Knowledge, Attitudes, and Beliefs Regarding the Role of Nutrition in IBD Among Patients and Providers

Tinsley, Andrew; Ehrlich, Orna; Hwang, Caroline; Issokson, Kelly; Zapala, Sophia; Weaver, Alandra; Siegel, Corey A.; Melmed, Gil Y.

doi:10.1097/mib.0000000000000901

Cited by 62 publications

(42 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the growing interest of patients regarding the role of diet in IBD, and their attitude to seek information, it is important for healthcare professionals to include dietary recommendations in the routine visit, in order to avoid self-imposed restrictions with consequent adverse effects [52]. Indeed, notwithstanding the fact that more than half of the interviewees received information from their gastroenterologist, 70% stated that they would like to receive even more.…”

Section: Discussionmentioning

confidence: 99%

Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization

et al. 2019

View full text Add to dashboard Cite

Background and objectives: Despite the serious concerns of patients about the role of food in triggering or ameliorating their intestinal disease, there are few studies dealing with patients’ beliefs and practices regarding diet in inflammatory bowel disease (IBD). The aim of this study was to investigate how the disease affected the dietary habits of patients with IBD, and to assess if patients’ food restrictions were responsible for low bone mineralization. Materials and Methods: For this study, 90 consecutive patients referred for IBD were interviewed regarding their dietary habits. Demographic features and clinical characteristics potentially associated with the dietary habits were collected. A validated and self-administered survey questionnaire dealing with dietary habits and patients’ beliefs and perceptions regarding food was analyzed. Multivariate logistic regression analysis was performed in order to identify risk factors for dietary restrictions among participants and to evaluate the relationship between dietary restrictions and low bone mineral density (BMD). Results: Among the 63 (70%) patients who claimed a self-prescribed dietary restriction, 84% avoided dairy products. Significant risk factors (adjusted odds ratio (OR), 95% confidence interval (CI)) for the dietary restrictions were a younger age (p = 0.02), a higher level of education (p = 0.007), and a higher visceral sensitivity index (p = 0.009). Most (80%) of the patients displayed an inadequate calcium intake, and an abnormal result at dual-energy X-ray absorptiometry (DXA) scan accounting for low BMD was reported in 46 (51%) of them. Dietary restrictions (p = 0.03), and in particular avoiding dairy products (p = 0.001), were significant risk factors for a low BMD, along with female gender (p = 0.001), smoking (p = 0.04), and steroid abuse (p = 0.03). Almost all (86%) patients changed their diet after IBD diagnosis, as 8% believed that foods could have been a trigger for IBD and 37% that a proper diet was more important than drugs in controlling disease. Although 61% of the patients claimed to have received nutritional advice, 78% of the participants showed interest in receiving more. Conclusions: Dietary habits of IBD patients should be investigated by healthcare professionals as part of the routine visit. Clinicians are invited to provide nutritional recommendations to these patients in order to avoid unnecessary self-prescribed dietary restrictions.

show abstract

Section: Discussionmentioning

confidence: 99%

Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Dietary research is fraught with challenges, not in the least including the manifold variables in dietary intake, the proportion of food intake relative to other dietary components, the potential for complex interactions between food groups, variable food metabolism among individuals, and inherent differences in food products [ 10 ]. Strong patient interest in diet in IBD, the lack of credible scientific evidence to support dietary recommendations, perceived physician indifference, or indeed variable knowledge among healthcare professionals has led patients to seek information from the lay press, internet, and other sources to address their unmet needs, potentially misleading patients through inaccurate information and fuelling self-imposed restrictions with consequent adverse effects [ 11 , 12 ]. This underpins the need for physicians and healthcare professionals to have a better understanding of dietary practices, in triggering, perpetuating, and improving IBD.…”

Section: Introductionmentioning

confidence: 99%

Dietary practices and inflammatory bowel disease

Limdi

2018

Indian J Gastroenterol

View full text Add to dashboard Cite

The etiology of inflammatory bowel disease (IBD) remains elusive but it is believed to result from incompletely understood interactions between environmental triggers in a potentially genetically susceptible host and a subsequent aberrant immune response. Its incidence is increasing worldwide at an unprecedented rate, outpacing what genetic influences alone could instigate. The increasingly integral role played by eating in social life has led patients to gravitate to diet and food in their consultations with physicians and other health care professionals, in an attempt to improve, control, or even “cure” IBD through diet. Diet is a modifiable factor, and both patients and healthcare professionals have fuelled resurgent interest in the role of diet in maintaining IBD remission. Despite significant and increasing interest, there is a lack of credible evidence to support dietary modification or restrictions to prevent relapse of IBD. However, recent studies have shown that more than half of the patients believe that diet plays an important role in triggering relapse, leading to self-imposed dietary restrictions, some of which can have adverse consequences. This underpins the need for physicians and health care professionals to have a better understanding of dietary practices, in triggering, perpetuating, and improving IBD. This review examines and discusses the evidence behind this.

show abstract

“…A large majority of patients with IBD perceive food as a risk factor and impose dietary restrictions without proper counseling, which results in malnutrition [ 3 , 105 , 117 – 119 ]. However, there is little evidence from interventional studies to support specific dietary restrictions in IBD [ 120 ].…”

Section: The Asian Working Group Guidelines Regarding Diet In Inflammmentioning

confidence: 99%

Diet and inflammatory bowel disease: The Asian Working Group guidelines

Sood

Ahuja

Kedia

et al. 2019

Indian J Gastroenterol

View full text Add to dashboard Cite

Introduction These Asian Working Group guidelines on diet in inflammatory bowel disease (IBD) present a multidisciplinary focus on clinical nutrition in IBD in Asian countries. Methodology The guidelines are based on evidence from existing published literature; however, if objective data were lacking or inconclusive, expert opinion was considered. The conclusions and 38 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required. Results Diet has an important role in IBD pathogenesis, and an increase in the incidence of IBD in Asian countries has paralleled changes in the dietary patterns. The present consensus endeavors to address the following topics in relation to IBD: (i) role of diet in the pathogenesis; (ii) diet as a therapy; (iii) malnutrition and nutritional assessment of the patients; (iv) dietary recommendations; (v) nutritional rehabilitation; and (vi) nutrition in special situations like surgery, pregnancy, and lactation. Conclusions Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations.

show abstract

Knowledge, Attitudes, and Beliefs Regarding the Role of Nutrition in IBD Among Patients and Providers

Abstract: Significant gaps in knowledge relating to nutrition in IBD seem to exist. Targeted educational initiatives and improved access to nutritional experts are warranted. In addition, a standardized process for the assessment of malnutrition among patients with IBD should be developed.

Cited by 62 publications

References 28 publications

Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization

Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization

Dietary practices and inflammatory bowel disease

Diet and inflammatory bowel disease: The Asian Working Group guidelines

Contact Info

Product

Resources

About