Perception of the Role of Food and Dietary Modifications in Patients with Inflammatory Bowel Disease: Impact on Lifestyle
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Burisch, J.; Jess, T.; Martinato, M.; Lakatos, P.L.; ECCO-EpiCom. The burden of inflammatory bowel disease in Europe. J. Crohns Colitis 2013, 7, 322–337. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Abegunde, A.T.; Muhammad, B.H.; Bhatti, O.; Ali, T. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review. World J. Gastroenterol. 2016, 22, 6296–6317. [Google Scholar] [CrossRef] [PubMed]
- Levine, A.; Boneh, R.S.; Wine, E. Evolving Role of Diet in the Pathogenesis and Treatment of Inflammatory Bowel Diseases. Gut 2018, 67, 1726–1738. [Google Scholar] [CrossRef]
- Zallot, C.; Quilliot, D.; Chevaux, J.B.; Peyrin-Biroulet, C.; Guéant-Rodriguez, R.M.; Freling, E.; Collet-Fenetrier, B.; Williet, N.; Ziegler, O.; Peyrin-Biroulet, L.; et al. Dietary Beliefs and Behavior among Inflammatory Bowel Disease Patients. Inflamm. Bowel. Dis. 2013, 19, 66–72. [Google Scholar] [CrossRef] [Green Version]
- Crooks, B.; McLaughlin, J.; Matsuoka, K.; Kobayashi, T.; Yamazaki, H.; Limdi, J.K. The dietary practices and beliefs of people living with inactive ulcerative colitis. Eur. J. Gastroenterol. Hepatol. 2020, 33, 372–379. [Google Scholar] [CrossRef]
- Limdi, J.K.; Aggarwal, D.; McLaughlin, J.T. Dietary Practices and Beliefs in Patients with Inflammatory Bowel Disease. Inflamm. Bowel Dis. 2016, 22, 164–170. [Google Scholar] [CrossRef] [Green Version]
- Holt, D.Q.; Strauss, B.J.; Moore, G.T.C. Patients with inflammatory bowel disease and their treating clinicians have different views regarding diet. J. Hum. Nutr. Diet. 2016, 30, 66–72. [Google Scholar] [CrossRef] [Green Version]
- De Vries, J.H.; Dijkhuizen, M.; Tap, P.; Witteman, B.J. Patient’s Dietary Beliefs and Behaviours in Inflammatory Bowel Disease. Dig. Dis. 2019, 37, 131–139. [Google Scholar] [CrossRef] [PubMed]
- Czuber-Dochan, W.; Morgan, M.; Hughes, L.D.; Lomer, M.C.; Lindsay, J.O.; Whelan, K. Perceptions and Psychosocial Im-pact of Food, Nutrition, Eating and Drinking in People with Inflammatory Bowel Disease: A Qualitative Investigation of Food-Related Quality of Life. J. Hum. Nutr. Diet. 2019, 33, 115–127. [Google Scholar] [CrossRef] [PubMed]
- Limketkai, B.N.; Sepulveda, R.; Hing, T.; Shah, N.D.; Choe, M.; Limsui, D.; Shah, S. Prevalence and factors associated with gluten sensitivity in inflammatory bowel disease. Scand. J. Gastroenterol. 2017, 53, 147–151. [Google Scholar] [CrossRef] [PubMed]
- Aziz, I.; Branchi, F.; Pearson, K.; Priest, J.; Sanders, D.S. A Study Evaluating the Bidirectional Relationship between Inflamma-tory Bowel Disease and Self-Reported Non-Celiac Gluten Sensitivity. Inflamm. Bowel. Dis. 2015, 21, 847–853. [Google Scholar] [CrossRef] [PubMed]
