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Summary: Background & aim: Hypersensitivity to fructose-containing foods including those containing high fructose corn syrup (HFCS) contributes to the worsening of irritable bowel syndrome (IBS) symptoms. There is scarcity of healthy food options in food desert areas. This may result in increased HFCS consumption in its residents. Thus there is a critical need to evaluate HFCS consumption of IBS patients, especially in socioeconomically challenged communities. The aim of this study was to explore the extent and origins of HFCS consumption in IBS patients that will help in the management of this disease. Methods: We carried out a retrospective chart review of 969 IBS patients for demographics and medical and psychiatric comorbidities. We then collected information about dietary HFCS intake from a subset of IBS patients and control subjects using USDA-database-driven-surveys that included 398 HFCS-rich food items. Control subjects lacked history of gastrointestinal symptoms/disorders. Results: 84% and 78% of IBS patients were female and Caucasian, respectively. 82% IBS patients were >40 years old. All IBS patients had at least one psychological comorbidity: depression, anxiety, bipolar, PTSD or psychosis; depression (66%) and anxiety (54%) being the most common. Overall HFCS intake was significantly higher in IBS patients compared to control subjects (p > 0.0001), which occurred via beverages, breakfast foods, jams, jellies, syrup, and desserts. Beverages contributed (76%) to the highest HFCS consumption observed in the IBS-diarrhea patients. Conclusion: Our study is first to show a significantly high consumption of HFCS in IBS patients suffering from socioeconomic challenges and underscores the urgent need for provider-driven patient education regarding dietary interventions. This intervention is pivotal to avoid exacerbation of gastrointestinal symptoms as well as that of co-existing psychological comorbidities.

Irritable bowel syndrome (IBS) is a common gastroenterological disorder with triggers such as fructose. We showed that our IBS patients suffering from socioeconomic challenges have a significantly high consumption of high-fructose corn syrup (HFCS). Here, we characterize gut microbial dysbiosis and fatty acid changes, with respect to IBS, HFCS consumption, and socioeconomic factors. Fecal samples from IBS patients and healthy controls were subjected to microbiome and lipidome analyses. We assessed phylogenetic diversity and community composition of the microbiomes, and used linear discriminant analysis effect size (LEfSe), analysis of compositions of microbiomes (ANCOM) on highly co-occurring subcommunities (modules), least absolute shrinkage and selection operator (LASSO) on phylogenetic isometric log-ratio transformed (PhILR) taxon abundances to identify differentially abundant taxa. Based on a Procrustes randomization test, the microbiome and lipidome datasets correlated significantly (p = 0.002). Alpha diversity correlated with economic factors (p < 0.001). Multiple subsets of the phylogenetic tree were associated with HFCS consumption (p < 0.001). In IBS patients, relative abundances of potentially beneficial bacteria such as Monoglobaceae, Lachnospiraceae, and Ruminococcaceae were lower (p = 0.007), and Eisenbergiella, associated with inflammatory disorders, was higher. In IBS patients, certain saturated fatty acids were higher and unsaturated fatty acids were lower (p < 0.05). Our study aims first to underscore the influence of HFCS consumption and socioeconomic factors on IBS pathophysiology, and provides new insights that inform patient care.

Challenging the notion of “teaching by telling,” active learning utilizes a student-oriented approach by emphasizing the concept of knowledge retention through peer interaction. To further examine the potential of active learning, we created a workshop based on didactic education and student collaboration. Participants included undergraduate students from traditionally underrepresented and disadvantaged backgrounds. The workshop was part of our summer academic enrichment program run in an urban, medically underserved community. The workshop focused on clinical and biochemical nutrition, wherein students synthesized information by discussing dietary choices and the socioeconomic aspects of nutrition. Student reception of the workshop was adjudged by anonymous surveys. The survey questions were designed to gauge how the workshop objectives were achieved. Cronbach alpha (0.276) confirmed that there was more than a single theme contained in the questions. The majority of students (97%) agreed that the workshop met the learning objectives: (1) acquire basic clinical knowledge, (2) gain a better understanding of nutrition, (3) formulate a linkage between clinical nutrition and disease, and (4) benefit from peer interaction. Students’ performance in the post-quiz (100% correct answers) had improved significantly compared to the pre-quiz (25% correct answers) suggesting acquisition, understanding and application of nutrition aspects taught in the workshop. Overall, the present study demonstrated the engagement and understanding of students with respect to learning about nutrition and community health in an active learning setting. These types of active-learning-based sessions may have broad applicability for any academic discipline to improve student engagement and knowledge retention.