Dietary Patterns Associated to Clinical Aspects in Crohn’s Disease Patients

Abstract

Diet is an important factor in both the pathogenesis and in the clinical course of Crohn's disease (CD). However, data on dietary patterns of CD patients are rather limited in the literature. This cross-sectional study included 60 patients with CD, aged 18-60 years. Dietary intake was assessed using a validated food frequency questionnaire to measure food consumption patterns by principal component analysis (PCA). Multiple regression analysis was performed to investigate the association between dietary patterns and clinical and demographic variables. Three dietary patterns were identified: "Traditional + FODMAP" was associated with symptoms, gender, previous surgeries, and duration of the disease. "Fitness style" was positively associated with physical activity and negatively associated with body mass index and smoking. "Snacks and processed foods" was positively associated with duration of the disease and negatively associated with age. According to the weekly food consumption analysis, patients with active disease consumed less coffee and tea. We found significant associations between the three dietary patterns and the variables, but not with the stage of the disease. Prospective studies are necessary to determine the effects of food consumption patterns on the clinical course of CD. Crohn's disease (CD) causes chronic inflammation in the gastrointestinal tract 1. Multiple factors play a role in the pathogenesis of inflammatory bowel disease (IBD), such as genetics, host immune dysregulation, gut microbiota and "Western style diet" 2,3. This diet is known to be high in fats and calories, red and processed meat and n-6 polyunsaturated fatty acids (PUFA) and low in fruits and vegetables (for review see ref. 4). A case-control study in a Japanese population, in which the incidence of IBD is rapidly growing, found increased CD risk with higher consumption of sugars and sweeteners, sweets, fats and oils, and fish and shellfish 5. The role of diet has also been discussed in the clinical course of CD 6. It is obviously difficult to perform interventional studies to analyze the role of diet in the clinical course of IBD. Analyses focused on the role of single nutrients or foods are the most common type of dietary study on CD. However, this approach is limited because nutrients and foods are not consumed in isolation, and investigating the significance of overall diet with focused attention on the dietary patterns approach represents an advance in nutrition that can facilitate nutritional recommendations, as well as the management of CD in order to induce and maintain the clinical and endoscopic remission of the disease 7. Diet patterns may also aggravate symptoms in patients with IBD. A Mexican study reported that foods such as beans, whole milk, plum, lima beans and spicy sauce increased the frequency of symptoms in patients with Ulcerative Colitis (UC), another condition of IBD 8. In addition, a recent randomized controlled trial implemented within an Internet-based cohort found that the level of red and processed me...

Inflammatory Bowel Disease: Are Symptoms and Diet Linked?

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Dietary Triggers of Gut Inflammation Following Exclusive Enteral Nutrition in Children with Crohn’s Disease: A Pilot Study

“…Using machine learning on food group-based analysis, we showed that a dietary pattern consisting of cereal and meat-based products could successfully predict the assignment of 92% of patients into their respective FC group. In a recent cross-sectional study of patients with CD, principal component analysis also identi ed that a dietary pattern rich in rice, pasta and red meat, among other foods, was associated with increased symptom frequency, but did not differentiate patients with active disease from those in remission (34). In the current study, patients with higher FC levels also reported a higher consumption of gluten containing cereal products, which points to gluten-containing foods as potential driver of intestinal in ammation.…”

Role of diet and nutrition in inflammatory bowel disease

“…Diet is an important nutritional factor to be taken into account when assessing the impact of nutrients, as well as the existence of dietary patterns involved in both the pathogenesis and the clinical progression of IBD. Recent dietary research has shown that whole dietary patterns are more representative and more important than isolated individual nutrient evaluations[ 54 ].…”

“…These patterns are: (1) “Traditional + FODMAP”; (2) “fitness style”; and (3) “snacks and processed foods”. These patterns can be considered good indicators of patients’ eating habits, and facilitate the understanding of the relationship between diets and diseases[ 54 ]. Therefore, in general, results of dietary pattern studies should be considered when providing nutritional counseling to patients.…”