The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

Abstract

Background Diet may play a role in disease status in patients with inflammatory bowel disease. We tested whether the inflammatory potential of diet, based on a summation of pro- and anti-inflammatory nutrients, is associated with disease activity in patients with Crohn’s disease and ulcerative colitis. Methods Participants completed a disease activity questionnaire (short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI)) and a Food Frequency Questionnaire (FFQ). FFQ data were used to calculate the Dietary Inflammatory Index (DII) which enables categorization of individuals’ diets according to their inflammatory potential on a continuum from pro- to anti-inflammatory. Associations with disease activity were investigated by multiple linear regression. Results The analysis included 329 participants; 168 with Crohn’s disease (median sCDAI score 93 [IQR 47–156]), and 161 with ulcerative colitis (median P-SCCAI score 1 [IQR 1–3]). Mean DII was 0.71 ± 1.33, suggesting a slightly pro-inflammatory diet. In Crohn’s disease, the DII was positively associated with disease activity, even after adjustment for confounders (p = 0.008). The mean DII was significantly different between participants in remission and with mild and moderately active disease (0.64, 0.97 and 1.52 respectively, p = 0.027). In ulcerative colitis, the association was not significant. Conclusions Disease activity was higher in IBD participants with a more pro-inflammatory diet with statistical significance in Crohn’s disease. Although the direction of causality is not clear, this association strengthens the role for diet in medical treatment, which should be tested in an intervention study.

Patient experiences with the role of physical activity in inflammatory bowel disease: results from a survey and interviews

“…This study consisted of an online survey and interviews. The online survey was part of a larger survey about lifestyle factors and disease activity [ 13 ], which was conducted between July and October 2018. The survey was composed of questions regarding disease activity, physical activity and participants’ characteristics.…”

“…IBD patients aged 18 years or older, diagnosed with either CD or UC, were included. Details about recruitment can be found elsewhere [ 13 ]. In total, 397 patients showed interest in the study and received access to our online survey.…”

Treatment of Inflammatory Bowel Disease: A Comprehensive Review

“…Dietary inflammatory index (DII) is an index to quantify the potential inflammatory effect in the diet, which reflects a large literature and population base, and is associated with international standard (238,239). A recent analysis found that dietary patterns with a high DII could increase the risk of CD (240). It has been shown that DII is positively correlated with disease activity in CD patients and there is no correlation between DII and disease activity of UC (241).…”

The Gut–Brain Axis and Its Role in Controlling Eating Behavior in Intestinal Inflammation

“…CD patients may have stronger hedonic desires for food and emotional eating patterns possibly to alleviate symptoms of low mood, anxiety, and depression [ 11 ]. A recent study found an association between the inflammatory potential of diet, as assessed by Dietary Inflammatory Index (DII) [ 19 ] and disease severity in CD but not in UC [ 20 ]. Palatable but, pro-inflammatory foods found in the Western diet may provide immediate reward but worsen CD severity in the long term.…”