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TOPLINE:

A personalized diet, created by integrating microbiome analysis with artificial intelligence (AI) algorithms, is a promising approach to the management of irritable bowel syndrome (IBS) symptoms, leading to enhanced symptom relief and greater gut microbiome diversity than a standard low–fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet, new research suggests.

METHODOLOGY:

• Emerging evidence suggests that changes in the composition and function of the gut microbiome play a key role in the onset and symptoms of IBS.
• Among the various dietary interventions explored in IBS, the low-FODMAP diet has shown promising results in reducing symptoms and improving overall well-being; however, long-term use of the diet may reduce abundance and diversity of beneficial microbial species.
• The researchers used the Enbiosis personalized nutrition model (ENBIOSIS Biotechnologies, London, England), based on machine learning models, to evaluate the microbiome and develop personalized dietary recommendations.
• They compared the efficacy of a microbiome-based AI-assisted personalized diet with that of a low-FODMAP diet in 121 patients who met the Rome IV criteria for IBS (70 in the personalized diet group and 51 in the low-FODMAP group).
• Both diet interventions lasted for 6 weeks. Women made up 60% of both groups. The most common IBS subtype was constipation (IBS-C), followed by mixed (IBS-M), and diarrhea.

TAKEAWAY:

• Both diet groups experienced significant improvement in IBS symptom severity scores (P < .001), frequency (P < .001), abdominal distension (P < .001), and life interference (P < .001), as well as anxiety levels and IBS quality of life scores (P < .001).
• The personalized diet also led to significant improvements in IBS symptom severity scores across IBS subtypes, while the low-FODMAP diet showed comparable improvements in IBS-C and IBS-M subtypes.
• The personalized diet led to significant microbiome diversity shifts, including increased alpha and beta diversities, and notably an increase in beneficial Faecalibacterium prausnitzii and a decrease in Ruminococcus species, which are known to be increased in IBS. The low-FODMAP diet did not exhibit similar positive effects on gut microbiome parameters.

IN PRACTICE:

"By incorporating individualized dietary recommendations based on patients' symptom profiles and gut microbiome composition, a personalized approach can potentially target the unique mechanisms contributing to symptom generation and provide more targeted symptom relief," the authors wrote.

SOURCE:

The study, with first author Varol Tunali, MD, PhD, Manisa Celal Bayar University, Manisa, Turkey, was published online in The American Journal of Gastroenterology.

LIMITATIONS:

The study had an uneven distribution of participants between the groups, with a larger number in the personalized diet group than in the low-FODMAP group, which may have affected statistical power. A total of 28 participants dropped out during the study, resulting in a completion rate of 81%, which could influence the interpretation of the data. The dietary intervention was limited to 6 weeks, and longer-term studies may be needed to evaluate the sustained effects of the interventions.

DISCLOSURES:

The research received no external funding, but the microbiome analysis was carried out by ENBIOSIS Biotechnologies. Two authors work with ENBIOSIS Biotechnologies, which developed the AI-assisted personalized nutrition model used in the study.