Obesity and Crohn’s disease: what comes first, the egg or the chicken?

Kotze, Paulo Gustavo

doi:10.1590/s0004-2803.201700000-37

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Our results showed an excess of body fat and significant overweight and obesity proportions associated with disease activity, with higher consumption of cholesterol and less fiber, similar to other studies ( 34 ). As described by Kotze ( 35 ), the literature is still controversial about ‘what comes first: the egg or the chicken’.…”

Section: Discussionsupporting

confidence: 92%

Nutritional Global Status and Its Impact in Crohn’s Disease

Prieto

Andrade

Magro

et al. 2021

Journal of the Canadian Association of Gastroenterology

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Background Malnutrition among inflammatory bowel disease (IBD) subjects is well documented in literature and may emerge from factors including inadequate dietary intake, malabsorption and disease activity. The aim of this study was to complete a comprehensive nutrition assessment and explore what possibilities may help bring a better quality of life for IBD subjects. Methods Nutritional status based on biochemical tests, body composition and body mass index (BMI). Food intake was assessed by an alternate 3-day food record and the adequacy of intake was evaluated according to national and international references. Clinical disease activity was evaluated by the Harvey-Bradshaw index and CRP levels. Results The study included 217 patients and 65 controls, where 54.4% of these patients were classified as normal weight with a mean BMI lower than controls (23.8 ± 4.9 versus 26.9 ± 4.8 kg/m2, P = 0.02). Patients with disease activity showed more overweight and obesity than patients with controlled disease. Vitamin B12 deficiency was present in 19% of Crohn’s disease (CD), mainly in patients with ileal commitment and small bowel resections. Anemia was present in 21.7% of patients, being more common in patients with active disease (25%) and bowel resection (23%). Regarding calorie intake (EI), CD group ingested more than controls (1986.3 ± 595.9 kcal versus 1701.8 ± 478.9 kcal; P = 0.003). Conclusions CD patients presented micronutrient deficiency when compared with controls, explained for other reasons than intake restrictions. Also, fat excess might have contributed to disease burden as continuously reported in the literature.

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Section: Discussionsupporting

confidence: 92%

Nutritional Global Status and Its Impact in Crohn’s Disease

Prieto

Andrade

Magro

et al. 2021

Journal of the Canadian Association of Gastroenterology

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“…Almost half the patients in this study were overweight or obese. This is in line with studies linking environmental factors, especially diet, to an increased risk of immune-mediated diseases [38][39][40] . In Brazil, the increased consumption of ultra-processed foods over the last few decades has contributed to the burden of obesity 41,42 .…”

Section: Discussionsupporting

confidence: 89%

Clinical factors associated with severity in patients with inflammatory bowel disease in Brazil based on 2-year national registry data from GEDIIB

Fróes,

Andrade,

Faria

et al. 2024

Sci Rep

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The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) established a national registry of inflammatory bowel disease (IBD). The aim of the study was to identify clinical factors associated with disease severity in IBD patients in Brazil. A population-based risk model aimed at stratifying the severity of IBD based on previous hospitalization, use of biologics, and need for surgery for ulcerative colitis (UC) and Crohn’s Disease (CD) and on previous complications for CD. A total of 1179 patients (34.4 ± 14.7y; females 59%) were included: 46.6% with UC, 44.2% with CD, and 0.9% with unclassified IBD (IBD-U). The time from the beginning of the symptoms to diagnosis was 3.85y. In CD, 41.2% of patients presented with ileocolic disease, 32% inflammatory behavior, and 15.5% perianal disease. In UC, 46.3% presented with extensive colitis. Regarding treatment, 68.1%, 67%, and 47.6% received biological therapy, salicylates and immunosuppressors, respectively. Severe disease was associated with the presence of extensive colitis, EIM, male, comorbidities, and familial history of colorectal cancer in patients with UC. The presence of Montreal B2 and B3 behaviors, colonic location, and EIM were associated with CD severity. In conclusion, disease severity was associated with younger age, greater disease extent, and the presence of rheumatic EIM.

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“…Contrary to what one should expect, 15%-40% of the individuals with IBD also present with obesity, and it is uncertain whether it might contribute to the development and evolution of IBD (3) . Many IBD cohorts and adult populations showed that the prevalence of overweight/obese IBD patients is similar to the general population (20%-30%) (4)(5)(6) . There are plenty of explanations regarding a possible link between IBD and obesity increased rates, such as gut microbiome alterations, changes in food intake behavior, increased consumption of industrialized food, animal fat/protein (western diet) and decreased dietary fiber intake, as well a reduction in physical exercice and increase in sedentarism.…”

Section: Introductionmentioning

confidence: 96%