Search

Background and Aims Diet plays an integral role in the modulation of the intestinal environment, with the potential to be modified for management of individuals with inflammatory bowel disease [IBD]. It has been hypothesised that poor 'Western-style' dietary patterns select for a microbiota that drives IBD inflammation and, that through dietary intervention, a healthy microbiota may be restored. This study aimed to systematically review the literature and assess current available evidence regarding the influence of diet on the intestinal microbiota composition in IBD patients, and how this may affect disease activity. Methods MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library were searched from January 2013 to June 2023, to identify studies investigating diet and microbiota in IBD. Results Thirteen primary studies met the inclusion criteria and were selected for narrative synthesis. Reported associations between diet and microbiota in IBD were conflicting due to the considerable degree of heterogeneity between studies. Nine intervention studies trialled specific diets and did not demonstrate significant shifts in the diversity and abundance of intestinal microbial communities or improvement in disease outcomes. The remaining four cross-sectional studies did not find a specific microbial signature associated with habitual dietary patterns in IBD patients. Conclusions Diet modulates the gut microbiota, and this may have implications for IBD; however, the body of evidence does not currently support clear dietary patterns or food constituents that are associated with a specific microbiota profile or disease marker in IBD patients. Further research is required with a focus on robust and consistent methodology to achieve improved identification of associations. [ABSTRACT FROM AUTHOR]

The irritable bowel syndrome (IBS) is the best-recognized disorder of gut brain interactions (DGBI). However, it is controversial if the Rome IV criteria iteration for IBS diagnosis is fit for purpose. This review critically evaluates Rome IV criteria for diagnosis of IBS and addresses clinical considerations in IBS treatment and management, including dietary factors, biomarkers, disease mimics, symptom severity, and subtypes. The role of diet in IBS is critically reviewed along with the influence of the microbiota, including small intestinal bacterial overgrowth. Emerging data suggest the Rome IV criteria are more suitable for identifying severe IBS and least useful for sub-diagnostic patients who are still likely to benefit from IBS treatment. Despite convincing evidence that IBS symptoms are diet-driven and often postprandial, a relationship to eating is not a Rome IV diagnostic criterion. Few IBS biomarkers have been identified, suggesting the syndrome is too heterogeneous to be measured by a single marker, and combined biomarker, clinical, dietary, and microbial profiling may be needed for objective characterization. With many organic diseases mimicking and overlapping with IBS, it's important clinicians are knowledgable about this to mitigate the risk of missing comorbid organic intestinal disease and to optimally treat IBS symptoms. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore dietitians' perspectives on the evidence surrounding the relationship between diet and 'gut health' and the current and emerging role of dietetics practice in this area. Methods: A qualitative descriptive methodology was used. Online semi‐structured interviews were conducted with Australian dietitians, focused on the perspectives related to gut health management in dietetics practice. Inductive thematic analysis was employed, commencing with initial coding by two researchers, and further coding leading to development of emergent themes. Divergent data were discussed and considered in analysis. Results: Fourteen interviews were conducted (2 males, 12 females). An overarching theme identified that current evidence is insufficient to direct dietetics practice change regarding gut health. Six subthemes on dietetics practice in 'gut health' emerged including (a) practice is multifaceted, (b) current practice aligns with dietary guidelines, (c) symptom management remains the primary concern, (d) evidence‐based information is sought, (e) translational evidence is required for practice change and (f) there is a role for dietetics in gut health research and translation. Conclusions: Dietitians do not appear confident in their practice regarding gut microbiome‐related management and recognise there is currently limited translatable research to inform practice. Evidence to date suggests that recommendations for positive gut health do not differ substantially from Australian Dietary Guidelines. Dietitians will need additional education if further evidence emerges, however they demonstrated a strong commitment to evidence‐based practice. [ABSTRACT FROM AUTHOR]

