428名少年6种常见病患病情况及相互关系调查

目的 了解青少年肠易激综合征、复发性口腔溃疡、偏头痛、痤疮、经前期综合征及痛经的患病情况、相关关系及危险因素。方法 采用随机整群抽样方法调查高一至高三学生中相关疾病患病情况、饮食生活习惯、常见症状及心理人格气质特点,采用频数分析、单因素分析及logistic回归等方法分析数据。结果 肠易激综合征、复发性口腔溃疡、偏头痛、痤疮患病率分别13.1%、16.1%、22.0%、57.9%,女生经前期综合征和痛经患病率分别为36.8%和66.5%。疾病之间存在一定的相关关系。生活习惯和常见症状作为危险或保护因子出现在疾病的logistic回归模型中。结论 青少年肠易激综合征、复发性口腔溃疡、偏头痛、痤疮、经前期综合征及痛经的患病率较高且存在一定的相关关系;生活习惯和常见症状以及心理个性气质特征可能是患病的危险或保护因素。     

邢台市干部职工冠状动脉粥样硬化性心脏病患病率及危险因素研究

目的 了解邢台市干部职工冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CHD)患病率及其相关因素。 方法 自行设计流行病学调查表,对30 068名干部职工进行问卷调查、体格检查和生化检测。患病率的比较应用χ²检验。相关因素应用logistic回归分析。 结果 邢台市干部职工CHD的患病率为4.59%(1 381/30 068)。单因素分析显示,年龄、性别、血脂异常、高血压、糖尿病、肥胖、吸烟、饮酒、运动量、高脂饮食、高糖饮食、髙盐饮食、嗜好饱食和家族史均与CHD的患病相关联(P<0.001)。多因素分析显示,CHD患病的危险因素为年龄大(OR=4.49,95%CI: 3.30～6.58)、男性(OR=4.46,95%CI:3.13～6.45)、血脂异常(OR=41.96,95%CI:27.50～64.02)、高血压(OR=49.64,95%CI:33.87～88.24)、糖尿病(OR=58.20,95%CI:43.18～97.71)、肥胖(OR=23.58,95%CI:12.30～45.12)、吸烟(OR=17.19,95%CI:5.31～15.82)、饮酒(OR=4.30,95%CI:3.18～5.90)、运动量小(OR=3.34,95%CI:1.86～5.99)、高脂饮食(OR=23.01,95%CI:12.65～41.86)、高糖饮食(OR=21.11,95%CI:12.05～36.32)、髙盐饮食(OR=6.88,95%CI:3.83～12.16)、嗜好饱食(OR=12.01,95%CI:6.90～20.81)和家族史(OR=13.46,95%CI:4.16～12.12)。 结论 邢台市干部职工CHD的患病率较高,CHD的患病与年龄大、男性、血脂异常、高血压、糖尿病、肥胖、吸烟、饮酒、运动量小、高脂饮食、高糖饮食、髙盐饮食、嗜好饱食和家族史密切相关。     

学龄前孤独症谱系障碍儿童情绪行为问题与饮食行为问题调查

目的 研究学龄前孤独症谱系障碍(ASD)儿童情绪行为问题与饮食行为问题,并对该群体中两者的关系进行初步探究。方法 2020年8月—2021年4月使用长处和困难问卷(SDQ,父母版)和学龄前儿童饮食行为问卷(PEBQ)对150例学龄前ASD儿童情绪行为问题及饮食行为问题展开评估,利用Logistic回归分析探究两者关系。结果 学龄前ASD儿童常见的情绪行为问题检出率分别为:同伴交往问题(86.0%)、社会行为问题(72.7%)、多动问题(51.3%)。常见的饮食行为问题检出率分别为:主动进食能力不足(83.3%)、挑食(57.3%)、情绪性进食(42.0%)。品行问题是学龄前ASD儿童食物响应问题(OR=3.48, 95%CI:1.04~11.63)和情绪性进食(OR=6.11, 95%CI:1.56~23.86)的危险因素。社会行为问题是学龄前ASD儿童挑食(OR=3.07,95%CI:1.40~6.74)和主动进食不足(OR=5.32,95%CI:1.25~22.70)的危险因素,多动问题是学龄前ASD儿童挑食(OR=3.40,95%CI:1.65~7.00)和不良饮食习惯(OR=4.29,95%CI:1.55~11.88)的危险因素。结论 学龄前ASD儿童情绪行为问题及饮食行为问题均较严重。学龄前ASD儿童情绪行为问题与挑食、主动进食能力不足、食物响应问题、不良饮食习惯及情绪性进食有关。     

