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Guo M, Ruan G, Ding X, Yu Y, Tian L, Shen J, Bai X, Jiang L, Zheng W, Shu H, Zhang X, Yang H. The influence of sleep factors and dietary habits on the disease pattern of ulcerative colitis patients with long and short disease courses - a multicentre cross-sectional analysis. Ann Med 2024; 56:2313685. [PMID: 38346400 PMCID: PMC10863541 DOI: 10.1080/07853890.2024.2313685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Ulcerative colitis (UC) is a disease characterized by chronic relapsing-remitting inflammatory disorders and is associated with environmental changes. AIM To explore the disease patterns of Chinese UC patients and to determine controllable related environmental factors. METHODS This multicentre cross-sectional study was performed using a questionnaire survey. Data on clinical characteristics and environmental factors were collected. Patients with a disease course ≥5 years were defined as the long course group, and those with a disease course < 5 years were defined as the short course group. RESULTS A total of 588 effective questionnaires were collected. The proportion of the chronic continuous pattern was the highest among patients with a long disease course (46.8%), and in patients with a short disease course, the proportion of the active to remission pattern was the highest (53.3%). In patients with a long disease course, a higher proportion of patients with adequate sleep was found in the active to remission pattern than in the chronic intermittent (72.1% vs. 43.3%, p = 0.008) and chronic continuous (72.1% vs. 52.4%, p = 0.016) patterns. In patients with a short disease course, the frequency of shellfish and shrimp was higher in the chronic continuous pattern group than in the active to remission pattern group (P = 0.001 and 0.017 respectively). CONCLUSIONS For early diagnosis patients, dietary guidance should be actively carried out. With the prolongation of the disease course, attention should be given to the sleep quality of patients.
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Affiliation(s)
- Mingyue Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gechong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueli Ding
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yanbo Yu
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, P.R, China
| | - Linglin Tian
- Department of Gastroenterology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jun Shen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiaoyin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingjuan Jiang
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Weiyang Zheng
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijun Shu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolan Zhang
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Sadeghi O, Khademi Z, Saneei P, Hassanzadeh-Keshteli A, Daghaghzadeh H, Tavakkoli H, Adibi P, Esmaillzadeh A. Dietary Magnesium Intake Is Inversely Associated With Ulcerative Colitis: A Case-Control Study. CROHN'S & COLITIS 360 2024; 6:otae009. [PMID: 38464345 PMCID: PMC10923208 DOI: 10.1093/crocol/otae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Indexed: 03/12/2024] Open
Abstract
Background Ulcerative colitis (UC) causes long-lasting inflammation and ulcers in the gut. Limited observational data are available linking dietary magnesium intake and UC. In the present study, we aimed to investigate the association between dietary magnesium intake and UC in adults. Methods The current population-based case-control study was performed on 109 UC patients and 218 age (±2 years) and sex-matched controls. The diagnosis of UC was made according to the standard criteria by a gastroenterology specialist. Dietary intakes were assessed using a validated self-administrated 106-item dish-based Food Frequency Questionnaire (FFQ). We also used a pretested questionnaire to collect data on potential confounders. Results Individuals in the top tertile of magnesium intake were less likely to have UC compared with those in the bottom tertile. A significant inverse relationship was found between dietary magnesium intake and UC (odds ratio [OR]: 0.32, 95% confidence interval [CI]: 0.18-0.59) in the crude model. This relationship was also observed when we took several potential confounding into account (OR: 0.30, 95% CI: 0.14-0.68). Conclusions Adherence to a magnesium-rich diet may have a role in preventing UC. However, further studies are needed to confirm our findings.
