Uma intervenção nutricional com restrição de Fodmaps integrada no tratamento da fibromialgia : uma realidade com benefícios?
Year: 2016
Type: dissertation
Study design: Clinical Trial
Abstract: Introduction- Fibromyalgia (FM) is a chronic rheumatic disease characterized by widespread pain of unknown aetiology and low effective pharmacotherapy. Low FODMAPS Diet has growing scientific evidence as IBS therapy. A shared comorbidity with gastrointestinal functional disorders is found in FM. Objectives: Study the effects of a Low FODMAPs Diet (LFD) on the FM symptoms, IBS symptoms, impact on daily life, quality of life (QOL), and distress as well to study the effect on the nutritional status of the participants. Methods: Interventional study with 38 FM patients according to 2011 ACR criteria on a 4 week LFD and FODMAPs reintroduction for another 4 weeks. Evaluation was made on moments 1.2 and 3, before and after dietary intervention and subsequent reintroduction. A clinical and dietary anamnesis was made. Applied questionnaires: FSQ, RFIQ, IBS_SSS, Euro-QOL, Core-OM and VAS method. Nutritional status was studied by weight, Body mass index, waist circumference and body composition. Daily consumption in FODMAPs and other dietary nutrients was quantified. ANOVA and Friedman tests were applied and Pearson coefficient using SPSS software 22. Results: At baseline the scores of severity and impact of FM were 22 (0-31) and 62 (0-100); IBS score was 275 (0-500). It was demonstrated a significant improvement in IBS score (p <0.01) with a 50% reduction in the score after a 4 week LFD. A significant improvement in the FM scores, RFIQ and FSQ (p <0.01) was also demonstrated. A specific improvement on visceral and somatic pain hypersensitivity (VAS Pain = p < 0.01) was also seen. The quality of life tended to improve but without significance in the period in which the study took place. The distress score reduced with significance (p<0.01). It was found an interesting positive correlation between improved RFIQ score and IBS score (rs=0.36; p <0.05), also between improved RFIQ and improved VAS abdominal pain (rs= 0.448; p <0.01) and a positive correlation between the rate of satisfaction with the symptomatic improvement and the compliance rate to the diet (r = 0.65; p <0.01). The satisfaction rate with the diet was 77% with a compliance to the diet of 85%. The adherence to the diet was confirmed comparing the intake of FODMAPs of the plan with the diets(p>0.05).The usual mean of FODMAPs intake was 25 g / day vs 2.5 g / day on LFD with a significant difference(p <0.01). The LFD significantly reduced the weight status but no significant effect on body composition was noticed. Conclusion: Prescription of a LFD resulted in a very positive impact on the gastrointestinal and pain symptoms and on the impact of fibromyalgia on the daily lives of this group of patients.. Data suggest that the restrictions of FODMAPs can have an effect on weight loss in the context of a normocaloric plan. The results stimulate the continuation of larges studies in the field Low FODMAPs Diet as a complementary therapy in fibromyalgia.
Author: Ana Paula Marum
Language: Portuguese
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2491075622