Diet Quality and Dietary Inflammatory Index in Dutch Inflammatory Bowel Disease and Irritable Bowel Syndrome Patients

Abstract

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) share common culprit foods and potential pathophysiological factors. However, how diet may contribute to disease course and whether this differs between both entities is unclear. We therefore investigated the association of dietary indices with intestinal inflammation and gastrointestinal symptoms in both IBD and IBS patients. Food frequency questionnaires from 238 IBD, 261 IBS and 195 healthy controls (HC) were available to calculate the overall diet quality by the Dutch Healthy Diet-Index 2015 (DHD-2015) and its inflammatory potential by the Adapted Dietary Inflammatory Index (ADII). Intestinal inflammation and symptoms were evaluated by faecal calprotectin and the Gastrointestinal Symptom Rating Scale, respectively. The DHD-2015 was lower in IBD and IBS versus HC (p < 0.001), being associated with calprotectin levels in IBD (b = −4.009, p = 0.006), and with abdominal pain (b = −0.012, p = 0.023) and reflux syndrome (b = −0.016, p = 0.004) in IBS. ADII scores were comparable between groups and were only associated with abdominal pain in IBD (b = 0.194, p = 0.004). In this side-by-side comparison, we found a lower diet quality that was differentially associated with disease characteristics in IBD versus IBS patients. Longitudinal studies are needed to further investigate the role of dietary factors in the development of flares and predominant symptoms.

The Intake of Dicarbonyls and Advanced Glycation Endproducts as Part of the Habitual Diet Is Not Associated with Intestinal Inflammation in Inflammatory Bowel Disease and Irritable Bowel Syndrome Patients

“…The mean energy intake was lower in IBS patients (1939.6 ± 604.9 kcal) as compared to IBD patients (2180.0 ± 634.3 kcal, p < 0.001) and HC (2180.4 ± 622.9 kcal, p < 0.001). Further details on the intake of food items and specific nutrients were reported previously [ 34 ].…”

“…For this study, we used cross-sectional data on habitual dietary intake and clinical data from the IBD South Limburg (IBDSL) cohort and the Maastricht IBS (MIBS) cohort as described previously [ 34 , 35 , 36 ]. Prior to participation, all participants provided written informed consent.…”

“…Additionally, data were used to calculate the Dutch healthy diet index 2015 (DHD-2015) [ 47 ] and the Adapted Dietary Inflammatory Index (ADII) [ 48 ], as also described previously [ 34 ]. The DHD-2015, developed to assess the adherence to the Dutch healthy diet guidelines [ 49 ], was based on 13 components with a maximum score (indicating high adherence) of 130.…”

Impact of Different Nutrition Strategies on Patients with Inflammatory Bowel Disease (IBD)

“…IBD prevention through the research of different kinds of diets has the lion’s share in the international literature. In the present Special Issue, de Graaf et al [ 8 ] investigated the pathophysiological factors and differences pertaining to diet in Dutch IBD and irritable bowel syndrome (IBS) patients. In a sample of 694 participants (238 with IBD, 261 with IBS, and 195 healthy controls), several dietary indices were estimated, i.e., the Dutch Healthy Diet Index 2015 (DHD 2015) and the Adapted Dietary Inflammatory Index (ADII).…”

“…Therefore, low diet quality was associated with higher intestinal inflammation, higher abdominal pain scores, and symptom scores in IBD and IBS patients, respectively. Thus, the authors highlighted the need for longitudinal studies to further elucidate the role of dietary factors in the development of symptom exacerbation [ 8 ].…”