Immune-mediated inflammatory diseases and nutrition: results from an online survey on patients’ practices and perceptions

Abstract

Background The central role of microbiota and the contribution of diet in immune-mediated inflammatory diseases (IMID) are increasingly examined. However, patients’ perspectives on nutrition and its impact on their disease has not received a lot of attention. We aimed to directly collect information from patients with IMID about their dietary behaviors and their perceptions of the influence of nutrition on their disease.Methods Adult patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn’s disease, ulcerative colitis or psoriasis registered in an online patient community were invited to participate in the study and complete an online self-administered questionnaire. We assessed patients’ dietary knowledge and choices by collecting information on the diet regimens they were following or recommended and their perceptions of the diet and its consequences on their disease.Results Fifty patients per target disease were included with a mean age of 48.1 years (95%CI 46.7–49.6). Other sociodemographic and clinical characteristics varied across the diseases. Since diagnosis, 44% of the patients changed their eating habits, mainly patients with inflammatory bowel disease with 69% of these making the change on their own initiative. Patients who did not change their diet habits reported not having received nutritional advice from their healthcare professionals (HCP) in 69% of the cases. The perceived impact of nutrition on their symptoms was mixed (overall 74% of the patients reported positive consequences and 60% negative ones) and varied across the diseases. Patients with psoriasis only experienced positive consequences from changing their diet, such as reduction of stress and improved mental health, while patients with Crohn’s disease reported more negative effects such as increased fatigue and disturbed sleep. Patients with rheumatic diseases and ulcerative colitis reported weight loss and better physical fitness, but also increased fatigue.Conclusions Even if differences exist across diseases, the importance of nutrition and its potential positive role in symptom management is acknowledged by the majority of the patients. However, there is a need and a demand from patients to receive more dietary advice. Developing therapeutic education tools on nutrition for people with IMID and involving patients’ organizations would provide useful information and encourage communication between HCP and patients.

Approaches to nutrition intervention in plaque psoriasis, a multi‐system inflammatory disease—The Diet and Psoriasis Project (DIEPP)

“…Patients with psoriasis subject to lifestyle interventions report a mean PASI reduction of −2.49 95% CI −3.90 to −1.08 compared to control groups (Upala & Sanguankeo, 2015). These findings are contrasted with observational data reporting that psoriasis patients receive limited dietary advice from healthcare professionals, compared to patients with other inflammatory conditions (Pham et al, 2021). The ERAPSO study delineated that only 13% of patients with psoriasis received dietary advice (Schwarz et al, 2019).…”

Nutrients, foods and dietary patterns in the management of autoimmune rheumatic diseases

“…Even if nutritional care appears promising, current nutritional information in the RD management is extremely scarce and varies according to the different diseases. A recent survey by Pham and colleagues [5] revealed that only a small percentage of people diagnosed with RD received nutritional advice and that most of them were rather dissatisfied with information and service provided. RD patients frequently ask their doctors about which diets to follow, and even in the absence of advice, most of them are undertaking different dietary choices since its own experience.…”