- Mishkin, S. Dairy sensitivity, lactose malabsorption, and elimination diets in inflammatory bowel disease. Am. J. Clin. Nutr. 1997, 65, 564–567. [Google Scholar] [CrossRef] [Green Version]
- D’Haens, G.; Sandborn, W.J.; Feagan, B.G.; Geboes, K.; Hanauer, S.B.; Irvine, E.J.; Lémann, M.; Marteau, P.; Rutgeerts, P.; Schölmerich, J.; et al. A Review of Activity Indices and Efficacy End Points for Clinical Trials of Medical Therapy in Adults with Ulcerative Colitis. Gastroenterology 2007, 132, 763–786. [Google Scholar] [CrossRef] [Green Version]
- Harvey, R.; Bradshaw, J. A Simple index of crohn’s-disease activity. Lancet 1980, 315, 514. [Google Scholar] [CrossRef]
- Cohen, A.B.; Lee, D.; Long, M.D.; Kappelman, M.D.; Martin, C.F.; Sandler, R.S.; Lewis, J.D. Dietary Patterns and Self-Reported Associations of Diet with Symptoms of Inflammatory Bowel Disease. Dig. Dis. Sci. 2013, 58, 1322–1328. [Google Scholar] [CrossRef]
- Andersen, V.; Chan, S.; Luben, R.; Khaw, K.T.; Olsen, A.; Tjonneland, A.; Kaaks, R.; Grip, O.; Bergmann, M.M.; Hart, A.; et al. Fibre Intake and the Development of Inflammatory Bowel Disease: A European Prospective Multi-Centre Cohort Study (EPIC-IBD). J Crohns Colitis 2018, 12, 129–136. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Preda, C.M.; Manuc, T.; Chifulescu, A.; Istratescu, D.; Louis, E.; Baicus, C.; Sandra, I.; Diculescu, M.-M.; Reenaers, C.; Van Kemseke, C.; et al. Diet as an environmental trigger in inflammatory bowel disease: A retrospective comparative study in two European cohorts. Rev. Española Enferm. Dig. 2020, 112, 440–447. [Google Scholar] [CrossRef]
- Levine, A.; Rhodes, J.M.; Lindsay, J.O.; Abreu, M.T.; Kamm, M.A.; Gibson, P.R.; Gasche, C.; Silverberg, M.S.; Mahadevan, U.; Boneh, R.S.; et al. Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clin. Gastroenterol. Hepatol. 2020, 18, 1381–1392. [Google Scholar] [CrossRef] [PubMed]
- Rondanelli, M.; Lamburghini, S.; Faliva, M.A.; Peroni, G.; Riva, A.; Allegrini, P.; Spadaccini, D.; Gasparri, C.; Iannello, G.; Infantino, V.; et al. A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease. Endocrinol. Diabetes Nutr. 2021, 68, 17–46. [Google Scholar] [CrossRef]
- Papada, E.; Amerikanou, C.; Forbes, A.; Kaliora, A.C. Adherence to Mediterranean Diet in Crohn’s Disease. Eur. J. Nutr. 2020, 59, 1115–1121. [Google Scholar] [CrossRef]
- Ritchie, J.K.; Wadsworth, J.; E Lennard-Jones, J.; Rogers, E. Controlled multicentre therapeutic trial of an unrefined carbohydrate, fibre rich diet in Crohn’s disease. BMJ 1987, 295, 517–520. [Google Scholar] [CrossRef] [Green Version]
- Jowett, S.L.; Seal, C.J.; Phillips, E.; Gregory, W.; Barton, J.R.; Welfare, M.R. Dietary beliefs of people with ulcerative colitis and their effect on relapse and nutrient in-take. Clin. Nutr. 2004, 23, 161–170. [Google Scholar] [CrossRef]
- Wong, C.; Harris, P.J.; Ferguson, L.R. Potential Benefits of Dietary Fibre Intervention in Inflammatory Bowel Disease. Int. J. Mol. Sci. 2016, 17, 919. [Google Scholar] [CrossRef] [Green Version]
