Does the inflammatory potential of diet affect disease activity in patients with inflammatory bowel disease?

Abstract

BackgroundDiet is an important modulator of inflammation, which is associated with inflammatory bowel disease (IBD). In this study, we examined whether the inflammatory properties of diets are associated with disease activity in patients with IBD.MethodsA cross-sectional study was conducted on 143 IBD patients, including 32 patients with Crohn’s disease (CD) and 111 patients with ulcerative colitis (UC). Dietary intakes were assessed by a valid 168-item food frequency questionnaire (FFQ). The inflammatory potential of the diet was assessed by calculating the two scores of Dietary Inflammatory Index (DII®), and the Empirical Dietary Inflammatory Pattern (EDIP), and CD and UC disease activity were determined by the Crohn’s disease activity index (CDAI) and the Mayo score, respectively. Associations of the inflammatory indices as median and as tertiles with disease activity were analyzed using logistic regression in a univariate model and after adjusting for total energy intake (continuous), type of disease (CD and UC) and drug consumption (no drugs, single drug, and multiple drugs).ResultsSixty-four IBD patients (44.8%) in this study had active disease.The DII® score and the EDIP did not differ significantly between active and inactive patients (− 1.45 ± 1.04 vs.− 1.20 ± 1.24; 0.56 ± 0.22 vs. 0.53 ± 0.28, respectively). After adjusting for energy intake, drug use, and IBD type, the odds (95%CIs) of active disease among patients in tertile 3 compared to those in tertile 1 were 0.84 (0.32–2.17) for DII and 1.50 (0.61–3.72) for EDIP; neither of which were statistically significantly different from the rates in tertile 1.ConclusionsAlthough point estimates were in the expected direction of increased risk, the inflammatory potential of diet, assessed using DII or EDIP, was not associated with severity of disease in IBD patients. Whether diet-related inflammation affects disease activity in patients with IBD deserves further investigations.

The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

“…An analysis of three large prospective cohorts showed that dietary patterns with high inflammatory potential were associated with an increased risk of developing CD, but not UC, though they used a slightly different inflammatory index [2]. In contrast to our results, a recently published cross-sectional study in Iranian patients with an established IBD diagnosis did not find an association between the inflammatory potential of diet and disease activity [22]. The null finding in the Iranian patients might be due to the small sample size (n = 143), especially the small number of participants with CD (n = 32), as compared to 178 CD patients in the present study.…”

Systematic review with meta‐analysis: dietary intake in adults with inflammatory bowel disease

“…Few studies reported the educational level of participants. Of the seven studies that reported the education level, this ranged from 39.6% to 80.8% of participants possessing a college level of education 26,59 …”

“…The most frequently used tool was a 3‐day food record (eight studies 42,47,52,53,55,60‐62 ), followed by a 7‐day food record (five studies 32,40,44,50,54 ). Various food frequency questionnaires were used which captured food frequency data over 24 hours (six studies 30,33,41,51,56,61 ), 1 week (2 studies 27,28 ), 1 month (three studies 23,36,37 ), 3 months (one study 58 ) and 1 year (two studies 26,63 ) periods and ranged from 86, 57 99, 43 110, 23,48 150, 38 18 59 or 630 food items 22 . Three studies used multiple methods of a food recall and food frequency questionnaire 32,51,62 .…”

Inflammatory Potential of the Diet and Incidence of Crohn’s Disease and Ulcerative Colitis in the EPIC-Spain Cohort

“…There have also been some studies examining the effect of the inflammatory potential of the diet, as measured by a score, on gut inflammation and disease activity in patients already diagnosed with IBD, but both positive and null relationships have been reported [ 38 , 39 ].…”