The irregular meal pattern and meal-skipping might be related to irritable bowel syndrome (IBS), however, findings of previous investigations are contradictory. We aimed to examine the relation of meal regularity with IBS in Iranian adult population.
Data on 4599 adults who worked in 50 different health centers were used in this cross-sectional study. Dietary habits were measured using a pretested questionnaire. IBS identification was performed through the use of a modified version of Rome III questionnaire.
IBS was prevalent among 18.6% of men and 24.1% of women. After adjustment for potential confounders, those with regular meal pattern, in comparison to those with irregular meals, had 40% lower odds for IBS (OR:0.60, 95%CI: 0.41–0.87). Individuals with regular meals had also 82 lower risk for IBS-Mixed, in comparison to those who had irregular meals (OR:0.18, 0.95%CI: 0.08–0.43). Stratified analysis by gender revealed that women with regular meals, compared with those who did not, had 44% lower risk for IBS (OR: 0.56, 0.95%CI: 0.34–0.91). Normal-weight individuals who had regular meal pattern, compared to those who did not, had 63% lower risks for IBS (OR:0.37, 95%CI: 0.22–0.64). Furthermore, subjects who had regular meal pattern had 53% lower risk for severe symptoms of IBS (OR:0.47, 95%CI: 0.30–0.71).
We found that participants with regular meal pattern had reduced odds of IBS, IBS-Mixed and the syndrome severity. Meal regularity was also linked to reduced IBS prevalence in women, and in normal-weight individuals. More prospective studies are needed to affirm these associations.
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Aziz I, Törnblom H, Palsson OS, Whitehead WE, Simrén M. How the change in IBS criteria from Rome III to Rome IV impacts on clinical characteristics and key pathophysiological factors. Am J Gastroenterol. 2018;113:1017–25.
Fukudo S, Kaneko H, Akiho H, Inamori M, Endo Y, Okumura T, et al. Evidence-based clinical practice guidelines for irritable bowel syndrome. J Gastroenterol. 2015;50:11–30.
Chang L. Epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharm Ther. 2004;20:31–9.
Thompson WG. Irritable bowel syndrome: pathogenesis and management. Lancet. 1993;341:1569–72.
van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA, et al. Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO. BMC Complement Alter Med. 2008;8:1–7.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130:1480–91.
Nilholm C, Larsson E, Roth B, Gustafsson R, Ohlsson B. Irregular dietary habits with a high intake of cereals and sweets are associated with more severe gastrointestinal symptoms in IBS patients. Nutrients. 2019;11:1279.
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015;313:949–58.
Mansueto P, D’Alcamo A, Seidita A, Carroccio A. Food allergy in irritable bowel syndrome: the case of non-celiac wheat sensitivity. World J Gastroenterol. 2015;21:7089.
Mansueto P, Seidita A, D’Alcamo A, Carroccio A. Role of FODMAPs in patients with irritable bowel syndrome. Nutr Clin Pr. 2015;30:665–82.
Hayes PA, Fraher MH, Quigley EM. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol (N. Y). 2014;10:164.
Gwee KA, Bak YT, Ghoshal UC, Gonlachanvit S, Lee OY, Fock KM, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1189–205.
Kosako M, Akiho H, Miwa H, Kanazawa M, Fukudo S. Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey. Biopsychosoc Med. 2018;12:12.
Khademolhosseini F, Mehrabani D, Nejabat M, Beheshti M, Heydari ST, Mirahmadizadeh A, et al. Irritable bowel syndrome in adults over 35 years in Shiraz, southern Iran: prevalence and associated factors. J Res Med Sci. 2011;16:200–6.
Black CJ, Yiannakou Y, Houghton LA, Ford AC. Epidemiological, clinical, and psychological characteristics of individuals with self-reported irritable bowel syndrome based on the Rome IV vs Rome III criteria. Clin Gastroenterol Hepatol. 2020;18:392–8.
Keshteli AH, Dehestani B, Daghaghzadeh H, Adibi P. Epidemiological features of irritable bowel syndrome and its subtypes among Iranian adults. Ann Gastroenterol. 2015;28:253.
Michalsen VL, Vandvik PO, Farup PG. Predictors of health-related quality of life in patients with irritable bowel syndrome. a cross-sectional study in Norway. Health Qual Life Outcomes. 2015;13:113.
Thomas A, Quigley EM. Diet and irritable bowel syndrome. Curr Opin Gastroenterol. 2015;31:166–71.
