{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:58:05Z","timestamp":1785473885590,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disorders of gut\u2010brain interaction (DGBI) are highly prevalent and frequently associated with psychological distress and meal\u2010related symptoms. While the habitual Italian diet is Mediterranean and nutritionally protective, its high content of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) may exacerbate gastrointestinal (GI) discomfort in susceptible individuals. The extent to which DGBI and psychological distress are associated with real\u2010world dietary behavior remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from the Italian arm of the Rome Foundation Global Epidemiology Study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091930) were analyzed. Participants were classified as controls, diagnostic groups (DGBI and sub\u2010diagnostic DGBI) according to Rome IV criteria, and stratified by psychological distress (PHQ\u20104\u2009&lt;\u20096\u2009=\u2009low; \u2265\u20096\u2009=\u2009high) and GI symptom frequency. Habitual diet was assessed as weekly frequency of consumption of general food categories as well as predefined high\u2010FODMAP (HF) and low\u2010FODMAP (LF) groups. Multivariable negative binomial regression models were used to examine associations among diagnostic groups, psychological distress, GI symptom frequency, and weekly intake of general and FODMAP\u2010classified foods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DGBI affected 46.1% of participants, 20.2% were sub\u2010diagnostic, and 33.7% were controls. High psychological distress was more frequent in DGBI (28.1%) and sub\u2010diagnostic groups (19.0%) than in controls (6.2%) and increased with symptom frequency (adjusted rate ratio [aRR]: 3.90, 95% CI: 2.83\u20135.38 for DGBI vs. controls). Compared to controls, DGBI participants with low distress reported modest reductions in LF fruits (aRR: 0.94, 95% CI: 0.88\u20131.00) and vegetables (aRR: 0.91, 95% CI: 0.86\u20130.97), whereas those with high distress reported broader, nonselective restriction of both HF and LF fruits (aRR: 0.83\u20130.85) and vegetables (aRR: 0.92, 95% CI: 0.85\u20131.00). Compared to controls, sub\u2010diagnostic participants without distress reported mild reductions in dairy and fruit intake; those with distress were too few for reliable analysis. Carbohydrate staples (bread, pasta, pizza) did not differ across all groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Psychological distress exerts a dominant, emotion\u2010driven influence on dietary behavior, promoting nonselective restriction of plant foods independent of FODMAP content. These findings highlight the need for integrated psycho\u2010nutritional interventions that combine psychological support with culturally adapted Mediterranean dietary guidance to preserve nutritional adequacy and improve gut\u2010brain health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70372","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:01:03Z","timestamp":1784174463000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disorders of Gut\u2010Brain Interaction and Psychological Distress Affect Dietary Behavior: Italian Data From the Worldwide Rome Foundation Global Epidemiology Study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-166X","authenticated-orcid":false,"given":"E.","family":"Ribichini","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Fabiani","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases Istituto Superiore di Sanit\u00e0  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. S.","family":"Palsson","sequence":"additional","affiliation":[{"name":"Center for Functional GI &amp; Motility Disorders University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. D.","family":"Sperber","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. I.","family":"Bangdiwala","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7941-1328","authenticated-orcid":false,"given":"E. S.","family":"Corazziari","sequence":"additional","affiliation":[{"name":"Centro di Eccellenza Per le Malattie Gastroenterologiche Ed Endocrino\u2010Metaboliche, Ospedale Isola Tiberina  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2013.259"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00238-3"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32115-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32392"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1708\/3142.31248"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2012.00581.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800389"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2017.58"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14650"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-325214"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17091545"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17813"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16203515"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.121"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.36603"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.027"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.014"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13698"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70060"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14020397"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2014.02.014"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2382"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0791-y"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.03.063"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13706"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14400"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12530"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2016.01.1419"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70372","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70372","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:03:48Z","timestamp":1785470628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/nmo.70372"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70372","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70372"}}