秦皇岛地区中老年人慢性便秘流行病学调查及相关因素分析

目的 探讨秦皇岛地区中老年人慢性便秘患病情况,并分析其相关影响因素,为预防中老年人慢性便秘提供依据。 方法 2018年2月,采用整群随机抽样方法,随机选取秦皇岛地区常住人口中≥45岁的2 786名居民予以问卷调查,内容包括一般情况、生活方式和饮食习惯、烟酒嗜好、排便行为、慢性便秘症状、心理因素及既往史等,采用χ²检验以及多因素logistic回归分析影响中老年人慢性便秘因素。 结果 在接受调查的2 786名居民中,男1 524名,女1 262名,患有慢性便秘者173例,患病率为6.21%,其中男性、女性患者分别为82例、91例,患病率分别为5.38%、7.21%,男、女患病率比较差异有统计学意义(χ²=3.970,P=0.046)。随着年龄增长,慢性便秘患病率越高,差异有统计学意义(χ²=9.839,P=0.043);不同职业及文化程度人群的慢性便秘患病率比较差异无统计学意义(P＞0.05);单因素分析表明:居民吸烟、酗酒、运动与否与慢性便秘无关(P＞0.05),便秘家族史、睡眠差、长时间处于坐位、SAS＞50分、SDS＞53分、嗜食辛辣饮食和慢性便秘有关(P＜0.05),而定时排便、喜食生蔬菜、进食粗粮人群可降低患病率(P＜0.05);慢性便秘多因素logistic回归分析显示,年龄≥60岁、女性、便秘家族史、睡眠差、长时间处于坐位、处于焦虑、抑郁等负面情绪中、嗜食辛辣是慢性便秘的主要危险因素,定时排便、喜食生蔬菜与进食粗粮则是其保护因素。 结论 慢性便秘在秦皇岛地区中老年人中发病率较高,其患病与性别、饮食、遗传因素、心理因素有关,而形成良好的生活与饮食习惯,改变不良的排便习惯,保持愉悦的心理状态,则能够对慢性便秘起到预防作用。     

清河县老年脑卒中急性期焦虑患病率及影响因素

目的 调查老年脑卒中急性期焦虑患病率,探索其影响因素。 方法 对2016年10月-2017年6月就诊于清河县中心医院的老年脑卒中患者986例进行基本情况、焦虑自评量表(SAS)、日常生活活动能力(ADL)量表及社会支持量表(SSAS)调查。采用卡方检验及多因素非条件二分类logistic回归分析其急性期焦虑患病影响因素。 结果 老年脑卒中急性期焦虑患病率为26.27%,老年脑卒中焦虑的危险因素有女性(OR=1.141,P=0.012)、合并其它疾病(OR=1.901,P＜0.001)、生活不能自理(OR=13.152,P=0.017),焦虑的保护因素有家庭人均收入高(OR=0.164,P=0.021)和社会支持量表得分高(OR=0.926,P＜0.001)。 结论 清河县老年脑卒中后恢复期焦虑患病率较高,患病的影响因素有性别、家庭人均收入、合并其他疾病、日常生活活动能力以及社会支持度。     

江西省城乡中老年糖尿病居民营养状况及危险因素分析

目的 分析江西省城乡中老年糖尿病(DM)患病情况及危险因素,为制定居民营养计划和预防控制慢性病防治提供依据。方法 采用多阶段随机抽样,应用中国营养与健康状况调查表对江西省城乡中老年居民进行糖尿病与健康状况的评估。根据空腹血糖监测及口服糖耐量试验诊断DM,分析性别、年龄、食物消费量、营养素摄入情况、运动、吸烟、糖尿病家族史与DM的关系。结果 江西省城乡中老年糖尿病的患病率为11.14%,居民城市的患病率为13.45%,乡镇的患病率为8.83%,城市患病率高于乡镇(χ²=4.26,P<0.05);食盐(OR=3.05)、肉摄入(OR=2.91)、脂肪(OR=4.89)、家族史(OR=5.89)、吸烟(OR=2.14)、饮酒(OR=3.67)是糖尿病的独立危险因素(P<0.05);维生素E(OR=0.23)、维生素B族(OR=0.46)、钙(OR=0.14)、运动(OR=0.41)是DM的保护性因素;江西省城乡中老年糖尿病居民膳食来源构成中脂肪性食物来源所占比例较高。结论 江西省城乡中老年糖尿病的患病率较高,膳食结构不合理、能量和脂肪摄入过量、年龄等是DM的患病因素。因此应建立营养状况评估及干预体系,为制定改善策略,防治DM措施提供科学的依据。     