- Gibson, P.R. Use of the low-FODMAP diet in inflammatory bowel disease. J. Gastroenterol. Hepatol. 2017, 32, 40–42. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Crooks, B.; McLaughlin, J.; Limdi, J. Dietary beliefs and recommendations in inflammatory bowel disease: A national survey of healthcare professionals in the UK. Front. Gastroenterol. 2020. [Google Scholar] [CrossRef]
- Principi, M.; Losurdo, G.; Iannone, A.; Contaldo, A.; Deflorio, V.; Ranaldo, N.; Pisani, A.; Ierardi, E.; Di Leo, A.; Barone, M. Differences in dietary habits between patients with inflammatory bowel disease in clinical remission and a healthy population. Ann. Gastroenterol. 2018, 31, 469–474. [Google Scholar] [CrossRef] [PubMed]
- Cioffi, I.; Imperatore, N.; Di Vincenzo, O.; Pagano, M.C.; Santarpia, L.; Pellegrini, L.; Testa, A.; Marra, M.; Contaldo, F.; Castiglione, F.; et al. Evaluation of nutritional adequacy in adult patients with Crohn’s disease: A cross-sectional study. Eur. J. Nutr. 2020, 59, 3647–3658. [Google Scholar] [CrossRef] [Green Version]
- Lim, H.-S.; Kim, S.-K.; Hong, S.-J. Food Elimination Diet and Nutritional Deficiency in Patients with Inflammatory Bowel Disease. Clin. Nutr. Res. 2018, 7, 48–55. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Opstelten, J.L.; De Vries, J.H.; Wools, A.; Siersema, P.D.; Oldenburg, B.; Witteman, B.J. Dietary intake of patients with inflammatory bowel disease: A comparison with individuals from a general population and associations with relapse. Clin. Nutr. 2019, 38, 1892–1898. [Google Scholar] [CrossRef]
- Halpin, S.J.; Ford, A.C. Prevalence of Symptoms Meeting Criteria for Irritable Bowel Syndrome in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Am. J. Gastroenterol. 2012, 107, 1474–1482. [Google Scholar] [CrossRef]
- Limdi, J.K. Dietary practices and inflammatory bowel disease. Indian J. Gastroenterol. 2018, 37, 284–292. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Age (mean ± SD) | 48.6 ± 16 |
Gender | |
Male | 96 (57.5%) |
Female | 71 (42.5%) |
Marital status | |
Single | 57 (34.1%) |
Married | 110 (65.9%) |
BMI (mean ± SD) | 24.4 ± 3.9 |
Diagnosis | |
UC | 81 (48.5) |
CD | 86 (51.5%) |
Smoking habit | |
No | 70 (41.9%) |
Yes | 34 (20.4%) |
Ex-smokers | 63 (37.7%) |
Disease duration | |
<5 years | 56 (33.5%) |
5–10 years | 44 (26.3%) |
11–20 years | 34 (20.4%) |
>20 years | 33 (19.8%) |
Disease activity ( patients’ perception) | |
remission | 66 (39.5%) |
mild | 45 (26.9%) |
moderate | 50 (29.9%) |
severe | 6 (3.6%) |
Disease Activity UC (Partial Mayo Score) | |
remission | 50 (61.7%) |
mild | 27 (33.3%) |
□ moderate | 3 (3.7%) |
□ severe | 1 (1.2%) |
Disease activity CD (HBI) | |
□ remission | 63 (73.3%) |
□ mild | 12 (14%) |
□ moderate | 10 (11.6%) |
□ severe | 1 (1.2%) |
Therapy | |
Mesalamine | 140 (83.8%) |
Immunomodulators | 24 (14.4%) |
