{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:14:28Z","timestamp":1791454468335,"version":"4.3.3"},"reference-count":100,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Approximately 20% of patients with irritable bowel syndrome (IBS) link symptoms to food intake; a low-FODMAP diet is effective in managing these symptoms. Aims: To evaluate the effectiveness of the Mediterranean version of the low-FODMAP Diet (MED\u2013LFD) compared to NICE guidelines for IBS and to assess changes in stool volatile compound levels. Methods: 108 patients with Rome IV IBS without constipation were randomized into the MED\u2013LFD or NICE group. Primary endpoints included changes in symptom severity and responder rate (reduction of &gt;50 IBS-SSS points) after intervention and at 6 months. Secondary endpoints assessed quality of life, symptom burden, adequate relief, anxiety\/depression levels, and adherence. Volatile compound levels were measured using Gas Chromatography\/Mass Spectrometry. Results: At both time points, the MED\u2013LFD group showed a significantly greater improvement in symptom severity (159 \u00b1 80 vs. 253 \u00b1 94 and 168 \u00b1 117 vs. 245 \u00b1 98), responder rates (84.6% vs. 60.8% and 79.1% vs. 52.3%), and adherence (75% vs. 41% and 45% vs. 7%). Similar results were observed for all secondary endpoints, with no serious adverse events reported. The MED\u2013LFD intervention was the strongest independent predictor of being a responder at the first (OR = 6.66; 95%CI = 1.46, 30.4) and second follow-up (OR = 4.85; 95%CI = 1.31, 17.96). Short and branched-chain fatty acids were significantly reduced at both follow-ups. Conclusions: The MED\u2013LFD is superior to NICE recommendations in managing non-constipated IBS symptoms and quality of life. It remains to be proven that reduced volatile compound levels might be an objective marker of response to dietary interventions. ClinicalTrials.gov ID: NCT03997708.<\/jats:p>","DOI":"10.3390\/nu17091545","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T05:10:32Z","timestamp":1746076232000},"page":"1545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Clinical Trial: A Mediterranean Low-FODMAP Diet Alleviates Symptoms of Non-Constipation IBS\u2014Randomized Controlled Study and Volatomics Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7282-4939","authenticated-orcid":false,"given":"Arezina N.","family":"Kasti","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3327-9330","authenticated-orcid":false,"given":"Konstantinos","family":"Katsas","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-0812","authenticated-orcid":false,"given":"Dimitrios E.","family":"Pavlidis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Technology, University of Peloponnese, 24100 Kalamata, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2581-5727","authenticated-orcid":false,"given":"Emmanouil","family":"Stylianakis","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, Medical School, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-2127","authenticated-orcid":false,"given":"Konstantinos I.","family":"Petsis","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-3472","authenticated-orcid":false,"given":"Sophia","family":"Lambrinou","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece"},{"name":"Department of Clinical Nutrition and Dietetics, General Hospital of Karpathos \u201cAghios Ioannis Karpathios\u201d, 85700 Karpathos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-722X","authenticated-orcid":false,"given":"Maroulla D.","family":"Nikolaki","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece"},{"name":"Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University, 72300 Sitia, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-6168","authenticated-orcid":false,"given":"Ioannis S.","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"Hepatogastroenterology Unit, 2nd Propaedeutic Department of Internal Medicine, Medical School, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erifili","family":"Hatziagelaki","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Propaedeutic Medicine, Medical School, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9614-6543","authenticated-orcid":false,"given":"Konstantinos","family":"Papadimitriou","sequence":"additional","affiliation":[{"name":"Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kapolos","sequence":"additional","affiliation":[{"name":"Department of Food Science and Technology, University of Peloponnese, 24100 Kalamata, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6669-4004","authenticated-orcid":false,"given":"Jane G.","family":"Muir","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Monash University, Melbourne 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-9426","authenticated-orcid":false,"given":"Konstantinos","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Hepatogastroenterology Unit, 2nd Propaedeutic Department of Internal Medicine, Medical School, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.2147\/JIR.S174982","article-title":"The Role of Inflammation in Irritable Bowel Syndrome (IBS)","volume":"11","author":"Ng","year":"2018","journal-title":"J. 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