邢台市干部职工冠状动脉粥样硬化性心脏病及危险因素的调查研究

目的 了解邢台市干部职工冠状动脉粥样硬化性心脏病（CHD,简称冠心病）及危险因素,为预防控制CHD提供依据。方法 以2018年3—6月在邢台市某医院中心参加体检的市直56个单位全体在职和离退休干部职工进行调查,调查内容为体检相关结果、CHD患病情况及相关因素,采用描述流行病学分析方法对结果进行描述,分别采用单、多因素分析方法对该人群的CHD患病相关因素进行分析。结果 本研究共对20 232名邢台市干部职工进行调查,调查对象中老年人（≥60岁）占50.31%,女性占54.05%。CHD患病率4.57%。多因素logistic回归分析结果显示,中老年人（OR=4.489）、男性（OR=4.452）、肥胖（OR=23.576）、高血压（OR=58.196）、血脂异常（OR=41.961）、糖尿病（OR=13.851）、吸烟（OR=17.193）,饮酒（OR=4.305）、运动量小（OR=3.342）、高脂饮食（OR=23.007）、高糖饮食（OR=20.395）、高盐饮食（OR=6.867）、嗜好饱食（OR=12.016）和CHD家族史（OR=13.471）的邢台市干部职工患CHD的风险更高。结论 邢台市干部职工CHD的患病率较高,该人群CHD的患病受较多因素影响,预防与控制CHD应切实做到管住嘴,迈开腿,吃动两平衡。     

唐山市7～14岁肥胖儿童非酒精性脂肪肝流行现状及危险因素初步分析

目的 初步了解唐山市肥胖儿童非酒精性脂肪肝(NAFLD)流行特点及危险因素,为早期干预提供理论依据。方法 以2018—2019年唐山市学龄儿童体检筛查出的肥胖儿童为研究对象,依年龄分组描述NAFLD患病率,比较NAFLD组与非NAFLD组代谢综合征(MetS)、体重指数(BMI)、腰围(WC)、腰围身高比(WHtR)、转氨酶、尿酸(UA)、糖脂代谢等指标,分析NAFLD发生的危险因素。结果 1)唐山市肥胖儿童NAFLD患病率为34.62%,不同性别间差异无统计学意义(χ²=0.009,P=1.000),NAFLD患病率随年龄增加而增高(r=0.425,P<0.001);2)7～9岁NAFLD组脂代谢紊乱患病率、10～14岁NAFLD脂代谢紊乱、高血压、MetS患病率高于非NAFLD组,差异均有统计学意义(χ²=6.159、10.994、5.543、4.524,P<0.05);3)多因素Logistic回归分析显示NAFLD的危险因素为年龄增长(OR=3.91)、高尿酸血症(OR=2.09)、BMI增加(OR=1.07)、ALT升高(OR=1.04)(P<0.05)。结论 唐山市肥胖儿童总体NAFLD患病率处于较高水平,其患病率随年龄增长而增高;肥胖儿童NAFLD与年龄、高尿酸血症、BMI、ALT水平密切相关。     

饮食行为及饮食习惯对学龄前期儿童超重肥胖的影响

目的 了解苏州市工业园区学龄前期儿童超重肥胖的现状,探讨其中饮食相关因素,提供预防方法。方法 采用随机抽样的方法,在苏州工业园区斜塘街道所属于幼儿园随机抽取5所3～6岁儿童2 034名作为本次研究的调查现场,进行问卷调查和相关体格测量。结果 超重肥胖检出率为16.8%,进食膨化食品次数多(χ2=9.200,P<0.05)、喜欢看食品广告(χ2=13.069,P<0.05),尤其膨化食品和甜饮料广告(P<0.05)、临睡前进食主食和零食、食欲好、吃饭时间短、边看电视边吃零食(P均<0.05)为学龄前儿童超重肥胖的危险因素。结论 为儿童营造健康的饮食环境,培养儿童良好的饮食行为,可有效预防儿童超重肥胖的发生。     

