Difference in clinical response favored MD and demonstrated noninferiority and superiority to traditional dietary advice
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Oct. 29, 2025 (HealthDay News) — For patients with irritable bowel syndrome (IBS), the Mediterranean diet (MD) is superior to traditional dietary advice (TDA) as first-line therapy, according to a study published online Oct. 27 in the Annals of Internal Medicine.
Joy O. Bamidele, from the University of Sheffield in the United Kingdom, and colleagues examined whether the MD is noninferior to TDA for managing IBS symptoms in a study involving 139 persons with IBS. Participants received six weeks of the MD or TDA (68 and 71, respectively). The proportion achieving clinical response, defined as 50-point or greater reduction in the IBS Symptom Severity Scale (IBS-SSS), was examined as the primary end point.
The researchers found that in a modified intention-to-treat analysis, the primary end point was met by 62 and 42 percent of participants following MD versus TDA. The difference in clinical response favored the MD, demonstrating noninferiority and superiority (difference, 20 percent; P = 0.017). A greater reduction was seen in mean IBS-SSS after MD versus TDA (–101.2 versus –64.5; P = 0.034). The groups did not differ with respect to changes in mood, somatic symptoms, quality of life, or diet satisfaction. There was significant improvement in the Mediterranean Diet Adherence Screener after MD versus TDA.
“This trial found the MD to be noninferior (rather, it showed superiority) to TDA in managing IBS symptoms. It can be considered as another first-line dietary option before escalating to demanding second-line therapies,” the authors write.
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