Kan tillskott av pre-eller probiotika öka förekomsten av bifidobakterier hos personer med IBS som äter låg FODMAP-kost?

Detta är en Kandidat-uppsats från Göteborgs universitet/Institutionen för medicin

Sammanfattning: AbstractTitle: Can supplement of pre- or probiotics increase the abundance of bifidobacteria in people with IBS consuming a low FODMAP-diet? - A systematic review Author: Maja Sandberg and Gabriella JirnerSupervisor: Jenny van OdijkExaminer: Heléne Bertéus ForslundProgramme: Programme in dietetics, 180/240 ECTSType of paper: Bachelor’s thesis in clinical nutrition, 15 higher education creditsDate: 2021-04-01Background: IBS is a common functional disease among today's population. One of the treatments is a diet low in FODMAPs. A low FODMAP-diet has previously been shown to reduce bifidobacteria abundance. Bifidobacteria are known to be beneficial for our health. Previous studies have shown that pre- and probiotics can increase the abundance of bifidobacteria.Objective: The objective of this systematic review was to examine whether supplementation with either pre- or probiotics can prevent the reduction in bifidobacteria shown when consuming a low FODMAP-diet.Search strategy: The literature search was done in the two databases PubMed and Scopus. Search terms used were: IBS, FODMAP, intestinal flora, bifidobacteria, pre- and probiotics. Synonyms to these terms were also used.Selection criteria: Criteria of inclusion was: human studies, RCT-studies, an adult population (18-65 years old), IBS according to ROME III or IV criteria, intervention was low FODMAP-diet in combination with supplement of either pre- or probiotics, the intervention was compared to placebo and the measured outcome was change in bifidobacterial abundance. Exclusion criteria was: animal studies, studies in other languages than english and swedish, studies that were not already paid for and secondary analyses of previous results. Data collection and analysis: A broad search was done using many search terms. Following this, a more specific search was made to ensure no articles within the area of interest had been missed. Elevenarticles were read in full text, out of which two were included in this systematic review. The articles were assessed using the template “Bedömning av randomiserade studier (effekt av att tilldelas en intervention (ITT))” by SBU. An assessment according to GRADE was made to evaluate the results of this systematic review.Main results: The two articles included had a low risk of bias. One of these articles studied the effect of probiotics and the other studied the effect of prebiotics (B-GOS 1,4g) in combination with a low FODMAP-diet. The study on probiotics showed an increase in bifidobacterial abundance when a low FODMAP-diet was supplemented with probiotics compared with a low FODMAP-diet with placebo. This reached statistical significance. The other study showed a decrease in bifidobacteria when a lowFODMAP-diet was supplemented with B-GOS 1,4g compared to a low FODMAP-diet supplemented with placebo. This did not reach statistical significance. Conclusions: The reliability of the results is low that supplementation with pre- or probiotics cancounteract the decrease in bifidobacterial abundance when consuming a low FODMAP-diet. More research within the field is necessary.

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