小肠X射线钡餐检查对腹泻型肠易激综合征的诊断价值

目的 探讨小肠X射线钡餐检查对腹泻型肠易激综合征的诊断价值。方法 利用数字化胃肠机对腹泻型肠易激综合征患者1164例进行全消化道X射线钡餐检查,观察小肠蠕动增强、蠕动过快和肠管痉挛等。结果 1164例患者(其中男性患者686例,女性患者478例)中小肠蠕动异常者931例,约占80%。其中小肠蠕动增强者共366例,肠蠕动过快152例,蠕动增强并有肠蠕动过快者186例,肠管痉挛者227例。小肠运动功能无异常改变者为233例,约占20%。结论 X射线钡餐检查可作为腹泻型肠易激综合征诊断的辅助指标。     

福州市某高校学生不良饮食行为及其影响因素研究

目的 对福州市某高校大学生不良饮食行为现状及其影响因素进行调研分析,为大学生开展营养教育提供参考依据。方法 采取整群抽样法对福州市某高校1 036名在校大学生进行饮食行为的问卷调查。结果 有977人(94.3%)具有不良饮食行为,760人(73.4%)存在两种以上不良饮食行为问题。女生的不良饮水(87.78%)与零食行为(42.60%)高于男生(χ2=7.482,P=0.006; χ2=6.356,P=0.012),医学生的不良早餐行为(14.04%)和过度食用垃圾食品行为(38.39%)明显少于非医学生(χ2=18.303,P=0.000;χ2=7.167,P=0.007),大四及以上的学生过度食用垃圾食品行为(60.47%)和其他年级比较具有统计学意义(Z=-2.362,P=0.018),母亲文化程度仅与大学生的不良早餐行为有关(Z=-1.99,P=0.046),大学生的生活费水平与不良早餐、过度食用垃圾食品、不良夜宵、不良零食行为的发生都密切相关(Z=-3.826,P=0.000;Z=-4.367,P=0.000;Z=-3.089,P=0.002;Z=-3.463,P=0.001)。多因素回归分析表明月生活费水平为大学生综合不良饮食行为的危险因素。结论 福州市某高校大学生不良饮食行为普遍存在,加强大学生合理营养、均衡膳食知识健康教育是极为必要的。     

Effects of a high-fiber diet on symptoms of irritable bowel syndrome: a randomized clinical trial

OBJECTIVE: We investigated the effects of dietary fiber on symptoms of irritable bowel syndrome. METHODS: A single-blind randomized clinical trial was designed. Fifty-six subjects with irritable bowel syndrome were prospectively and randomly assigned to one of two groups: group 1 received a diet containing 10.4 g/d of fiber and group 2 received a diet containing 30.5 g/d of fiber. Patients' body weights, nutritional intakes as assessed with 3-d written food records, and symptom scores were assessed at baseline and at 3 mo. RESULTS: There were no dropouts during the study. Total energy intake and the distribution of macronutrients were not significantly different between groups. Total dietary fiber intake did not reach recommended levels in either group but was higher in group 2 than in group 1 (25.95 +/- 2.12 g/d versus 6.06 +/- 2.7 g/d, P < 0.05). Initial fiber intake did not differ significantly between groups. Pain scores, bowel scores, and general scores improved in both groups (from baseline to 3 mo), and no significant differences were detected between groups. CONCLUSIONS: A modest fiber intake in patients with irritable bowel syndrome relieved symptoms, but this therapeutic benefit of fiber may have been due to a placebo effect because the results were similar in the low-fiber group.     

