Publications & Research

American College of Gastroenterology, Annual Scientific & Educational Meeting, Orlando, Florida, November 2004, Fred H. Williams, MD, Department of Gastroenterology, St. John’s Mercy Medical Center, St. Louis, Missouri, United States

BACKGROUND

Diarrhea predominant IBS (D-IBS) is a common condition that is often refractory to standard therapy. Though some treatments may improve certain symptoms, there is no treatment that has been shown to result in the improvement of global D-IBS symptoms. The Lifestyle Eating and Performance Mediator Release Test (LEAP MRT) is an in vitro test that detects non-IgE mediated food reactions that can trigger D-IBS symptoms. We report on our early experience with this dietary modification program.

METHODS

Ten patients who met Rome II criteria for D-IBS are reported in this study. These patients presented to our community-based gastroenterology practice and were evaluated by a gastroenterologist. Evaluation for other causes of their symptoms was based on the patient’s previous evaluation and the discretion of the gastroenterologist. Typically, if not already employed in the past, a trial of standard therapy such as fibre and anti-spasmodic agents was attempted. If the patient didn’t improve, they were then offered LEAP MRT testing. Using an in vitro assay, the patient’s blood was tested for non-IgE mediated reactivity to 150 foods and food additives. A specific elimination diet that omitted the reactive foods was then designed for the patient. A Symptom Survey was employed to follow the patients for improvement in D-IBS as well as systemic symptoms. The survey graded multiple GI and systemic symptoms on a scale of 0-4 with increasing severity represented by a higher number. The maximum number of points possible for the entire survey was 236 and for the GI portion was 36.

RESULTS

Prior to beginning the LEAP MRT-based elimination diet, the average score for the entire survey was 56.9 and for the GI portion was 19.1. After at least one month on the diet, the average scores had decreased to 26.3 and 6.3 respectively. Patients generally reported a marked improvement in their D-IBS symptoms, decreased systemic symptoms, and an overall increase in their feeling of well-being.

CONCLUSION

The LEAP MRT identifies non-IgE mediated immunologic food reactions that trigger D-IBS symptoms. Elimination of these foods from the diet results in a marked improvement in D-IBS and other systemic symptoms.

