Zinc Deficiency is Associated with Poor Clinical Outcomes in Patients with Inflammatory Bowel Disease

Siva, Shankar; Rubin, David T.; Gulotta, George; Wroblewski, K.; Pekow, Joel

doi:10.1097/mib.0000000000000989

Cited by 130 publications

(113 citation statements)

References 31 publications

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“…A lack of iron is present in 30% to 90% of anemic IBD patients [16] and zinc deficiency is associated with a poor disease outcome and a higher risk for disease-related complications [52]. The daily intake of these minerals, as well as of potassium and magnesium, was in accordance with the recommendations of DACH in all our study participants.…”

Section: Food Group Hc Total Ibd Ibd (Intake In [G/d]) CD Ucmentioning

confidence: 52%

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Schink¹,

Mirsch²,

Dieterich³

et al. 2017

J Nutr Food Sci

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Patients with inflammatory bowel diseases (IBD) are often affected by nutrient deficiencies. Besides a limited nutrient intake by disease-related side effects and malabsorption, the influence of diets and dietary changes is much discussed. However, data about food patterns are mostly based on subjective declarations. Therefore, this study aimed to achieve a detailed and objective analysis of nutrient intake and individual food habits in IBD, a prerequisite for an appropriate nutritional intervention in risk patients. One hundred IBD patients (n=70 Crohn's disease (CD), n=30 ulcerative colitis (UC)) and 30 healthy controls (HC) were included in the study. All participants filled in a disease-related and food frequency questionnaire. Fifteen healthy controls and 71 IBD patients additionally completed a questionnaire for self-imposed food restrictions. Most IBD patients and healthy controls showed a normal body mass index. However, within the IBD group, UC patients were more often overweight than CD patients (p=0.007). Food restrictions were common in all participants, but significantly more IBD patients restricted their consumption of fast food (p=0.037), fruits and vegetables (p=0.019). Especially CD patients with acute relapse consumed less fruits and vegetables (p=0.035). Contrary to subjective assessment, an objective survey of dietary intake revealed a significantly higher sugar intake of IBD patients compared to healthy controls (p<0.001) with an increased ingestion of sugar/confectionery (p=0.041), soft/isotonic drinks (p<0.001) and fruit/vegetable juices (p=0.022). Additionally, IBD patients ingested higher amounts of salt than healthy controls (p=0.005). Both groups showed an insufficient ingestion of folate, vitamin D and pantothenic acid.In conclusion, self-managed food restrictions appear to be common in IBD patients. The huge discrepancy between the subjective view of dietary habits and objective evaluation of nutrient intake indicates that nutrient assessment should be based on objective tools. A repetitive professional nutritional counseling is recommended to prevent and treat nutritional deficiencies.

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Section: Food Group Hc Total Ibd Ibd (Intake In [G/d]) CD Ucmentioning

confidence: 52%

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Schink¹,

Mirsch²,

Dieterich³

et al. 2017

J Nutr Food Sci

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“…Moreover, inflammation in itself may be a catalyst for elevated urinary excretion of zinc . In a recent adult study, low zinc levels correlated with the severity of IBD, plausibly via disruption of epithelial barrier function and elevation of proinflammatory cytokines such as TNFα. Zinc is also known as a regulator of macrophages and antioxidants .…”

Section: Discussionmentioning

confidence: 99%

Micronutrient Deficiencies in Children With Inflammatory Bowel Diseases

et al. 2019

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Background Children with inflammatory bowel diseases (IBDs) are at risk of developing nutrition deficiencies, particularly because of reduced intake, restrictive diets, malabsorption, and excessive nutrient loss. In this study, we aimed to assess the status of trace elements, minerals, and vitamins in a large cohort of children with IBDs. Methods Medical records of children diagnosed with IBDs during 2000–2016 were reviewed retrospectively. Retrieved data included demographics, disease characteristics, disease activity indices, anthropometric measures, and specific trace elements, minerals, and vitamins at diagnosis and during follow‐up. Results Out of 359 children with IBD (158 [44%] females, median age at diagnosis 14.1 years, interquartile range [IQR] 12.0–16.0), 240 (67%) were diagnosed with Crohn's disease (CD) and 119 (33%) with ulcerative colitis (UC). Median follow‐up time was 7 years (IQR 5–10). The prevalence of deficiencies in patients with CD at diagnosis and last follow‐up, respectively, were iron (88% and 39.5%), zinc (53% and 11.5%), vitamin D (39% and 36%), and folic acid (10% and 13%). In patients with UC, frequencies were: iron (77% and 40%), vitamin D (49% and 33%), zinc (31% and 10%), and folic acid (3.8% and 9.7%). Magnesium and vitamin B12 deficiencies were rare. For both diseases, iron deficiency was associated with hypoalbuminemia. Deficiencies in iron and zinc were more common in patients with CD than those with UC. Conclusions Deficiencies in iron, zinc, and vitamin D are common at pediatric IBD diagnosis with limited improvement during follow‐up, whereas deficiencies in magnesium and vitamin B12 are rare.

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“…The prevalence of zinc deficiency in IBD ranges from 15 to 40% [87–90]. A low serum zinc level has also been associated with hospitalization, operation or other complications in CD patients [91]. Ulcerative colitis patients with low serum zinc level also have increased hospitalizations and a trend towards increased complications.…”

Section: Vitamins and Micronutrientsmentioning

confidence: 99%

Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease

Kakodkar

Mutlu

2017

Gastroenterology Clinics of North America

128

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Summary There are many mechanisms to explain how food may drive and also ameliorate inflammation. Despite there being no consistent macronutrient associations with the development of IBD, many exclusion diets have been described in the medical literature and lay press: IgG-4 guided exclusion diet; semi-vegetarian diet; Low fat, fiber limited exclusion diet (LOFFLEX Diet); Paleolithic diet; Maker’s diet; vegan diet; Life without Bread diet; exclusive enteral nutrition (EEN), the Specific Carbohydrate Diet (SCD) and the low FODMAP diet. The literature on diet and IBD is reviewed with a particular focus on EEN, the SCD and low FODMAP diet in IBD. Lessons learned from the existing observations and strengths and shortcomings of existing data is presented, along with recommendations for patients.

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Zinc Deficiency is Associated with Poor Clinical Outcomes in Patients with Inflammatory Bowel Disease

Cited by 130 publications

References 31 publications

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Micronutrient Deficiencies in Children With Inflammatory Bowel Diseases

Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease

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