上海市崇明区中学生功能性便秘筛查状况

  目的  了解上海市崇明区中学生功能性便秘(functional constipation, FC)的流行病学特征及相关因素。  方法  采用多级分层整群随机抽样法, 于2019年3-6月对上海市崇明区18周岁以下的4 969名在读初、高中生进行问卷调查。  结果  上海市崇明区中学生FC患病率为13.95%, 不同性别、学段、城乡之间患病率差异均无统计学意义(P值均>0.05)。在高中组中, 临毕业年级组FC的患病率(17.36%, 130/749)高于非临毕业年级组(13.77%, 201/1 460)(χ2=5.01, P=0.03), 市示范性高中组FC的患病率(18.23%, 115/631)高于普通高中组(13.07%, 49/375)和区示范性高中组(13.88%, 167/1 203)(χ2=7.43, P=0.02)。多因素Logistic回归分析显示, 体育锻炼频率、食用辛辣食品频率高、饮食中辛辣食品占比、食用蔬菜频率、饮食中蔬菜占比、每日饮水量、是否纳差、睡眠质量、是否就读于示范型学校与中学生FC有关(OR=0.11~7.71, P值均 < 0.05)。  结论  FC为上海市崇明区中学生的常见病, 好发于高中临毕业年级组, 且危险因素较多。     

肠易激综合征患者胃肠运动功能的临床研究

目的：对16例肠易激综合征（IBS）患者胃肠运动功能进行临床分析,为临床研究肠易激综合征的发病机制及临床药物治疗提供理论依据。方法：对16例肠易激综合征患者进行食管动态pH监测、胃电检测和呼吸氢试验分析。结果：肠易激综合征患者进餐前、后胃电变化较对照组明显（t＝-8.437,t＝-7.126;P〈0.01）,胃电变异指数、肠道传递时间与对照组有显著性差异（t＝-2.312,t＝-1.694,t＝-9.163,t＝-7.894;P〈0.01）。结论：肠易激综合征患者消化吸收及肠道运动功能异常可能是由于肠道电生理活动异常而引起。     

High-Fat Foods and FODMAPs Containing Gluten Foods Primarily Contribute to Symptoms of Irritable Bowel Syndrome in Korean Adults

Dietary control plays an important role in the treatment of irritable bowel syndrome (IBS). However, few studies have examined the relationship between dietary intake and symptoms of IBS in Koreans. The current cross-sectional study aimed to examine the diet in food consumption and nutrient intake in Korean adults aged 20 to 40 with IBS. The data collected were completed by 857 subjects using a community-based web survey. The questionnaire covered functional bowel disorders based on Rome III, the semi-quantitative Food Frequency Questionnaire (SQ-FFQ), and the food items causing symptoms. In total, 186 of 857 subjects (21.7%) were diagnosed with IBS. The non-IBS group had a fat intake of 76.9 ± 47.9 g/day, while the IBS group had a fat intake of 86.6 ± 55.1 g/day (p = 0.014). The non-IBS group had a total fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) intake of 12.6 ± 9.7 g/day, whereas the IBS group had a total FODMAP intake of 13.9 ± 9.9 g/day (p = 0.030). Foods that contributed to the onset of symptoms in the IBS group were instant noodles (70.8%), Chinese noodles with vegetables and seafood (68.7%), pizza (67.2%), and black bean sauce noodles (66.3%) which are mostly classified as high fat and high gluten foods. The dietary intake of IBS patients differs from that of non-IBS subjects. Increased intake of gluten-containing or high-fat foods due to the westernized diet caused more IBS symptoms than high FODMAPs and dairy products in Korean adults in their 20 s to 40 s.     

井下煤矿工人肠易激综合征患病现状分析

目的探讨煤矿井下工人肠易激综合征的患病现状及患病的危险因素,为煤矿工人胃肠疾病的研究提供流行病学资料。方法采用单纯随机抽样问卷方法进行肠易激综合征相关症状调查,根据结果决定是否进行结肠镜检查。结果肥城矿区井下作业煤矿工人肠易激综合征患病率为22.69%,矿区附近一般人群患病率为15.04%。两组患病率比较,差异有显著性(P<0.05)。结论井下作业煤矿工人肠易激综合征患病率高于一般人群。井下作业环境、心理障碍及不良生活习惯是患病的危险因素。     

Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders.