Steroids | 34 (20.4%) |
Biologics | 84 (50.3%) |
Infliximab | 44 (52.4%) |
Ustekinumab | 2 (2.4%) |
Vedolizumab | 38 (45.2%) |
Variable | Conventional Therapy N = 83 | Biologic Therapy N = 84 | p |
---|---|---|---|
Age (mean ± SD.) | 51.5 ± 15.6 | 45.7±16.0 | 0.02 |
Sex | |||
Male | 45 (54.2%) | 51 (60.7%) | 0.4 |
Female | 38 (45.8%) | 33 (39.3%) | |
Marital status | |||
Single | 25 (30.1%) | 24 (28.6%) | 0.9 |
Married/widower/divorced | 58 (69.9%) | 60 (71.4%) | |
Smoker | |||
No | 34 (41.0%) | 36 (42.9%) | 0.9 |
Yes (including ex smokers) | 49 (59.0%) | 48 (57.1%) | |
BMI (mean ± SD) | 23.5 ± 3.9 | 25.4±3.7 | 0.002 |
Diagnosis | |||
UC | 43 (51.8%) | 38 (45.2%) | 0.4 |
CD | 40 (48.2%) | 46 (54.8%) | |
Diet as cause of disease | |||
No | 45 (54.2%) | 54 (64.3%) | 0.2 |
Yes | 38 (45.8%) | 30 (35.7%) | |
Dietary changes after diagnosis | |||
No | 15 (18.1%) | 15 (17.9%) | 0.9 |
Yes | 68 (81.9%) | 69 (82.1%) | |
Symptoms changes after diet changes | |||
No | 16 (23.5%) | 32 (46.4%) | 0.005 |
Yes | 52 (76.5%) | 37 (53.6%) | |
Specific diet | |||
No | 59 (71.1%) | 62 (73.8%) | 0.7 |
Yes | 24 (28.9%) | 22 (26.2%) |
Diet Perceived as Cause of the Disease | No (N = 99) | Yes (N = 68) | p |
---|---|---|---|
Age (mean ± SD) | 48.1 ± 14.5 | 49.3 ± 18.0 | 0.6 |
Gender | |||
Male | 56 (56.6%) | 40 (58.8%) | 0.8 |
Female | 43 (43.4%) | 33 (41.2%) | |
Marital status | |||
Single | 25 (25.3%) | 24 (28.6%) | 0.1 |
Married/widower/divorced | 74 (74.7%) | 44 (71.4%) | |
Smoker | |||
No | 42 (42.4%) | 28 (41.2%) | 0.9 |
Yes (ex smokers included) | 57 (57.6%) | 48 (58.8%) | |
BMI (mean ± SD) | 24.8 ± 3.9 | 23.9±3.9 | 0.2 |
Diagnosis | |||
UC | 53 (53.5%) | 28 (41.2%) | 0.1 |
CD | 46 (46.5%) | 40 (58.8%) | |
Dietary changes after diagnosis | |||
No | 26 (26.3%) | 4 (5.93%) | 0.001 |
Yes | 73 (73.7%) | 64 (94.1%) | |
Changes in symptoms after dietary changes | |||
No | |||
Yes | 35 (47.9%) | 13 (20.3%) | 0.001 |
Follow a specific diet* | 38 (52.1%) | 51 (79.7%) | |
No | |||
Yes | 71 (71.7%) | 0 (73.5%) | 0.8 |
Therapy | 28 (28.3%) | 18 (26.5%) | |
Biologics | |||
Conventional therapy | 54 (54.5%) | 30 (44.1%) | 0.2 |
45 (45.5%) | 38 (55.9%) |
Diet Changed after Diagnosis | No (N = 30) | Yes (N = 137) | p |
---|---|---|---|
Age (mean ± SD) | 48.0 ± 16.1 | 48.7 ± 16.0 | 0.8 |
Gender | |||
Male | 21 (70.0%) | 75 (54.7%) | 0.1 |
Female | 9 (30.0%) | 62 (45.3%) | |
Marital status | |||
Single | 9 (30.0%) | 40 (29.2%) | 0.9 |
Married/widower/divorced | 21 (70.0%) | 97 (71.8%) | |
Smoker | |||
No | 14 (46.7%) | 56 (40.9%) | 0.6 |
Yes (ex smokers included) | 16 (53.3%) | 81 (59.9%) | |
BMI (mean ± SD) | 24.1 ± 3.2 | 24.5 ± 4.1 | 0.6 |
Diagnosis | |||
UC | 17 (56.7%) | 64 (46.7%) | 0.3 |
CD | 13 (43.3%) | 73 (53.3%) | |
Diet perceived as cause of the disease | |||
No | 26 (86.7%) | 73 (53.3%) | 0.001 |
Yes | 4 (13.3%) | 64 (46.7%) | |
Changes in symptoms after dietary changes | |||