Canavan C, West J, Card T. The economic impact of the irritable bowel syndrome. Aliment Pharm Ther. 2014;40:1023–34.
Volta U, Pinto-Sanchez MI, Boschetti E, Caio G, De Giorgio R, Verdu EF. Dietary triggers in irritable bowel syndrome: is there a role for gluten? J Neurogastroenterol Motil. 2016;22:547.
Black CJ, Ford AC. Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management. Med J Aust. 2018;209:86–91.
Talley NJ, Holtmann G. Irritable bowel syndrome and functional dyspepsia: what can epidemiology tell us about etiology? Expert Rev Gastroenterol Hepatol. 2018;12:633–5.
Creed F. The incidence and risk factors for irritable bowel syndrome in population‐based studies. Aliment Pharm Ther. 2019;50:507–16.
Spiller RC. Role of infection in irritable bowel syndrome. J Gastroenterol. 2007;42:41–7.
Böhn L, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108:634–41.
Simrén M, Månsson A, Langkilde AM, Svedlund J, Abrahamsson H, Bengtsson U, et al. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001;63:108–15.
Böhn L, Störsrud S, Simrén M. Nutrient intake in patients with irritable bowel syndrome compared with the general population. Neurogastroenterol Motil. 2013;25:23–e1.
Khayyatzadeh S, Esmaillzadeh A, Saneei P, Keshteli A, Adibi P. Dietary patterns and prevalence of irritable bowel syndrome in Iranian adults. Neurogastroenterol Motil. 2016;28:1921–33.
Jarrett M, Visser R, Heitkemper M. Diet triggers symptoms in women with irritable bowel syndrome: the patient’s perspective. Gastroenterol Nurs. 2001;24:246–52.
Esmaillzadeh A, Keshteli AH, Hajishafiee M, Feizi A, Feinle-Bisset C, Adibi P. Consumption of spicy foods and the prevalence of irritable bowel syndrome. World J Gastroenterol. 2013;19:6465.
Zaribaf F, Keshteli AH, Esmaillzadeh A, Saneei P, Feizi A, Daghaghzadeh H, et al. Empirically derived dietary habits are associated with irritable bowel syndrome. Eur J Clin Nutr. 2018;72:1537–47.
Khayyatzadeh SS, Kazemi‐Bajestani SMR, Mirmousavi SJ, Heshmati M, Khoshmohabbat S, Ferns GA, et al. Dietary behaviors in relation to prevalence of irritable bowel syndrome in adolescent girls. J Gastroenterol Hepatol. 2018;33:404–10.
Hajishafiee M, Keshteli AH, Saneei P, Feinle‐Bisset C, Esmaillzadeh A, Adibi P. Healthy lifestyle score and irritable bowel syndrome: a cross‐sectional study in adults. Neurogastroenterol Motil. 2020;32:e13793.
Okami Y, Kato T, Nin G, Harada K, Aoi W, Wada S, et al. Lifestyle and psychological factors related to irritable bowel syndrome in nursing and medical school students. J Gastroenterol. 2011;46:1403–10.
Reed‐Knight B, Squires M, Chitkara DK, van Tilburg MA. Adolescents with irritable bowel syndrome report increased eating‐associated symptoms, changes in dietary composition, and altered eating behaviors: a pilot comparison study to healthy adolescents. Neurogastroenterol Motil. 2016;28:1915–20.
Colwell L, Prather C, Phillips S, Zinsmeister A. Effects of an irritable bowel syndrome educational class on health-promoting behaviors and symptoms. Am J Gastroenterol. 1998;93:901–5.
Guo Y-B, Zhuang K-M, Kuang L, Zhan Q, Wang X-F, Liu S-D. Association between diet and lifestyle habits and irritable bowel syndrome: a case-control study. Gut Liver. 2015;9:649.
Alharbi SH, Alateeq FA, Alshammari KI, Alshammri ASS, Alabdali NAN, Alsulaiman MAS, et al. Irritable bowel syndrome and dietary habits in northern Saudi Arabia. Health. 2019;11:289–97.
Shinozaki M, Fukudo S, Hongo M, Shimosegawa T, Sasaki D, Matsueda K, et al. High prevalence of irritable bowel syndrome in medical outpatients in Japan. J Clin Gastroenterol. 2008;42:1010–6.
Kim YJ, Ban D. Prevalence of irritable bowel syndrome, influence of lifestyle factors and bowel habits in Korean college students. Int J Nurs Stud. 2005;42:247–54.
