biltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al Gharbia, Egypt
Mohammed Al-Biltagi, Department of Pediatrics, University Medical Center, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Bahrain
Doaa El Amrousy, Samir Hasan, Department of Pediatrics, Tanta University, Faculty of Medicine, Tanta 31527, Alghrabia, Egypt
Heba El Ashry, Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
Sara Maher, Department of Immunology, Theodor Bilharz Research Institute, Cairo 12411, Egypt
Mahmoud A Mohammed, Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt
Author contributions: Hasan S, El-Amrousy D, and El-Ashry H performed the clinical part and collected the data; Maher S performed the laboratory part; Mohammed MA did the statistical analysis; Al-Biltagi M analyzed the data and wrote the manuscript; and All the authors revised and agreed on the final version of the manuscript.
Institutional review board statement: We performed to study according to the latest version of Helsinki's Declaration. The Research and Ethics Committee at the Ministry of Health, Kingdom of Bahrain, approved the study.
Informed consent statement: An informed written consent was signed by all subjects (and their caregivers).
Conflict-of-interest statement: None of the authors had potential undisclosed conflicts of interest.
Data sharing statement: Data are available upon reasonable request.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Mohammed Al-Biltagi, MBChB, MD, MSc, PhD, Chairman, Professor, Department of Pediatrics, University Medical center, King Abdulla Medical City, Arabian Gulf University, King Abdulaziz Avenue, Manama 26671, Bahrain. mbelrem@hotmail.com
Received: December 13, 2021
Peer-review started: December 13, 2021
First decision: March 24, 2022
Revised: March 24, 2022
Accepted: April 28, 2022
Article in press: April 28, 2022
Published online: July 9, 2022
ARTICLE HIGHLIGHTS
Research background
Irritable bowel syndrome (IBS) has a significant effect on the lives of affected children and their families and poses a substantial burden on healthcare systems. A few potential therapeutic modalities are available to treat children with IBS, and fewer of them have shown some benefits.
Research motivation
A few potential therapeutic modalities are available to treat children with IBS, and fewer of them have shown some benefits. The authors need to conduct more studies to help patients with IBS alleviate their symptoms.
Research objectives
The authors aimed to study the effects of the Mediterranean diet on the symptoms of IBS in children and adolescents.
Research methods
The authors studied one hundred consecutive IBS patients diagnosed according to Rome IV criteria, aged 12-18 years old. The authors divided the patients into two groups (50 patients each), the group I received a Mediterranean diet with good adherence (KIDMED Score ≥ 8 points), and Group II received a regular diet.
Research results
IBS children and adolescents with good adherence to the Mediterranean diet (KIDMED Score ≥ 8 points); group I showed significant improvement in IBS scores. IBS-SSS in the Mediterranean diet group was 237.2 ± 65 at the beginning of the study and decreased to 163.2 ± 33.8 at the end of the study (P < 0.001). It did not show a significant improvement in the group with a regular diet (248.3 ± 71.1 at the beginning of the study compared to 228.5 ± 54.3 at the study end with P < 0.05). The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet. Mean IBS-QoL in group I improved from 57.3 ± 12.9 at the start of the study to 72.4 ± 11.2 at the study end (P < 0.001) and significantly improved when compared to its level in group II at the study end (59.2 ± 12.7) with P < 0.001, while group II showed no significant improvement in IBS-QoL at the study end when compared to the beginning of the study (59.2 ± 11.7 with P > 0.05). The mean total IBS score in group I became 28.8 ± 11.2 at the end of our study compared to 24.1 ± 10.4 at the start (P < 0.05) and significantly improved when compared to its level in group II at the end of the study (22.1 ± 12.5) with P < 0.05, while in group II, non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study (22.8 ± 13.5) with P > 0.05.
Research conclusions
Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.
Research perspectives
The authors need to extend our study for a longer duration. We also need to investigate the effects of the Mediterranean diet on the various GIT functions, including bowel movement, stool consistency, and the impact on the gut microbiota.