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Affiliation(s)
- Omid Sadeghi
- Nutrition and Food Security Research Center, Department of Community Nutrition, Student Research Committee, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Khademi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvane Saneei
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ammar Hassanzadeh-Keshteli
- Department of Medicine, University of Alberta, Edmonton, Canada
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Tavakkoli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular–Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mocic Pavic A, Sila S, Misak Z, Kolaček S, Hojsak I. The Frequency and Impact of Self-Imposed Elimination Diets on the Nutritional Status and Clinical Course of Disease in Children with Inflammatory Bowel Disease. Nutrients 2023; 15:4712. [PMID: 38004106 PMCID: PMC10675566 DOI: 10.3390/nu15224712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND AIMS From the patients' perspective, diet has a relevant role in triggering symptoms of inflammatory bowel disease (IBD). There is a lack of prospective studies regarding the diet of children with IBD. The aim of this study was to assess the frequency and impact of self-imposed elimination diets on the nutritional status and clinical course of disease in the pediatric population. METHODS This was a prospective case-control study that included newly diagnosed patients with IBD and healthy controls (age/sex-matched peers and siblings) over a one-year period. The participants were examined in three categories: (1) anthropometric data and nutritional status; (2) dietary intake, as obtained by a Food Frequency Questionnaire (FFQ); and (3) dietary beliefs and elimination diets, as obtained by a structured questionnaire. RESULTS Overall, one-hundred and thirty-seven participants were included (twenty-eight with Crohn's disease, sixteen with ulcerative colitis, three with IBD-unclassified, and seventy healthy controls). Only 15% of patients followed the self-imposed elimination diet upon the diagnosis, which increased to 47.6% by the end of the follow-up. The elimination diet did not influence the nutritional status and quality of the diet. Self-imposed elimination diets were not a risk factor for disease relapse. Most of the patients received nutritional counseling during the follow-up. CONCLUSIONS The number of patients following self-imposed elimination diets had increased during the disease course but with no influence on nutritional status or relapse risk.
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Affiliation(s)
- Ana Mocic Pavic
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (S.S.); (Z.M.); (S.K.); (I.H.)
| | - Sara Sila
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (S.S.); (Z.M.); (S.K.); (I.H.)
| | - Zrinjka Misak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (S.S.); (Z.M.); (S.K.); (I.H.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Kolaček
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (S.S.); (Z.M.); (S.K.); (I.H.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Iva Hojsak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, 10000 Zagreb, Croatia; (S.S.); (Z.M.); (S.K.); (I.H.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Pediatrics, University J.J. Strossmayer School of Medicine, 31000 Osijek, Croatia
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Fu J, Chai C, Chen L, Cai M, Ai B, Li H, Yuan J, Lin H, Zhang Z. Associations of Fish and Fish Oil Consumption With Incident Inflammatory Bowel Disease: A Population-Based Prospective Cohort Study. Inflamm Bowel Dis 2023:izad262. [PMID: 37889850 DOI: 10.1093/ibd/izad262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Indexed: 10/29/2023]
Abstract
BACKGROUND We examined the associations of fish and fish oil consumption with inflammatory bowel disease (IBD) incidence. PATIENTS AND METHODS We conducted a longitudinal analysis based on the UK Biobank, a population-based prospective cohort. Dietary consumption of fish and fish oil was collected by questionnaire. IBD incident cases were identified through links to National Health Services datasets. Cox proportional hazards regression models were used to assess the associations between oily fish, nonoily fish, and fish oil intake and IBD incidence with adjustment for various confounding factors. RESULTS A total of 265 839 participants free of IBD at baseline were included, and 1554 incident IBD cases were identified during an average follow-up of 11.8 years. In fully adjusted models, we found that compared with participants who never ate oily fish, those having <1 serving/wk, 1 serving/wk, and >1 serving/wk had 9% (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.77-1.08), 19% (HR, 0.81; 95% CI, 0.69-0.96), and 12% (HR, 0.88; 95% CI, 0.73-1.06) lower risks of IBD, respectively, albeit not all statistically significant. A significant association was found between fish oil intake and a reduced risk of IBD (HR, 0.84; 95% CI, 0.75-0.93). We found no significant associations for nonoily fish. In a subsample (n = 105 714) of participants with multiple subsequent dietary reviews, we also found a negative association between the frequency of fish oil intake over time and incident IBD (P trend < .05). CONCLUSIONS Our findings indicate that oily fish and fish oil supplements might be protective factors against IBD.
