PP263 - EFFICACY OF A NOVEL LOW-FODMAP EXPERIMENTAL BREAD ON SYMPTOMS' SEVERITY IN IRRITABLE BOWEL SYNDROME: A CROSSOVER RANDOMIZED TRIAL

PP263

EFFICACY OF A NOVEL LOW-FODMAP EXPERIMENTAL BREAD ON SYMPTOMS' SEVERITY IN IRRITABLE BOWEL SYNDROME: A CROSSOVER RANDOMIZED TRIAL

M. Cintoni^1,2,*, E. Leonardi³, M. Palombaro¹, P. C. Raoul¹, E. Rinninella^1,2, F. Galgano⁴, N. Condelli⁴, T. Scarpa⁴, A. Tramutola⁴, A. Reale⁵, I. D'antuono⁶, A. Gasbarrini⁷, M. C. Mele^1,2

¹UOC Nutrizione Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, ²Centro di Ricerca e Formazione in Nutrizione Umana, ³Scuola di Dottorato di Ricerca in “Scienze della nutrizione, del metabolismo, dell’invecchiamento e delle patologie di genere, Università Cattolica del Sacro Cuore, Roma, ⁴Dipartimento di Scienze Agrarie, Forestali, Alimentari e Ambientali (DAFE), Università degli Studi della Basilicata, Potenza, ⁵Istituto di Scienze dell'Alimentazione, Consiglio Nazionale delle Ricerche, Avellino, ⁶Istituto di Scienze delle Produzioni Alimentari, Consiglio Nazionale delle Ricerche, Bari, ⁷UOC Medicina Interna, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy

Rationale: The low-FODMAP diet effectively manages Irritable Bowel Syndrome (IBS), but eliminating staples like conventional bread impairs adherence. We evaluated the clinical efficacy of a novel low-FODMAP experimental bread (BREAD4IBS) on IBS symptom severity compared to a control bread (CB).

Methods: BREAD4IBS formulation involved screening T. durum and T. aestivum flours. The breadmaking process used a mixed starter of baker's yeast and specific lactic acid bacteria to degrade fructans without increasing other FODMAPs. A double-blind, crossover trial included 40 IBS patients maintaining a strict low-FODMAP diet. Participants consumed BREAD4IBS or CB for 2 weeks, with a 2-week washout before crossover. Symptom severity was evaluated using the GSRS-IBS.

Results: Four drop-outs occurred due to diet adherence issues or symptom exacerbation. 36 patients completed the trial (34F; age 30.7±10.8). GSRS-IBS scores were significantly lower with BREAD4IBS (32.4±9.1) than at baseline (52.4±14.7; p<0.001), demonstrating clinical superiority over CB (44.6±13.6; p=0.023). Notably, BREAD4IBS symptoms equaled the "no bread" phase (35.8±13.4; p=0.73). BREAD4IBS also significantly improved subscale clusters: indigestion (p=0.0001), reflux (p=0.002), abdominal pain (p=0.007), and constipation (p=0.02).

Conclusion: BREAD4IBS, produced via targeted biotechnological fermentation, significantly reduces gastrointestinal symptoms compared to traditional bread, matching a bread-free diet profile. This novel food choice could strongly boost dietary adherence and quality of life for IBS patients on a low-FODMAP regimen.

Disclosure of Interest: None declared