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.

Beliefs, Experiences, and Openness Regarding Dietary Interventions: Data From an Urban Hispanic Population With Rheumatic Disease in the US

“…Prior survey‐based research in autoimmune populations has also shown a patient‐reported association between nutrition and underlying disease activity, as well as an interest in dietary modulation, including in classic rheumatic diseases such as psoriatic arthritis and non‐rheumatic diseases such as inflammatory bowel disease and multiple sclerosis (13,14,25–29). Many of these participants noted improvement in disease activity from higher intake of fruits and vegetables and from decreased consumption of processed foods.…”

The impact of dietary interventions in psoriatic arthritis

“…An observational study evaluated the effect of intermittent fasting on disease activity in psoriasis and PsA [69]. [70] performed an online survey on nutritional needs in patients with immunemediated inflammatory diseases. They found that patients seek more nutritional advice from their physicians and holistic management.…”

“…Pham et al [70] performed an online survey on nutritional needs in patients with immune-mediated inflammatory diseases. They found that patients seek more nutritional advice from their physicians and holistic management.…”

Immune-Mediated Inflammatory Diseases Awareness and Management among Physicians Treating Patients with Inflammatory Bowel Disease: An IG-IBD Survey

“…Lately, there has been a growing recognition of the necessity for a new collaboration with nutritionists. A recent review showed that patients affected by different IMIDs tend to adopt different types of self-imposed restrictive diets, often due to insufficient nutritional care from their physicians [14].…”