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Affiliation(s)
- Jiaying Fu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengwei Chai
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Baozhuo Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Shenzhen University General Hospital, Shenzhen, China
| | - Jinqiu Yuan
- Clinical Research Center, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Serrano Fernandez V, Seldas Palomino M, Laredo-Aguilera JA, Pozuelo-Carrascosa DP, Carmona-Torres JM. High-Fiber Diet and Crohn's Disease: Systematic Review and Meta-Analysis. Nutrients 2023; 15:3114. [PMID: 37513532 PMCID: PMC10384554 DOI: 10.3390/nu15143114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Crohn's disease (CD) is a subtype of inflammatory bowel disease (IBD). CD is a health problem in Western countries such as the US and European nations and is an idiopathic disease; however, certain cases of CD have been associated with intestinal dysbiosis. A systematic review with a meta-analysis was carried out to determine the efficacy of a diet rich in fiber with or without cointervention to improve remission rates for CD. The literature in the PubMed, Scopus, Web of Science, and ClinicalTrials databases was reviewed. The quality of the studies was evaluated using the Johanna Briggs Institute (JBI) scale. This review was conducted in accordance with the structure outlined in the PRISMA statement. In addition, a meta-analysis was performed with a 95% confidence interval (CI) and a random effects model. Eleven studies were included, totaling 2389 patients with CD. Applying a diet rich in fiber with or without the administration of routine therapies improved CD remission rates. Data regarding CD activity, remission time, and adverse effects derived from fiber consumption were analyzed. Consumption of fiber in the diet could improve remission rates for CD patients who receive or do not receive other treatment to maintain remission.
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Affiliation(s)
- Victor Serrano Fernandez
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- Hospital Universitario de Toledo, 45007 Toledo, Spain
| | | | - José Alberto Laredo-Aguilera
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
| | - Diana Patricia Pozuelo-Carrascosa
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Juan Manuel Carmona-Torres
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
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Analysis of the Nutritional Value of Diets and Food Choices in Polish Female Ulcerative Colitis Individuals Compared with a Pair-Matched Control Sample. Nutrients 2023; 15:nu15040857. [PMID: 36839214 PMCID: PMC9964133 DOI: 10.3390/nu15040857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Ulcerative colitis patients often attribute their symptoms to specific dietary products. Therefore, even though there are no specific dietary recommendations, these patients commonly have dietary restrictions, often with no consultation from their physician or dietitian, as they believe that they may be beneficial for them. The aim of the study was to analyze the nutritional value of diets and food choices in Polish female ulcerative colitis individuals, in comparison with a pair-matched control sample. The study was conducted on a group of 44 Polish female ulcerative colitis individuals being in remission and 44 individuals within a pair-matched control sample, matched by their age and concurrent diseases, excluding those resulting from ulcerative colitis. The analysis of the diet was based on the self-reported data, including 3-day dietary records (to assess the intake of nutrients and food products), as well as the simple open-ended question about food products excluded from their diet. It was stated that Polish female ulcerative colitis individuals were characterized by a lower energy value of diet (p = 0.0043), accompanied by the higher proportion of total protein (p = 0.0128) than the pair-matched control sample. As a result of a lower energy value for ulcerative colitis individuals, the intake of numerous nutrients was also lower (p < 0.05); however, after recalculation per 1000 kcal, ulcerative colitis individuals were characterized by higher total protein (p = 0.0121), starch (p = 0.0009), and vitamin B6 intake (p = 0.0319), as well as lower alcohol intake (p = 0.0464). Similarly, as a result of a lower energy value for ulcerative colitis individuals, the intake of numerous foods was also lower (p < 0.05); however, after recalculation per 1000 kcal, ulcerative colitis individuals were characterized by higher meat (p = 0.0058) and potatoes intake (p = 0.0052), as well as lower legumes (p = 0.0301), chocolate sweets (p = 0.0165), and alcoholic beverages intake (p = 0.0062). For chocolate sweets (p = 0.0134) and alcoholic beverages (p = 0.0091), ulcerative colitis individuals were characterized by a higher frequency of declaration of dietary exclusion. At the same time, ulcerative colitis individuals were characterized by a lower frequency of meeting the recommended intake for magnesium (p = 0.0005), iron (p = 0.0189), vitamin E (p = 0.0389), and vitamin B1 (p = 0.0032). It was concluded that even in remission, there is a risk of inadequate consumption, not meeting the recommended intake, and nutritional deficiencies in the population of female ulcerative colitis patients.
