Compliance with Dietary Recommendations in Adults with Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, affecting the lives of many young and middle-age adults. The majority of patients must cope with recurrent symptoms. Increasing fiber intake is generally recommended by clinicians for the management of IBS symptoms (Videlock & Chang, 2007). However, few studies have explored the effectiveness of dietary education on increasing compliance with dietary recommendations such as increasing fiber intake in adults with IBS. The aims of this secondary analysis were to: (a) describe the levels of dietary fiber, vegetable, and fruit consumption at three data collection points and by intervention condition; (b) examine the intervention effect; (c) test the association of compliance with ADA recommendations for fiber intake with improvement of GI symptoms; and (d) examine personal and environmental factors and severity of GI symptoms associated with compliance to ADA recommendations for fiber intake. One hundred seventy-three subjects were randomized to individualized comprehensive self-management face-to-face groups (CSM-FF), individualized comprehensive self-management telephone groups (CSM-TEL), or usual care (UC) groups. Of these, 126 participants (39 in the CSM-FF group, 42 in the CSM-TEL group, and 45 in the UC group) completed all measurements at the baseline, 3-month, and 6-month follow-ups. The primary outcome was compliance with dietary recommendations measured using the food frequency questionnaire (FFQ). The results partly supported the hypothesis that participants in the self-management groups were more compliant with fruit intake as compared to those in the UC group at the 3- and 6-month follow-ups. Results of the trend analysis showed that the self-management dietary modification program is significantly effective in increasing compliance with fiber and fruit recommendations at the 3-month follow-up. Overall, there were positive relationships between dietary fiber intake and GI symptoms (e.g., abdominal pain after eating, abdominal distension, bloating, and nausea) at the 3-month follow-up. Socioeconomic variables (e.g., age, gender, education, marital, and living status) were not significantly correlated with fiber intake at the baseline, 3-month, and 6-month follow-ups. Only personal income was significantly related to fiber intake at baseline. This secondary analysis suggests that long-term compliance with dietary recommendations for fiber, vegetable, and fruit are poor in patients with IBS.