High Dietary Intake of Specific Fatty Acids Increases Risk of Flares in Patients With Ulcerative Colitis in Remission During Treatment With Aminosalicylates

Abstract

Background & Aims Dietary factors may have a significant role in relapse of disease among patients with ulcerative colitis (UC). However, the relationship between diet and UC is inadequately understood. We analyzed data from the diet’s role in exacerbations of mesalamine maintenance study to determine whether dietary factors affect risk of disease flares in patients with UC. Methods We performed a prospective, multi-center, observational study of 412 patients, from 25 sites, with UC in remission during monotherapy with an aminosalicylate. Patients completed a validated food frequency questionnaire at enrollment and were followed for 12 months. We analyzed the relationship between diet and disease remission or flare for groups of macro- and micro-nutrients, as well as food groups previously associated with an increased risk of flare. Results Forty-five patients (11%) had a UC relapse within 1 year of study enrollment. When analyzed in tertiles, increasing intake of multiple fatty acids was associated with increasing odds of relapse. In multivariable logistic regression analysis, only myristic acid (Odds Ratio 3.01, 95% CI 1.17 – 7.74) maintained this dose-response relationship. Other foods previously implicated in flares of UC, such as processed meat, alcohol, and foods high in sulfur, were not associated with an increased risk of flare. Conclusions In a prospective study of more than 400 patients with UC undergoing treatment with aminosalicylates, we associated high dietary intake of specific fatty acids, including myristic acid (commonly found in palm oil, coconut oil and dairy fats) with an increased risk of flare. These findings can help design interventional studies to evaluate dietary factors in UC.

Differences in adiposity and diet quality among individuals with inflammatory bowel disease in Eastern Canada

“…In addition to excess adipose tissue, diet quality also plays a role in the regulation of the intestinal microbiome and can further augment the associated inflammatory conditions [ 7 – 10 ]. Diet quality deserves increased attention not only for modulating inflammation, but also to avoid nutritional deficiencies and manage symptoms in those with IBD [ 7 , 11 ].…”

Ernährung bei entzündlichen Darmerkrankungen

“…Die Autoren folgerten daraus, dass bestimmte Fette bei Wirten mit entsprechender genetischer Veranlagung möglicherweise IBD begünstigen können [109]. Eine kürzlich publizierte Prospektivstudie mit CU-Patienten ergab ein dreimal höheres Risiko für ein Wiederaufflammen der Krankheit bei Patienten, die bestimmte Fettsäuren wie Myristinsäure (enthalten in Palm- und Kokosnussöl sowie in Milchfett) konsumierten, sowie bei Patienten, die ALA zu sich nahmen [110]. Dieses Ergebnis mag überraschend erscheinen, da ALA zur Gruppe der n-3-PUFA zählt, denen eine entzündungshemmende Wirkung zugeschrieben wird [48].…”

Dietary strategies and food practices of pediatric patients, and their parents, living with inflammatory bowel disease: a qualitative interview study

“…In addition, supplementation with omega-3 free fatty acids was reported as not effective for the prevention of relapse in CD (Feagan et al, 2008;Lev-Tzion, Griffiths, Leder, & Turner, 2014). More recently, a prospective, multicenter study of patients with UC in remission on aminosalicylate therapy revealed that increasing intake of myristic acid (commonly found in palm oil, coconut oil, and dairy fats) was associated with disease relapse (Barnes, Nestor, Onyewadume, de Silva, & Korzenik, 2017). Other foods, such as processed meat, alcohol, and foods high in sulfur, were not associated with an increased risk of flare (Barnes et al, 2017).…”