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Kaliora AC. Nutrition in inflammatory bowel diseases; Is there a role? Best Pract Res Clin Gastroenterol 2023; 62-63:101827. [PMID: 37094912 DOI: 10.1016/j.bpg.2023.101827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 04/26/2023]
Abstract
Nutrition is of paramount importance not only for healthy individuals, but all the more for the ones with pathologies interlinked with the diet. In that light, diet, when used accordingly can act in a protective manner in inflammatory bowel diseases. The interplay of diet and IBD is not thoroughly defined, and guidelines are a work in progress. However, significant knowledge has been gained with regard to foods and nutrients that may exacerbate or alleviate the core symptoms. Patients with IBD restrict from their diet a plethora of foods often arbitrary, thus depriving themselves from valuable constituents. Careful navigation into the newfound field of genetic variants and personalization of diet should be employed with avoidance of the Westernized diet, processed foods and additives, and focus on a holistic approach with a balanced diet rich in bioactive compounds in order to improve the quality of life of these patients and address diet-related deficiencies.
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Affiliation(s)
- Andriana C Kaliora
- Human Nutrition and Foods, Department of Dietetics-Nutrition Science, School of Health and Education Sciences, Harokopio University, 70 El. Venizelou Ave., 17676, Athens, Greece.
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Inflammatory Bowel Disease and Customized Nutritional Intervention Focusing on Gut Microbiome Balance. Nutrients 2022; 14:nu14194117. [PMID: 36235770 PMCID: PMC9572914 DOI: 10.3390/nu14194117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Inflammatory bowel disease (IBD) represents a chronic relapsing–remitting condition affecting the gastrointestinal system. The specific triggering IBD elements remain unknown: genetic variability, environmental factors, and alterations in the host immune system seem to be involved. An unbalanced diet and subsequent gut dysbiosis are risk factors, too. This review focuses on the description of the impact of pro- and anti-inflammatory food components on IBD, the role of different selected regimes (such as Crohn’s Disease Exclusion Diet, Immunoglobulin Exclusion Diet, Specific Carbohydrate Diet, LOFFLEX Diet, Low FODMAPs Diet, Mediterranean Diet) in the IBD management, and their effects on the gut microbiota (GM) composition and balance. The purpose is to investigate the potential positive action on IBD inflammation, which is associated with the exclusion or addition of certain foods or nutrients, to more consciously customize the nutritional intervention, taking also into account GM fluctuations during both disease flare-up and remission.
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Diets for inflammatory bowel disease: What do we know so far? Eur J Clin Nutr 2022; 76:1222-1233. [PMID: 35064219 DOI: 10.1038/s41430-021-01051-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 02/06/2023]
Abstract
In recent years, the role of diet in the pathogenesis of inflammatory bowel disease (IBD) has gained great interest within the scientific community. Eating habits from industrialised countries (the so-called western diet or WD) have been associated with a higher incidence of IBD in observational studies, although the dietary factors responsible for the development of the disease are still to be elucidated. Some components of the diet with proinflammatory potential may cause changes in immunity and intestinal microbiota, leading to the inflammatory reaction that causes IBD-related lesions. The quality of available evidence is low, due to methodological issues, such as the lack of intervention studies, small sample size and heterogeneity of studies. For this reason, scientific societies have offered their recommendations using clinical practice guidelines and consensus documents, in order to establish a common criterion in the nutritional treatment of patients with IBD. The objective of this review was to summarise the data published regarding diet in IBD and review the recommendations given by scientific societies.
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Jaber M, Altamimi M, Altamimi A, Cavaliere S, De Filippis F. Mediterranean diet diminishes the effects of Crohn's disease and improves its parameters: A systematic review. Nutr Health 2022:2601060221102281. [PMID: 35611526 DOI: 10.1177/02601060221102281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The pathogenesis and clinical course of Crohn's disease (CD) is influenced by diet. Mediterranean Diet (MD) helps Crohn's patients through many mechanisms. AIMS This study aimed to evaluate the effect of the MD on CD patients and to evaluate such effect on body parameters. METHODS PubMed, Science Direct, Web of Science, MEDLINE and Cochrane central library were searched for MD and CD from 2010 to 2020. Included studies met the following criteria: (1) male and female adults (18-75 years) with a confirmed diagnosis of CD; (2) MD as an intervention; (3) original interventional Trial, Cross-Sectional Analysis, or Prospective Cohort Studies. RESULTS Five studies were included, involving 83,564 participants. A small number of patients with CD fulfilled the P-MDS criteria, the overall scores were low, 4.7 and 4.5 for females and males respectively. Patients with an inactive disease whose adherence to MD was greater, the MD score was negatively correlated with disease activity (p <0.001) and positively with IBDQ (p = 0.008). Twenty-seven percent had a prevalence of impaired adherence to a MD (mMED score = 0-2), giving such a population a risk attributed to 12% for the later CD. Seventy-point reduction in CDAI + decreased fecal CRP / calprotectin, calprotectin <250 mcg/gm or >50% decrease from baseline and hsCRP < 5 mg/L or >50% from baseline. CONCLUSIONS MD showed anti-inflammatory properties. Adherence to MD was associated with improvement in CD patients and negatively correlated with the disease activity, in addition to a lower risk of developing CD later in life.
