Low Intake of Micronutrients Observed in IBS Patients

Bodil Ohlsson, MD, PhD

A new investigation from Sweden found that patients with irritable bowel syndrome (IBS) had low intake of micronutrients that associated inversely with total IBS-severity scoring system (SSS), extraintestinal IBS-SSS, and fatigue.

However, investigators found that a starch- and sucrose-reduced diet (SSRD) increased the intake of several micronutrients which correlated weakly with symptom improvement.

Previous research has indicated that IBS patients have low intake of vitamins and minerals, which may be important for the development and experience of symptoms and psychological well-being related to the disease.

Investigators led by Bodil Ohlsson, MD, PhD, Department of Internal Medicine at Lund University, examined baseline data regarding intake and plasma/serum levels of micronutrients in IBS and whether they were associated with symptoms and various restrictions.

The Methods

Inclusion criteria for the 4-week intervention included a diagnosis of IBS, age 18-70 years, and of Northern European heritage.

Insufficient symptoms, the presence of a GI disease, severe organic and psychiatric diseases, and gluten-free, vegan-, and low carbohydrate high fat diets made up the exclusion criteria.

A total of 1039 patients with IBS from primary care centers were identified for the study, along with 640 IBS patients from the tertiary center.

Invitation letters were randomly sent to a total 679 patients, followed by a phone call in the following weeks. A total of 145 patients who suffered from abdominal pain at least once along with altered bowel habits were willing to participate, but 40 were excluded for varipus reasons.

A total of 105 patients, 23 of whom were men (22%) and 73% of whom came from primary care centers were included in the study, with 97 patients completing the study.

The Findings

Overall, investigators observed that the intake of micronutrients at baseline was lower than the national guideline recommendations.

Several micronutrients were ingested in small amounts around or below 50% of AR, such vitamin D, several vitamin B compounds,iron, and selenium, while folacin intake differed between IBS-C and IBS-D (262 [174–348] vs. 188 [155–225] μg; P=0.028).

Extraintestinal symptoms and fatigue were inversely associated with intake of vitamin B6, phosphorus, magnesium, and iodine, as was plasma levels of iron, and positively associated with plasma iron-binding capacity.

Fatigue was inversely associated with calcium, iron, and zinc intakes, and plasma ferritin was lower in participants on restrictions.

Finally, SSRD was shown to increase the intake of several vitamins including B12, D and E, folacin, as well as selenium and fat, while sodium intake was decreased.

While SSRD was shown to increase dietary intake, investigators concluded that “The role of malnutrition must be further explored in IBS and associated comorbidity.”

The study, "Poor intake of vitamins and minerals among patients with irritable bowel syndrome is associated with symptoms," was published online in Gastroenterology and Hepatology.