A236 A REAL-WORLD EVALUATION OF THE LOW FODMAP DIET IMPLEMENTATION: POOR COMPLIANCE IS SIGNIFICANTLY IMPROVED BY GUIDANCE FROM A DIETITIAN
Notice bibliographique
Résumé
Dietary modifications are now frequently used to manage gastrointestinal (GI) symptoms such as abdominal pain and bloating in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet has proven efficacy with dietitian-delivered education, but other forms of delivery have not been evaluated and it is unknown how patients proceed when they are recommended the diet by their physician. The aim of this study was to evaluate the real-world experience of patients who were recommended a low FODMAP diet. This was a retrospective evaluation of patients in a gastroenterology clinic with a previous recommendation to trial the low FODMAP diet or self-reported use of the diet. Patients were interviewed regarding who recommended the diet, what they felt their response was (as a percentage improvement), and their implementation of the diets 3-phases. Implementation of each phase was recorded as appropriate or not, depending on the length of time of restriction and food knowledge (phase 1: restriction), number of foods re-challenged (phase 2: re-challenge) and reintroduction of foods as tolerated (phase 3: long-term). Additional questionnaires were conducted including the comprehensive nutrition assessment questionnaire (CNAQ) providing data on daily FODMAP intake. Data was analyzed using percentages and unpaired t-tests. Seventy-nine patients undertook the study (56 IBS, 11 IBD, 12 other GI conditions; 21 male). The diet was recommended by the gastroenterologist in 54%, family doctor in 22%, and dietitian in 9%. Twenty-four (30%) of patients saw a dietitian for guidance. Overall, 56% of patients reported the diet provided a ≥50% improvement in their symptoms (67% who saw a dietitian, 51% who did not). However, the reported percentage improvement was not statistically different (55±31vs44±35, p=0.20). The diet was followed appropriately during phase 1 by 96% who saw a dietitian and 71% who did not. For phase 2, at least 2 foods were re-challenged by 70% of those who saw a dietitian vs 36% of those who did not. Phase 3, the long-term maintenance phase, was followed in 65% who saw a dietitian and 30% who did not. A FODMAP intake of <12g/day (considered therapeutic) was achieved by 79% who saw a dietitian vs 41% who did not. One third of patients recommended the low FODMAP diet see a dietitian for dietary guidance. Those who see a dietitian are more likely to appropriately undertake the 3-phases of the diet and reduce their FODMAP intake to therapeutic levels. This study highlights the importance of dietitian guidance for implementation of the low FODMAP diet. CIHRCanadian Nutrition Society
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».