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Affiliation(s)
- Mawada Jaber
- Department of Nutrition and food technology, An-Najah National University, Nablus, Palestine
| | - Mohammad Altamimi
- Department of Nutrition and food technology, An-Najah National University, Nablus, Palestine
| | - Almothana Altamimi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sara Cavaliere
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
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Chen H, Fu T, Dan L, Chen X, Sun Y, Chen J, Wang X, Hesketh T. Meat consumption and all-cause mortality in 5763 patients with inflammatory bowel disease: A retrospective cohort study. EClinicalMedicine 2022; 47:101406. [PMID: 35497068 PMCID: PMC9046121 DOI: 10.1016/j.eclinm.2022.101406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Whether meat consumption is related to risk of mortality in patients with inflammatory bowel disease (IBD) remains poorly understood. METHODS In the UK Biobank, 5763 patients with IBD were recruited from 2007 to 2010 and finished a brief food frequency questionnaire at baseline. We followed them until March 13, 2021 to document all-cause death events. Cox proportional hazard models were used to estimate hazard ratios (HRs) for all-cause mortality associated with consumptions of fish, unprocessed poultry, unprocessed red meat, and processed meat among the patients. FINDINGS During 67,095 person-years (mean follow-up 11·7 years, mean age 57·3, 52·5% female), we documented 590 death events. Higher consumption of processed meat was associated with an increased risk of all-cause mortality in patients with IBD (HR comparing >4·0 with 0-0·9 time/week=1·52, 95% confidence interval (CI) 1·05-2·19), but the P-trend for each 25 g increment was 0·075. This association remained significant in patients with Crohn's disease (HR 1·77, 95% CI 1·01-3·10) but not in patients with ulcerative colitis (HR 1·34, 95% CI 0·82-2·20). Consumptions of fish (HR 1·27, 95% CI 0·84-1·91), unprocessed poultry (HR 0·59, 95% CI 0·28-1·21), or unprocessed red meat (HR 0·87, 95% CI 0·60-1·26) were not significantly associated with the mortality of patients with IBD. INTERPRETATION More frequent consumption of processed meat was associated with an increased risk of mortality in patients with IBD, while no associations were observed for consumption of other types of meat. Our exploratory and speculative findings should be cautiously interpreted and need further replication in other cohorts. FUNDING The National Natural Science Foundation of China (81,970,494); Key Project of Research and Development Plan of Hunan Province (2019SK2041).
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Affiliation(s)
- Hui Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Tian Fu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Lintao Dan
- Centre for Global Health, Zhejiang University, Hangzhou, China
| | - Xuejie Chen
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuhao Sun
- Centre for Global Health, Zhejiang University, Hangzhou, China
| | - Jie Chen
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China
- Centre for Global Health, Zhejiang University, Hangzhou, China
- Corresponding authors at: XW: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China. JC: Centre for Global Health, Zhejiang University, Hangzhou, China.
| | - Xiaoyan Wang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China
- Corresponding authors at: XW: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China. JC: Centre for Global Health, Zhejiang University, Hangzhou, China.