Functional gastrointestinal disorders, including the irritable bowel syndrome, account for up to 40% of referrals to gastroenterologists, but accurate data on the natural history of these disorders in the general population are lacking. Using a reliable and valid questionnaire, the authors estimated the onset and disappearance of symptoms consistent with functional gastrointestinal disorders. An age- and sex-stratified random sample of 1,021 eligible residents of Olmsted County, Minnesota, aged 30-64 years were initially mailed the questionnaire; 82% responded (n = 835). In a remailing to responders 12-20 months later, 83% responded again (n = 690). The age- and sex-adjusted prevalence rates per 100 for irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent dyspepsia were 18.1 (95% confidence interval (CI) 15.1-21.1), 14.7 (95% CI 11.9-17.4), 7.3 (95% CI 5.3-9.3), and 14.1 (95% CI 11.5-16.8), respectively, on the second mailing. Symptoms were not significantly associated with nonresponse to the second mailing; moreover, the estimated prevalence rates were not significantly different from the first mailing. Among the 582 subjects free of the irritable bowel syndrome on the first survey, 9% developed symptoms during 795 person-years of follow-up, while 38% of the 108 who initially had the irritable bowel syndrome did not meet the criteria after 146 person-years of follow-up. Similar onset and disappearance rates were observed for the other main symptom categories. While functional gastrointestinal symptoms are common in middle-aged persons and overall prevalence appears relatively stable over 12-20 months, substantial turnover is implied by the observed onset and disappearance rates; several potential sources of bias do not seem to account for this variation.     

Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high-fat,low-carbohydrate and low-fat,high-carbohydrate isoenergetic diets

BACKGROUND: Hypertriglyceridemia is associated with increased risk of cardiovascular disease. Until recently, the importance of hepatic de novo lipogenesis (DNL) in contributing to hypertriglyceridemia was difficult to assess because of methodologic limitations. OBJECTIVE: We evaluated the extent of the contribution by DNL to different conditions associated with hypertriglyceridemia. DESIGN: After 5 d of an isoenergetic high-fat, low-carbohydrate diet, fasting DNL was measured in normoinsulinemic (or= 115 pmol/L) obese (n = 8) subjects. Fasting DNL was measured after a low-fat, high-carbohydrate diet in normoinsulinemic lean (n = 5) and hyperinsulinemic obese (n = 5) subjects. Mass isotopomer distribution analysis was used to measure the fraction of newly synthesized fatty acids in VLDL-triacylglycerol. RESULTS: With the high-fat, low-carbohydrate diet, hyperinsulinemic obese subjects had a 3.7-5.3-fold higher fractional DNL (8.5 +/- 0.7%) than did normoinsulinemic lean (1.6 +/- 0.5%) or obese (2.3 +/- 0.3%) subjects. With the low-fat, high-carbohydrate diet, normoinsulinemic lean and hyperinsulinemic obese subjects had similarly high fractional DNL (13 +/- 5.1% and 12.8 +/- 1.4%, respectively). Compared with baseline, consumption of the high-fat, low-carbohydrate diet did not affect triacylglycerol concentrations. However, after the low-fat, high-carbohydrate diet, triacylglycerols increased significantly and DNL was 5-6-fold higher than in normoinsulinemic subjects consuming a high-fat diet. The increase in triacylglycerol after the low-fat, high-carbohydrate diet was correlated with fractional DNL (P < 0.01), indicating that subjects with high DNL had the greatest increase in triacylglycerols. CONCLUSIONS: These results support the concept that both hyperinsulinemia and a low-fat diet increase DNL, and that DNL contributes to hypertriglyceridemia.     

Irritable bowel syndrome and dietary fiber.

The effects of an increase in dietary fiber include: (a) More frequent stools, (b) more voluminous stools, (c) an alteration in the fecal flora, (d) an increase in fecal sterol excretion, and, it appears likely, (e) a reduction in intraluminal pressures in the sigmoid colon. Epidemiologic data comparing global differences in prevalence of certain diseases with the fiber content of diets suggest that there may be a relationship between the two. With a certain amount of post-ad hoc reasoning, it can be shown that some of the known effects of fiber could account for differences in disease prevalence between populations. The prevalence of irritable bowel syndrome is so high that one is forced to concede the very real possibility that the environment, including the diet, may be responsible for symptoms that might not otherwise exist. It remains to be seen whether a marked increase in dietary fiber will prevent the symptoms of irritable bowel syndrome. It seems fairly certain that, given the preoccupation most of these individuals have with their bowel movements, the large bulky stools resulting from a high-fiber diet satisfy a very basic emotional need to "have a good BM" (meaning large), but whether this leads to better health remains to be proved.