No | 48 (35.0%) | ||
Yes | 89 (65.0%) | ||
Follow a specific diet | |||
No | 28 (93.3%) | 93 (67.9%) | 0.005 |
Yes | 2 (6.7%) | 44 (32.1%) | |
Therapy | |||
Biologics | 15 (50.0%) | 69 (50.4%) | 0.7 |
Conventional therapy | 15 (50.0%) | 68 (49.6%) |
Specific Diet | No (N = 121) | Yes (N = 46) | p |
---|---|---|---|
Age (mean ± SD) | 48.2 ± 16.5 | 49.7 ± 14.8 | 0.5 |
Gender | |||
Male | 77 (63.6%) | 19 (41.3%) | 0.009 |
Female | 44 (36.4%) | 27 (58.7%) | |
Marital status | |||
Single | 39 (32.2%) | 10 (21.7%) | 0.2 |
Married/widower/divorced | 82 (67.8%) | 36 (78.3%) | |
Smoker | |||
No | 56 (46.3%) | 14 (30.4%) | 0.1 |
Yes (ex smokers included) | 65 (53.8%) | −69.60% | |
BMI (mean± SD) | 24.5 ± 4.0 | 24.2 ± 3.9 | 0.7 |
Diagnosis | |||
UC | 60 (49.6%) | 21 (45.7%) | 0.6 |
CD | 61 (50.4%) | 25 (54.3%) | |
Diet perceived as cause of the disease | |||
No | 71 (58.7%) | 28 (60.9%) | 0.8 |
Yes | 50 (41.3%) | 18 (39.1%) | |
Dietary changes after the diagnosis | |||
No | 28 (23.1%) | 2 (4.3%) | 0.005 |
Yes | 93 (76.9%) | 44 (95.7%) | |
Changes in symptoms after dietary changes | |||
No | 35 (37.6%) | 13 (29.5%) | 0.3 |
Yes | 58 (62.4%) | 31 (70.5%) | |
Therapy | |||
Biologics | 62 (51.2%) | 22 (47.8%) | 0.7 |
Conventional therapy | 59 (48.8%) | 24 (52.2%) |
Frequently Avoided Foods | N = 167 |
---|---|
Spicy foods | 82 (49.1%) |
Seasoned foods | 64 (38.3%) |
Fried foods | 48 (28.7%) |
Carbonated drinks | 50 (29.9%) |
Milk and dairy products | 57 (34.1%) |
Energy drinks | 12 (7.2%) |
Alcoholic drinks | 31 (18.6%) |
Pork meat | 11 (6.6%) |
Processed meat | 11 (6.6%) |
Vegetables | 47 (28.1%) |
Fruit | 27 (16.2%) |
Legumes | 32 (19.2%) |
Whole grain bread | 22 (13.2%) |
Bread | 8 (4.8%) |
Eggs | 4 (2.4%) |
Rice | 3 (1.8%) |
Chicken | 1 (0.6%) |
Pasta | 2 (1.2%) |
Fish | 1 (0.6%) |
Coffee | 21 (12.6%) |
Refined sugars (sweets) | 15 (9%) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Guida, L.; Di Giorgio, F.M.; Busacca, A.; Carrozza, L.; Ciminnisi, S.; Almasio, P.L.; Di Marco, V.; Cappello, M. Perception of the Role of Food and Dietary Modifications in Patients with Inflammatory Bowel Disease: Impact on Lifestyle. Nutrients 2021, 13, 759. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030759
Guida L, Di Giorgio FM, Busacca A, Carrozza L, Ciminnisi S, Almasio PL, Di Marco V, Cappello M. Perception of the Role of Food and Dietary Modifications in Patients with Inflammatory Bowel Disease: Impact on Lifestyle. Nutrients. 2021; 13(3):759. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030759
Chicago/Turabian StyleGuida, Laura, Francesca Maria Di Giorgio, Anita Busacca, Lucio Carrozza, Stefania Ciminnisi, Piero Luigi Almasio, Vito Di Marco, and Maria Cappello. 2021. "Perception of the Role of Food and Dietary Modifications in Patients with Inflammatory Bowel Disease: Impact on Lifestyle" Nutrients 13, no. 3: 759. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030759