Dietary Patterns Are Associated With Variations in the Global Prevalence and Severity of Rome IV Irritable Bowel Syndrome

Background & Aims The relationship between regional dietary patterns and the global prevalence and severity of irritable bowel syndrome (IBS) is unclear. We aimed to determine whether dietary patterns are associated with variation in the global prevalence and severity of IBS. Methods A total of 54,127 participants from 26 countries completed online questionnaires including Rome IV IBS criteria and the frequency of intake of 10 foods or food groups (fruit, vegetables/legumes, milk, rice, bread, pasta, meat, fish, tofu, eggs). Latent class analysis was conducted to identify distinct dietary patterns (clusters), adjusted for country, religion, and age. Multivariable logistic regression analysis was then performed to explore the association between these clusters and IBS prevalence and severity. Results Four clusters with marked differences in dietary intake frequency of the 10 foods and IBS prevalence ( P < .001) were identified. Dietary clusters A (5.6%; 95% confidence interval [CI], 5.2%–6.0%) and B (4.5%; 95% CI, 4.2%–4.8%), with the highest IBS prevalence, also had the highest IBS symptom severity scores ( P < .001), and were predominantly represented by Egypt, Brazil, and Colombia in cluster A and Argentina, Germany, Poland, and the United States in cluster B. By contrast, the lower IBS prevalence clusters, cluster C (3.4%; 95% CI, 3.1%–3.7%), represented predominantly by Europe, and cluster D (2.6%; 95% CI, 2.3%–2.9%), strongly represented by Asian countries, had lower IBS symptom severity. Conclusions Dietary patterns adjusted by age, country, and religion are associated with the global prevalence and severity of IBS. Further studies are required to investigate population-specific dietary preferences and acceptability of dietary interventions for IBS.