Overview

• Built on four systematic reviews of 75 randomized trials, the guideline translates evidence into 59 recommendations using GRADE and a Delphi consensus process.
• The strongest support centers on psyllium fiber supplements (10 g or more daily, starting low for at least four weeks), magnesium oxide with dose titration, and a four‑week trial of probiotics.
• Targeted foods linked to improved stool frequency include kiwifruit (2–3 daily for four or more weeks), rye bread (6–8 slices daily for at least three weeks with variable tolerance), and mineral‑rich water.
• No whole‑diet approach, including generic high‑fiber diets, met the evidence threshold for recommendation due to insufficient high‑quality data.
• Most underpinning studies are low or very low quality, yet 27 statements are strong based on benefit–risk, cost, and feasibility, and the authors highlight research gaps, especially for whole‑diet and strain‑specific probiotic trials.