Elsevier

Nutrition Research

Volume 31, Issue 5, May 2011, Pages 356-361
Nutrition Research

Low intake of vitamin B6 is associated with irritable bowel syndrome symptoms

https://doi.org/10.1016/j.nutres.2011.04.001Get rights and content

Abstract

Most subjects with irritable bowel syndrome (IBS) experience an association between symptoms and food consumption. Although dietary intake has been the focus of previous research, attention to specific nutrients has been rare. We hypothesized that there is an association between the severity of IBS symptoms and the intake of specific food groups and specific nutrients. In this cross-sectional study, 17 human subjects with IBS, as defined according to the Rome II criteria, were recruited. IBS symptoms were recorded on diary cards every evening for 7 days, and an IBS sum score was calculated (range, 0-15). Intake of food was assessed from a food diary kept by the subjects in the same period. Associations between IBS sum score and dietary intake were explored. The daily IBS sum score was 6.43 (range, 3.86- 9.09). Intake of vitamin B6 was the only component of the diet that was significantly associated with the IBS sum score. The median daily intake of vitamin B6 was 0.9 mg/day (range, 0.6-1.5), the recommended daily intake for men and women is 1.6 mg/day or more and 1.2 mg/day or more, respectively. A high symptom score was associated with low vitamin B6 intake (adjusted R2 = 0.583; β = −4.431; 95% confidence interval, −6.386 to −2.476; P = 0.0002). A significant inverse association between intake of vitamin B6 and severity of IBS symptoms might have clinical implications.

Introduction

Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal disorder, with a prevalence of 5% to 11% [1], and is associated with high costs of health care and reduced quality of life [2].

Two thirds of subjects with IBS relate their symptoms to the intake of food, leading most patients to modify their diet, some to such a degree that their diet is inadequate [3], [4]. Previous studies have examined the diets of patients with IBS and compared them with those of control subjects [5], [6], [7]. Intolerance to and reduced intake of milk, eggs, fruits, vegetables, and cereals, along with a high intake of soft drinks and fast food, has been reported [4], [5]. Short-chain poorly absorbed carbohydrates in the diet have been shown to prolong gas production, and reduction of these carbohydrates in the diet relieved symptoms [8], [9].

The dietary recommendations for subjects with IBS include avoiding insoluble and gas-producing food items including short-chain poorly absorbed carbohydrates [10], [11], [12]. There are, to our knowledge, no studies on associations between types and amounts of foods and nutrients in the diet and the severity of symptoms in subjects with IBS. This study, with a precise registration of symptoms and dietary intake every day during a 1-week period, hypothesized that there are associations between symptoms and the intake of specific food groups and nutrients in subjects with IBS. The objective was to search for possibilities to improve the dietary treatment of the disorder.

Section snippets

Subjects

Subjects were recruited consecutively from a hospital-based gastroenterology outpatient clinic and a private gastroenterologic practice. Individuals aged 18 to 75 years who were diagnosed with IBS according to the Rome II criteria and had demonstrated symptoms during the previous 3 months were eligible for inclusion. All subjects had undergone a sigmoidoscopy or colonoscopy within the previous 5 years, biopsies were taken when appropriate, and a laboratory screening was performed according to

Results

Twenty-eight subjects were recruited between January and April 2006. Of these, 5 did not meet the inclusion criteria for the randomized controlled trial, 4 withdrew consent, 1 was unable to be contacted, and 1 was excluded for other reasons. Therefore, data from 17 participants were available for this study. Of these, 1 had constipation-predominant IBS, 9 had alternating IBS, and 7 had diarrhea-predominant IBS. The daily IBS sum score was 6.43 (3.86-9.09).

Table 1 shows the subject

Discussion

The study supports the hypothesis that there are associations between symptoms and the intake of specific food groups and nutrients in subjects with IBS. There was a significant inverse association between dietary intake of B6 and severity of IBS symptoms. To our knowledge, this association has previously not been reported. Intake of B6 was inversely associated not only with IBS sum score but also with each of the symptoms in the sum score. The intake of B6 was low compared with both NNR and

Acknowledgments

We thank Ole Breder, specialist in internal medicine, for his assistance in recruiting participants. The study was funded by Nortura BA, Norway, and the Norwegian Foundation for Health and Rehabilitation through the Norwegian Asthma and Allergy Association, Norway. The funding sources had no role in the study design, data collection, analysis, interpretation of data, or in writing the manuscript.

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