The association between meal and snack frequency and irritable bowel syndrome

Objective: The relationship between daily meal and snack frequency with irritable bowel syndrome (IBS) was less investigated in the literature. We aimed to evaluate this association with IBS symptoms. Design: A cross-sectional study. Setting: This investigation was performed in Isfahan, a large province in the centre of Iran. Individuals were asked to complete a self-administered questionnaire to quantify the numbers of daily main meals (one, two or three), snacks (never, 1-2, 3-5 or >5) and the total of them (<3, 3-5, 6-7 or >= 8). IBS and its subtypes were diagnosed according to Rome SIC criteria. Participants: General adults (n 4669, 2063 men and 2606 women). Results: The prevalence of IBS was 18 center dot 6 % in males and 24 center dot 1 % in females. Individuals consuming three main meals had 30 % decreased risk of IBS (OR 0 center dot 70, 95 % CI 0 center dot 52, 0 center dot 94) compared with those with one main meal in the crude model. After adjustments for all potential confounders this relation disappeared (OR 0 center dot 67, 95 % CI 0 center dot 43, 1 center dot 03). Gender-specified analysis revealed that women consuming three main meals per day had 32 % decreased likelihood of having IBS symptoms compared with one daily main meal takers (OR 0 center dot 68, 95 % CI 0 center dot 47, 0 center dot 99). This relation remained significant after adjustment for potential confounders (OR 0 center dot 56, 95 % CI 0 center dot 36, 0 center dot 89). A decreased likelihood of IBS in the highest category of main meal consumption compared with the lowest one was found in obese or overweight subjects (OR 0 center dot 54, 95 % CI 0 center dot 32, 0 center dot 91), after adjustment for all confounders. Conclusions: Our findings suggested that there was no significant relation between main meal or snack frequency and IBS in Iranian adults, but a small inverse association was found among females and overweight/obese individuals in subgroup analysis. Further prospective studies are needed confirming these associations.