Differences in dietary habits between patients with inflammatory bowel disease in clinical remission and a healthy population

Abstract

Background:Although patients with active inflammatory bowel disease (IBD) change their dietary habits according to suggestions from their healthcare team, no restriction is required in the remission phase. Accordingly, we compared eating patterns in IBD patients with drug-induced clinical remission with those in healthy subjects.Methods:A total of 150 IBD patients, 84 with Crohn’s disease (CD) and 66 with ulcerative colitis (UC), in clinical remission, receiving immunomodulator/biologic therapy, and 100 healthy volunteers (controls) were enrolled. The IBD diagnosis had previously been established by a combined assessment of symptoms, endoscopy, histology and abdominal imaging. Clinical remission was defined as a Harvey Bradshaw index <5 for CD and a partial Mayo score <2 for UC. An experienced nutritionist guided the compilation of a food diary for 7 days according to current guidelines. Macronutrient and fiber intake was evaluated using dedicated software. Comparison between continuous variables was performed using Student’s t-test or analysis of variance plus Bonferroni post-hoc analysis. Categorical variables were tested with the χ2 test.Results:No difference in protein and carbohydrate intake was observed. IBD patients ate more calories (1970.7±348.4 vs. 1882.1±280.2 kcal/day, P=0.03), more lipids (68.9±15.2 vs. 59.4±19.0 g/day, P<0.001) and less fibers (11.9±4.7 vs. 15.5±8.3 g/day, P<0.001) than controls. No significant difference in total calories, proteins, lipids, carbohydrates or fibers was seen between CD and UC patients.Conclusion:IBD patients have a different macronutrient and fiber intake compared to healthy subjects, even when clinical remission and no symptoms do not dictate dietary restrictions. Therefore, psychological issues may be involved.

Evaluation of nutritional adequacy in adult patients with Crohn’s disease: a cross-sectional study

“…Regarding the intake of dietary fiber, expressed as both the total and grams per 1000 kcal/day, we observed reduced values (7.2 g/1000 kcal) compared to the LARN recommendation (RI = ~ 15 g/1000 kcal), even in patients in clinical remission. Previous studies showed an average daily intake of fiber/1000 kcal that ranged from 6.13 [31] to 11.1 g [20], without showing any differences between active and quiescent groups [21], in agreement with our results.…”

Cross-Sectional Analysis of Overall Dietary Intake and Mediterranean Dietary Pattern in Patients with Crohn’s Disease

“…Compared to the representative sample, dietary MUFA intake from foods like olive and canola oils, avocado, and nuts were low in patients with CD. One recently published study showed that dietary lipid and overall energy intake in a mixed IBD sample was higher than that of the healthy control subjects, however, no differences were observed in protein and carbohydrate intake [ 34 ]. Dietary lipid composition, unfortunately, was not reported in this study, rendering the proportion of MUFA and PUFA unknown.…”

Intake of Lutein and Zeaxanthin as a Possible Factor Influencing Gastrointestinal Symptoms in Caucasian Individuals with Ulcerative Colitis in Remission Phase

“…The fiber intake (g) was assessed as an additional variable that may influence the other factors [31], because even individuals in the remission phase may reduce their fiber intake due to the fear of disease complications [32]. This variable was assessed using the Polish dietician software Dieta version 5.0 (National Food and Nutrition Institute, Warsaw, Poland) and the Polish database of the nutritional value of the products [33].…”