Sun J, Yi H, Liu Z, Wu Y, Bian J, Wu Y, et al. Factors associated with skipping breakfast among Inner Mongolia Medical students in China. BMC Public Health. 2013;13:42.
Son Y-J, Jun E-Y, Park JH. Prevalence and risk factors of irritable bowel syndrome in Korean adolescent girls: a school-based study. Int J Nurs Stud. 2009;46:77–85.
Wang Y, Jin F, Chi B, Duan S, Zhang Q, Liu Y, et al. Gender differences in irritable bowel syndrome among medical students at Inner Mongolia Medical University, China: a cross-sectional study. Psychol Health Med. 2016;21:964–74.
Adibi P, Keshteli AH, Esmaillzadeh A, Afshar H, Roohafza H, Bagherian-Sararoudi R et al. The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): Overview of methodology. J Res Med Sci. 2012;17:S292–S298.
NICE. Promoting and creating built or natural environments that encourage and support physcial activity: scope. National Institute for Health and Clinical Excellence, London 2006.
Soltani S, Keshteli AH, Esmaillzadeh A, Adibi P Food item avoidance of patients with irritable bowel syndrome compared with healthy people. Arch Iran Med. 2019;22:369-75.
Burden S. Dietary treatment of irritable bowel syndrome: current evidence and guidelines for future practice. J Hum Nutr Diet. 2001;14:231–41.
Floch MH, Narayan R. Diet in the irritable bowel syndrome. J Clin Gastroenterol. 2002;35:S45–S52.
Chirila I, Petrariu FD, Ciortescu I, Mihai C, Drug VL Diet and irritable bowel syndrome. J Gastrointestin Liver Dis. 2012;21:357-62.
Alpers DH. Diet and irritable bowel syndrome. Curr Opin Gastroenterol. 2006;22:136–9.
El-Salhy M, Gundersen D. Diet in irritable bowel syndrome. Nutr J. 2015;14:36.
Lovell RM, Ford AC. Effect of gender on prevalence of irritable bowel syndrome in the community: systematic review and meta-analysis. Am J Gastroenterol. 2012;107:991–1000.
Lee S-Y, Kim JH, Sung I-K, Park H-S, Jin C-J, Choe WH, et al. Irritable bowel syndrome is more common in women regardless of the menstrual phase: a Rome II-based survey. J Korean Med Sci. 2007;22:851–4.
Aro P, Ronkainen J, Talley NJ, Storskrubb T, Bolling-Sternevald E, Agréus L. Body mass index and chronic unexplained gastrointestinal symptoms: an adult endoscopic population based study. Gut. 2005;54:1377–83.
Ho W, Spiegel BM. The relationship between obesity and functional gastrointestinal disorders: causation, association, or neither? Gastroenterol Hepatol (N. Y). 2008;4:572.
Ohlsson B, Manjer J. Physical inactivity during leisure time and irregular meals are associated with functional gastrointestinal complaints in middle-aged and elder subjects. Scand J Gastroenterol. 2016;51:1299–307.
Saneei P, Esmaillzadeh A, Keshteli AH, Feizi A, Feinle-Bisset C, Adibi P. Patterns of dietary habits in relation to obesity in Iranian adults. Eur J Nutr. 2016;55:713–28.
Vakhshoori M, Saneei P, Esmaillzadeh A, Daghaghzadeh H, Hassanzadeh Keshteli A, Adibi P The association between meal and snack frequency and irritable bowel syndrome. Public Health Nutr. 2020;24:1-12.
Sasaki S, Katagiri A, Tsuji T, Shimoda T, Amano K. Self-reported rate of eating correlates with body mass index in 18-y-old Japanese women. Int J Obes Relat Metab Disord. 2003;27:1405–10.
The financial support for conception, design, data analysis and manuscript drafting comes from Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. We wish to thank all staff of Isfahan University of Medical Sciences who kindly participated in our study.
The financial support for conception, design, data analysis and manuscript drafting comes from Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
The authors declare no competing interests.
Ethical approval and consent to participate
All participants provided informed written consent. The study was ethically approved by the Research Council of Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (IUMS).
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Bavani, N.G., Hajhashemy, Z., Saneei, P. et al. The relationship between meal regularity with Irritable Bowel Syndrome (IBS) in adults. Eur J Clin Nutr 76, 1315–1322 (2022). https://doi.org/10.1038/s41430-022-01108-3