S2010 Clinical and Molecular Effects of a Reduced Starch and Sucrose Diet in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Introduction: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by a variety of symptoms that affect the digestive system. It is characterized by mild to chronic abdominal pain and altered bowel movements in the absence of a specific cause. Dietary modification is a component of symptom management, with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet commonly used, however, it can be restrictive. This study evaluates the clinical, metabolic and biomarker outcomes of a sucrose-reduced diet (SSRD) in adults with IBS. Methods: We conducted a systematic review and meta-analysis of clinical trials focusing on the impact of SSRD in adults with IBS. Seven studies were included from a comprehensive literature search using PubMed, Cochrane Library, OpenMD, and Google Scholar (2015-present). Study quality and bias were assessed with Cochrane risk of bias Robins2. The outcomes included gastrointestinal symptoms, quality of life, psychological well-being and metabolic markers and inflammatory markers. Results: Most studies showed no significant differences in baseline characteristics between the intervention and control group (P > 0.05). After 6 months of SSRD, significant improvements were observed in abdominal pain (P < 0.001), diarrhea (P < 0.007), bloating (P < 0.001), vomiting (P = 0.04) and a total IBS-SSS score (P < 0.001) in intervention groups. Between-group comparisons at 6 months showed that SSRD significantly improved multiple gastrointestinal symptoms compared to controls. Improvements were also noted in extraintestinal symptoms, including fatigue, psychological well-being, and metabolic parameters (BMI, blood pressure, inflammatory markers), though with varying significance across studies. Conclusion: Across all 7 studies, the SSRD diet from baseline to 6 months showed significant improvement across all primary and secondary outcomes. The SSRD appears to be a promising dietary intervention for adults with IBS, offering improvements not only in gastrointestinal symptoms but also in inflammatory and microbial markers. Further studies are needed that focus on a more diverse country patient population that is ethnicity-specific.