The effectiveness of low-carb diets has been confirmed

This is new evidence that diet plays a central role in irritable bowel syndrome (or “functional colopathy”). A study recently published in the journal Lancet Gastroenterology and Hepatology He confirms that a diet low in Fodmaps (the English abbreviation for “oligosaccharides, disaccharides, monosaccharides and polyols”) is effective in improving symptoms and quality of life of patients. This study even provides evidence for the first time that this diet is more effective than medication. As a reminder, this benign disease, which affects 5% of the population (women more than men), causes intestinal disorders and abdominal pain on a daily basis.

To reach this result, researchers at the University of Gothenburg, Sweden, tested three types of treatments on 300 patients for a month. The first group had to follow a low-Fodmaps diet, that is, exclude foods containing sugars that are poorly absorbed in the intestine. We can mention lactose found in dairy products; fructans, found in wheat, rye and barley; Fructose, found in fruits, but also added to all industrially prepared meals; Or even galactans, which are mainly found in legumes (chickpeas, lentils, etc.).

Long term benefits

The second group followed a “low-carb” diet, low in carbohydrates but high in protein. As for the patients in the third group, they were treated with antispasmodic, laxative, or antidiarrheal medications. After one month of treatment, all three groups experienced improvements in symptoms and quality of life. But not in the same proportions: three-quarters of patients who followed one of the two diets saw an improvement in their condition, compared to “only” half of people treated with medications.

Rather, the benefits of the diets appeared over time, as after six months, the majority of participants were in good shape, although they gradually returned to their usual diet. “ This finding suggests that small reductions in Fodmaps and carbohydrate intake can have beneficial effects »confirmed the study authors.

In practice, the low-FODMAPs diet is already recommended for treating irritable bowel syndrome, but not the high-protein “low-carb” diet, for which there is no evidence of effectiveness. “ The low FODMAPs diet consists of temporarily eliminating all foods containing fermentable sugars because these increase the secretion of water in the small intestine, generating bloating, and they also ferment in the colon, generating gas. »“, explains P.^s Benoit Coffin, Head of the Department of Hepatology and Gastroenterology at the Louis Maurier Hospital in Colombes (Hauts-de-Seine). Water and gas retention causes the digestive system to swell, causing pain.

Irritable bowel syndrome results from hypersensitivity of the gut-brain axis, and fermentable sugars exacerbate this phenomenon.

Professor François Millon, Head of the Department of Functional Exploration of the Digestive System at the Edouard Herriot Hospital in Lyon

“ Many patients think that they are intolerant or allergic to this or that food, especially gluten, but this is not the case. »specifies P.^s François Millon, Head of the Department of Functional Exploration of the Digestive System at the Edouard Herriot Hospital in Lyon. “ Irritable bowel syndrome results from hypersensitivity of the gut-brain axis, and fermentable sugars exacerbate this phenomenon. »He continued.

Foods that should be reintroduced little by little

On paper, the idea is simple: completely eliminate sources of Fodmaps for six to eight weeks. “ If the patient's condition improves, he is asked to gradually reintroduce the different food groups until he can determine whether the doses are acceptable for him. »refers to P^s François Millon. The first effects usually begin to be felt after one to two weeks. But in reality, removing these sugars from our diet is quite a challenge. “ It is difficult to follow a diet because many foods contain it. : Lots of fruits and vegetables, all products derived from wheat, industrial dishes… »lists the gastroenterologist.

Fortunately, there are alternatives. Instead of milk and yogurt, you should, for example, resort to lactose-free milk, plant-based drinks (soy, oat, etc.) or even soy yogurt. On the fruit side, apples, pears, peaches or even apricots should give way to bananas, pineapples, citrus fruits or even watermelon. “ You should also abstain from all foods made from wheat, barley, and rye, because they contain a type of starch that is resistant to digestion. »specifies P.^s Benoit's coffin. Goodbye to that pasta, semolina, flour, bread and cereals. “ Buckwheat, spelled, rice or oats, in all their forms, can replace wheat products »“, argues P^s Mion.

Get support from a nutritionist

“ It's a diet that works well, is prescribed often, and is worth trying »encourages P^s The coffin, while acknowledging the limitations this represents. Furthermore, cutting out all those fermentable carbohydrates can lead to an unbalanced diet Shortcomings. Therefore, the best solution is to seek help from a nutritionist or nutritionist, especially if you are prone to eating disorders.

“ This is not easy, because you have to find a specialist who knows this disease well and you have to have enough income to afford this care because it is not covered. »P confirms^s François Millon. However, in many cities (Lyon, Paris, Rouen, Nancy, Bordeaux, etc.), hospitals have created all-fee care paths, where everything can be done at once: medical consultations, diet sessions, and psychological support. But you have to be patient. “ In our hospital, the waiting period ranges from three to four months »specifies P.^s Mion.