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2. Zarini GG, Masters J, McLean MA, Strobel CT. Clinical and Anthropometric Improvements with a Tailored Dietary Approach in Pediatric Crohn’s Disease. Altern Ther Health Med. 2021 Mar 13:AT6717. https://pubmed.ncbi.nlm.nih.gov/33711815/
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1. McLean M, Zarini G, Johnson A, Savoury A, Lee C, Linke S, Patenaude J. A Novel Tailored Oligoantigenic Dietary Approach for Irritable Bowel Syndrome (IBS). Journal of the Academy of Nutrition and Dietetics, 2024, Volume 124, Issue 10, A22. https://www.jandonline.org/article/S2212-2672(24)00347-2/fulltext
2. Zarini G, McLean M, Johnson A, Savoury A, Lee C, Linke S, Patenaude P. Effectiveness of a Patient-Specific Oligoantigenic Diet on Global Symptoms for Irritable Bowel Syndrome. Current Developments in Nutrition, Volume 8, (2024) 102391.https://cdn.nutrition.org/article/S2475-2991(24)00325-1/fulltext
3. Zarini, G, McLean M, Delgado S, Lee L, Ondreyka J, Lee C, Linke S. Clinical Response to Personalized Dietary Therapy for Irritable Bowel Syndrome (IBS). Journal of the Academy of Nutrition and Dietetics, Volume 123, Issue 9, A24. https://www.jandonline.org/article/S2212-2672(23)00881-X/fulltext
4. McLean M, Zarini G, Delgado S, Lee L, Lee C, Ondreyka J, Patenaude J. P08-012-23. Evaluation of the Lifestyle Eating and Performance (LEAP) Program To Manage Symptoms and Quality of Life for Irritable Bowel Syndrome (IBS). Current Developments in Nutrition, Volume 7, 101147. Published in issue: July 2023.https://doi.org/10.1016/j.cdnut.2023.101147
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6. Zarini G, McLean M. S572. A Pilot Study for Precision Nutrition in Irritable Bowel Syndrome: In-Vitro Stimulation of Pro-and Anti-inflammatory Cytokine Release. The American Journal of Gastroenterology: October 2022 – Volume 117 – Issue 10S – p e406. doi: 10.14309/01.ajg.0000858928.65055.a2.
7. McLean M, Zarini GG, Linke S. Personalized Dietary Intervention for Women with Depression and Anxiety. Journal of the Academy of Nutrition and Dietetics. Vol. 122 Issue 9 Supplement A23. Published in issue: September 2022. https://doi.org/10.1016/j.jand.2022.06.084
8. Zarini G, McLean M. Study Protocol: Effectiveness of the Lifestyle Eating and Performance (LEAP) Program for the Treatment of Irritable Bowel Syndrome (IBS), Current Developments in Nutrition, Volume 6, Issue Supplement_1, June 2022, Page 1162, https://doi.org/10.1093/cdn/nzac072.034
9. Linke S, Zarini G, McLean M. Personalized Dietary Approach for Rhinitis and Sinusitis. Journal of the Academy of Nutrition and Dietetics, Volume 121, Issue 9, A28. Published in issue: September 2021. https://jandonline.org/action/doSearch?text1=Personalized+Dietary+Approach+for+Rhinitis+and+Sinusitis&field1=AllField
10. Linke S, Zarini G, McLean M, Hogan J, Hogan P, Patenaude J. Tailored Dietary Approach for Individuals with Migraine. Current Developments in Nutrition, Volume 5, Issue Supplement_2, June 2021, Page 849, https://doi.org/10.1093/cdn/nzab047_012
11. Patenaude J, Zarini G, McLean M, Linke S. Effectiveness of a Tailored Dietary Program in Subjects with Fibromyalgia. Current Developments in Nutrition, Volume 5, Issue Supplement_2, June 2021, Page 856, https://doi.org/10.1093/cdn/nzab047_019
12. Braunstein N, Hogan M, Diaz Escamilla R. The Lifestyle Eating and Performance (LEAP) Program for Improving Quality of Life in Women With PCOS: A Pilot Study of Dietitian-Directed Therapy. Current Developments in Nutrition, Volume 5, Issue Supplement_2, June 2021, Page 1123, https://doi.org/10.1093/cdn/nzab061_007
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1. Ceresnie M, Ondreyka J, Ezekwe N, Zarini G, McLean M, Hamzavi IH. Bridging the gap between personalized diet and dermatology in clinical trials: a prospective pilot study in patients with hidradenitis suppurativa. Integrative Dermatology Symposium, 2022. https://integrativedermatologysymposium.com/2022-poster-presentations/
2. Ceresnie M, Ondreyka J, Ezekwe N, Zarini G, McLean M, Hamzavi IH. A prospective pilot study on the clinical outcomes of the LEAP program in HS patients. American Medical Association (AMA) Research Challenge, 2022.
3. Ceresnie M, Ondreyka J, Ezekwe N, Zarini G, McLean M, Hamzavi IH. Hidradenitis suppurativa and the Lifestyle Eating and Performance program: A prospective pilot study. Symposium on Hidradenitis Suppurativa Advances (SHSA), 2022.
4. Zarini GG, McLean Role, Ondreyka J. Tailored Dietary Approach for Inflammatory Skin Disorders. FASEB Conference: The Nutrition, Immunity, and Inflammation Conference: From Model Systems to Human Trials – VIRTUAL, July 2021.
5. Linke S, Patenaude J, Zarini GG, McLean MA. Tailored Dietary Approach to Manage Irritable Bowel Syndrome. Lifestyle Medicine Conference. Virtual, October 2020.
6. Bethel LJ. Self-assessment of frequency and severity of symptoms with chronic inflammatory conditions following a patient-specific elimination diet and food reintroduction plan. Florida Dietetic Association Annual Meeting. Orlando, FL, July 2010.

1. Ceresnie M, Ondreyka J, Ezekwe N, Zarini G, McLean M, Hamzavi IH. The Lifestyle Eating and Performance (LEAP) program for patients with hidradenitis suppurativa Hurley stages I-II: a pilot study. In progress.