Aims: To explore consumer perceptions regarding dietary behaviours related to the gut microbiome, to assist in effective translation of research to practice. Methods: Online focus groups were conducted (adults with no formal medical or nutrition training). Semi‐structured open‐ended questioning explored perspectives related to gut health and dietary behaviours. A qualitative descriptive analysis approach was undertaken in duplicate. Results: Fourteen focus groups were conducted (n = 38, 15 males, 23 females). Four overarching themes regarding consumer perceptions were identified. These were (a) gut health equates with wellbeing, (b) there are divergent perceptions of how diet influences gut health, (c) interest in scientific evidence does not necessarily influence dietary behaviour and (d) gastrointestinal symptoms influence dietary behaviour. Conclusions: Consumers are interested in gut health and understand that diet may be important. Given that current literature regarding diet and gut health does not differ from dietary guidelines, consumer interest may provide a timely slant to promote longstanding guidelines. Consumer education to limit scepticism around government messaging, including utilisation of social media by nutrition professionals, may be key to improving adherence to guidelines. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of diabetic ketoacidosis (DKA) at the time of diagnosis of type 1 diabetes in youth varies between countries and is influenced by socioeconomic factors. We investigated the relationship between regional deprivation indices and DKA at the diagnosis of type 1 diabetes in six countries. Methods: We analyzed children 0.5–17.0 years old diagnosed with type 1 diabetes between 2019 and 2022 across six diabetes registries. Regional deprivation index within each country was standardized to compare each individual’s socioeconomic status internationally. Log-binomial regression models assessed the association between the standardized deprivation index and DKA, with sex, age group, and year as covariates. Results: Among 21,020 children (mean age 9.08 [SD 4.19] years), the DKA rate of 36.5%. Cohorts were Germany (n = 13,561, DKA 32.5%), Italy (4,659, 42.5%), Colorado, USA (1,318, 54.9%), Wales (769, 35.2%), New Zealand (407, 43.7%), and Slovenia (306, 37.6%). Deprivation was associated with the increased risk of DKA in children 0.5–<6 (OR 1.16 [95% CI: 1.10–1.23], p < 0.0001) and 6–<12 years of age (1.05 [1.05–1.11], p = 0.02). Female sex increased risk of DKA (1.06 [1.00–1.13], p = 0.04). The proportion of DKA was lower in 2019 than in 2020, 2021, and 2022 (each p < 0.0001). Conclusion: Deprivation was significantly associated with the risk of DKA at the diagnosis of type 1 diabetes, and DKA was more common during the pandemic years 2020–2022 than in 2019. Younger children appear to be more vulnerable to deprivation than older patients. Understanding and reducing local and demographic-specific disparities are essential for effective intervention. [ABSTRACT FROM AUTHOR]

Context Cereal fiber modulates the gut microbiome and benefits metabolic health. The potential link between these effects is of interest.0 Objective The aim for this systematic review was to assess evidence surrounding the influence of cereal fiber intake on microbiome composition, microbiome diversity, short-chain fatty acid production, and risk factors for metabolic syndrome. Data Sources and Extraction The MEDLINE, PubMed, CINAHL, and Cochrane Library databases were searched systematically, and quality of studies was assessed using the Cochrane Risk of Bias 2.0 tool. Evidence relating to study design, dietary data collection, and outcomes was qualitatively synthesized on the basis of fiber type. Data Analysis Forty-six primary publications and 2 secondary analyses were included. Cereal fiber modulated the microbiome in most studies; however, taxonomic changes indicated high heterogeneity. Short-chain fatty acid production, microbiome diversity, and metabolic-related outcomes varied and did not always occur in parallel with microbiome changes. Poor dietary data were a further limitation. Conclusions Cereal fiber may modulate the gut microbiome; however, evidence of the link between this and metabolic outcomes is limited. Additional research is required with a focus on robust and consistent methodology. Systematic Review Registration PROSPERO registration no. CRD42018107117 [ABSTRACT FROM AUTHOR]

Competing Interests: None