Long-term microbiome and clinical effects of a microbiome-guided personalized diet versus low-FODMAP diet in irritable bowel syndrome: A 12-month follow-up randomized controlled trial

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dc.authorid0000-0003-1799-2539
dc.authorid0000-0002-2282-7207
dc.authorid0000-0001-9676-9532
dc.authorid0000-0003-2806-8464
dc.authorid0000-0002-8722-6023
dc.authorid0000-0003-1187-1349
dc.authorid0000-0002-2278-7786
dc.contributor.authorTunalı, Varol
dc.contributor.authorArslan, Çiğdem
dc.contributor.authorDerviş Haki̇m, Gözde
dc.contributor.authorGündoğdu, Aycan
dc.contributor.authorErmi̇ş, Beyza Hilal
dc.contributor.authorHora, Mehmet
dc.contributor.authorNalbantoğlu, Özkan Ufuk
dc.date.accessioned2026-09-17T14:04:28Z
dc.date.available2026-09-17T14:04:28Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Genel Cerrahi Ana Bilim Dalı
dc.description.abstractDietary therapy is central to irritable bowel syndrome (IBS) management, yet the long-term durability of the low-FODMAP diet (LFD), and of microbiome-guided personalization, remains unclear. We assessed the long-term clinical and gut-microbiome effects of a microbiome-guided personalized diet (PD) compared with a standard LFD in adults meeting Rome IV criteria for IBS. In this multicenter, open-label randomized controlled trial with blinded outcome assessment, participants who completed a 6-week dietary intervention (PD or LFD) were followed at 6 and 12 months without further dietary intervention. Outcomes included the IBS Severity Scoring System (IBS-SSS), IBS Quality of Life (IBS-QOL), and the Hospital Anxiety and Depression Scale (HADS); gut microbiota were profiled by 16S rRNA sequencing. Longitudinal changes were evaluated using linear mixed-effects models, responder analyses, PERMANOVA, and PERMDISP. Both diets reduced IBS-SSS at 6 weeks. PD maintained symptom improvement at 6 and 12 months (−82.0 and −78.3 points from baseline), whereas LFD benefits regressed by 12 months (+29.3 points; between-group p = 0.001). At 12 months, IBS-SSS responder rates were higher with PD than LFD (62.5% vs 34.5%; absolute risk difference +28.0%, 95% CI 4.2–47.7; Fisher p = 0.029), and IBS-QOL, HADS-anxiety, and HADS-depression showed more favourable trajectories with PD. PD was associated with sustained Shannon alpha-diversity gains (+0.488 at 6 weeks; +0.205 at 12 months; both p < 0.01). A modest between-group beta-diversity difference at 6 months (R2 = 0.035; p = 0.011) was not significant at 12 months. This hypothesis-generating follow-up suggests more durable benefit with PD; larger trials powered for long-term clinical and microbiome outcomes are warranted.
dc.description.sponsorshipThis study was sponsored and funded by ENBIOSIS Biotechnologies (London, UK), which developed the personalized-diet intervention evaluated here and performed the 16S rRNA gene sequencing and microbiome analyzes; no additional external funding was received. Because several authors are employed by or affiliated with the sponsor (see Competing interests), the sponsor contributed to the study design, the personalized-diet intervention, and the generation and analysis of the microbiome data; clinical outcomes were assessed by investigators at the participating gastroenterology centers. The corresponding author, as guarantor, had full access to all study data and takes final responsibility for the decision to submit the manuscript for publication. Bu çalışma; burada değerlendirilen kişiselleştirilmiş diyet müdahalesini geliştiren ve 16S rRNA gen dizilemesi ile mikrobiyom analizlerini gerçekleştiren ENBIOSIS Biotechnologies (Londra, Birleşik Krallık) tarafından desteklenmiş ve finanse edilmiştir; ayrıca harici bir finansman sağlanmamıştır. Yazarlardan bazılarının sponsor kuruluş bünyesinde çalışması veya bu kuruluşla bağlantılı olması nedeniyle (bkz. Çıkar çatışmaları), sponsor; çalışma tasarımı, kişiselleştirilmiş diyet müdahalesi ile mikrobiyom verilerinin elde edilmesi ve analizine katkıda bulunmuştur; klinik sonuçlar ise katılımcı gastroenteroloji merkezlerindeki araştırmacılar tarafından değerlendirilmiştir. Sorumlu yazar, çalışma verilerinin tamamına tam erişim sağlamış ve çalışmanın yayımlanmak üzere sunulması kararının nihai sorumluluğunu üstlenmiştir.
dc.identifier.citationTunalı, V., Arslan, Ç., Derviş Haki̇m, G., Gündoğdu, A., Ermi̇ş, B. H., Hora, M., & Nalbantoğlu, Ö. U. (2026). Long-term microbiome and clinical effects of a microbiome-guided personalized diet versus low-FODMAP diet in irritable bowel syndrome: A 12-month follow-up randomized controlled trial. Gut Microbes, 18(1), pp. 1-17. https://doi.org/10.1080/19490976.2026.2719125
dc.identifier.doi10.1080/19490976.2026.2719125
dc.identifier.endpage17
dc.identifier.issn1949-0976
dc.identifier.issn1949-0984
dc.identifier.issue1
dc.identifier.pmidPMID: 42623122
dc.identifier.scopus2-s2.0-105047934013
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1080/19490976.2026.2719125
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1648
dc.identifier.volume18
dc.identifier.wosWOS:001855689400001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorArslan, Çiğdem
dc.institutionauthorid0000-0002-2282-7207
dc.language.isoen
dc.publisherTaylor & Francis
dc.relation.ispartofGut Microbes
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectIrritable Bowel Syndrome
dc.subjectMicrobiome
dc.subjectLow-FODMAP Diet
dc.subjectPersonalized Diet
dc.subjectPrecision Nutrition
dc.subjectArtificial Intelligence
dc.subject16S rRNA Sequencing
dc.subjectAlpha Diversity
dc.subjectDietary Intervention
dc.subjectRandomized Trial
dc.titleLong-term microbiome and clinical effects of a microbiome-guided personalized diet versus low-FODMAP diet in irritable bowel syndrome: A 12-month follow-up randomized controlled trial
dc.typeArticle
dspace.entity.typePublication

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