A136 A LONGITUDINAL STUDY EXAMINING FODMAP INTAKE AND THE METABOLOME IN IBS PATIENTS
Bibliographic record
Abstract
The low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet has proven efficacy to reduce symptoms of irritable bowel syndrome (IBS). Whilst some mechanisms of action are known, our previous work has suggested that FODMAP-microbiota interactions change the metabolome which may modulate pain signaling in the gut, which may also be important. The aim of this randomized cross-over study was to further characterize the effect of low and high FODMAP intake on symptoms and the metabolome. In this longitudinal IBS (Rome IV) study, patients underwent 4 assessments: two non-intervention periods including a 1-week ‘baseline’ and 3-week ‘run-in’, followed by two dietary interventions, a low- and high-FODMAP diet, given in random order for 3-weeks each. Patients were provided detailed dietary instruction by a specialized dietitian at the start of each diet and advised that either diet may have therapeutic potential. At the end of each of the 4 periods, patients completed a 7-day food diary, the IBS Severity Scoring System (IBS-SSS), the quality-of-life (QOL) Nepean Dyspepsia index (SF-NDI), and provided fasting urine samples. Identification and quantification of 117 urine metabolites was performed using LC-MS. Questionnaires were analyzed by one-way ANOVA with Bonferroni, and metabolomics by multivariate analysis. Ten female patients completed the study for this interim analysis (7 IBS-D, 2 IBS-C, 1 IBS-M). Dietary data showed good compliance with the interventions (Table 1). Symptoms were stable between the non-intervention time points, significantly reduced with the low FODMAP diet (p=0.00), and a trend was seen between the low and high FODMAP diets (p=0.07). The urinary metabolite levels in patients on the low FODMAP diet differed significantly from baseline, the main metabolites responsible for the change were phosphatidylcholines (e.g. PC40:2AA, PC36:0AA, LYSOC18:2). There was also a shift in the metabolome between the low and high FODMAP diets, the most significantly changed metabolites were sphingomyelins (SM 20:2), phosphatidylcholines (LYSOC20:4, PC40:6AE), and acylcarnitines (C18:1OH). This study showed that IBS symptoms were stable over 3 weeks and lowering dietary FODMAPs significantly improved symptoms. The diets caused a shift in the metabolome, but greater numbers of patients are needed to determine the complete metabolomic profile and their potential physiological significance in symptom responses. Table 1 CIHRCanadian Nutrition Society
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".