{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:25:04Z","timestamp":1791890704304,"version":"4.3.4"},"reference-count":30,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2016,10,1]],"date-time":"2016-10-01T00:00:00Z","timestamp":1475280000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","scandinavianjournalpain.com","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_j.sjpain.2016.07.004_s_001\">\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, \u201cfermentable oligo-, di- or mono-saccharides and polyols\u201d [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2016.07.004_s_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A longitudinal study using LFD intervention was performed on 38, 51\u00b110 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 \u2013 introduction of the protocol to participants; Moment 1 \u2013 first assessment and delivery of individual LFD dietary plans; Moment 2 \u2013 second assessment and reintroduction of FODMAPs; Moment 3 \u2013 last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman,\n                      <jats:italic>t<\/jats:italic>\n                      -student and Chi-square tests, using SPSS 22 software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2016.07.004_s_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0\u201331) \u2013 22\u00b14.4; RFIQ (0\u2013100) \u2013 65\u00b117; IBS-SSS (0\u2013500) \u2013 275\u00b1 101; and EQ-5D (0\u2013100) \u2013 48\u00b1 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g\/day vs. 2.5 g\/day;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). Comparisons between the three moments of assessment showed significant (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138\u00b1117, following LFD therapy. A significant correlation (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.36;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.65;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01) between \u201csatisfaction with improvement\u201d after introduction of LFDs and \u201cdiet adherence\u201d, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 6.16;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .05), showing that the probability of improvement, depends on the severity of the RFIQ score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2016.07.004_s_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2016.07.004_s_005\">\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.sjpain.2016.07.004","type":"journal-article","created":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T08:05:05Z","timestamp":1472025905000},"page":"166-172","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":68,"title":["A low fermentable oligo-di-mono saccharides and polyols(FODMAP) diet reduced pain and improve ddaily life in fibromyalgia patients"],"prefix":"10.1515","volume":"13","author":[{"given":"Ana Paula","family":"Marum","sequence":"first","affiliation":[{"name":"Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz , 1649-028 Universidade de Lisboa , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e1tia","family":"Moreira","sequence":"additional","affiliation":[{"name":"Escola Superior de Tecnologia da Sa\u00fade de Lisboa, Av. Dom Jo\u00e3o II Lote 4.69.01, 1990-096 Lisboa , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Saraiva","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz , 1649-028 Universidade de Lisboa , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Tomas-Carus","sequence":"additional","affiliation":[{"name":"Departamento de Desporto e Sa\u00fade , Escola de Ci\u00eancias e Tecnologia, Universidade de \u00c9vora , Portugal"},{"name":"Research Centre for Sports, Health and Human Development , CIDESD, GERON Research Community , \u00c9vora , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Sousa-Guerreiro","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz , 1649-028 Universidade de Lisboa , Portugal"},{"name":"Escola Superior de Tecnologia da Sa\u00fade de Lisboa, Av. 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