| | - Therese Hesketh
- Centre for Global Health, Zhejiang University, Hangzhou, China
- Institute for Global Health, University College London, London, United Kingdom
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12
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Vagianos K, Shafer LA, Witges K, Graff LA, Targownik LE, Bernstein CN. Self-reported flares among people living with IBD are associated with stress and worry but not associated with recent diet changes: The Manitoba Living with IBD Study. JPEN J Parenter Enteral Nutr 2022; 46:1686-1698. [PMID: 35147990 DOI: 10.1002/jpen.2349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/07/2022] [Accepted: 02/07/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND In this matched case-control longitudinal study among people living with inflammatory bowel disease (IBD), we investigated beliefs about what triggers a flare. METHODS Adults with confirmed IBD and active disease within 2 years were enrolled in the Manitoba Living with IBD Study and followed biweekly with online surveys for 1 year. The 7-point IBD Symptom Change Indicator was used for participant identification of a flare. Flare cases were matched to non-flare controls by sex and disease type. Members of each matched pair completed supplemental information on diet changes and psychological functioning in the previous two weeks, and provided stool samples to assess fecal calprotectin (FCAL). RESULTS Of 128 enrolled participants, 95 matched flare/non-flare pairs were created. Those reporting a flare were more likely to have elevated FCAL (51% vs 34% among non-flares, p=0.043). Although 61% of study participants believed at baseline that a food may trigger flares, and 25% of those in a flare believed that a food may have triggered their current flare, there was no difference in consumption of assessed foods between flares and non-flares in the previous two weeks. Flares were more likely to be having difficulties in emotional state than controls (40% vs 18%, p=0.001) and more likely to be stressed or worried (64% vs 33%, p=0.001). CONCLUSION While a majority of individuals with IBD believe that specific foods trigger their disease flares, this was not supported by the current findings. Recent psychological functioning was associated with self-reported IBD flare. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kathy Vagianos
- University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Nutrition and Food Services, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Leigh Anne Shafer
- University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kelcie Witges
- University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley A Graff
- University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Laura E Targownik
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Charles N Bernstein
- University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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13
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Dolovich C, Shafer LA, Vagianos K, Witges K, Targownik LE, Bernstein CN. The complex relationship between diet, symptoms, and intestinal inflammation in persons with inflammatory bowel disease: The Manitoba Living With IBD Study. JPEN J Parenter Enteral Nutr 2021; 46:867-877. [PMID: 34435688 DOI: 10.1002/jpen.2257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND We aimed to examine whether an association exists between diet quality, based on the Prospective Urban Rural Epidemiology (PURE) Healthy Diet Score (HDS), and active inflammatory bowel disease (IBD). METHODS Participants were drawn from the Manitoba Living With IBD Study cohort. The Harvard Food Frequency Questionnaire (FFQ) was used to calculate the HDS at two time points: baseline and 1-year follow-up. Using generalized estimating equations (GEE) logistic regression, we assessed the association between the HDS and (1) the IBD Symptom Inventory (IBDSI); (2) intestinal inflammation, measured by fecal calprotectin (FCAL); and (3) self-reported IBD flares. RESULTS There were 294 completed FFQs among 153 people. Of these, 100% had completed data about an IBD flare, 98% had FCAL measurements, and 96% had completed IBDSI scores. On a HDS scoring method of 0-8, the odds of FCAL >250 mcg/g were lower for participants with a HDS of 4 vs 0-3 (adjusted odds ratio [OR], 0.38; 95% CI, 0.19-0.77). When applying a second HDS scoring method (8-40), the odds of having an IBD flare were 3.6 times greater with a HDS between 21 and 24 compared with an HDS ≤20 (adjusted OR, 3.63; 95% CI, 1.03-12.78). CONCLUSIONS We found that active inflammation was less likely among those with a moderate HDS , whereas symptomatic IBD flares were more likely. People may choose to consume a moderate amount of healthy foods such as fruits and vegetables, even knowing that those foods may cause a symptomatic flare.
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Affiliation(s)
- Casandra Dolovich
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Leigh Anne Shafer
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathy Vagianos
- University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Nutrition and Food Services, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Kelcie Witges
- University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura E Targownik
- Division of Gastroenterology and Hepatology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
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14
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Food and Food Groups in Inflammatory Bowel Disease (IBD): The Design of the Groningen Anti-Inflammatory Diet (GrAID). Nutrients 2021; 13:nu13041067. [PMID: 33806061 PMCID: PMC8064481 DOI: 10.3390/nu13041067] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022] Open
Abstract
Diet plays a pivotal role in the onset and course of inflammatory bowel disease (IBD). Patients are keen to know what to eat to reduce symptoms and flares, but dietary guidelines are lacking. To advice patients, an overview of the current evidence on food (group) level is needed. This narrative review studies the effects of food (groups) on the onset and course of IBD and if not available the effects in healthy subjects or animal and in vitro IBD models. Based on this evidence the Groningen anti-inflammatory diet (GrAID) was designed and compared on food (group) level to other existing IBD diets. Although on several foods conflicting results were found, this review provides patients a good overview. Based on this evidence, the GrAID consists of lean meat, eggs, fish, plain dairy (such as milk, yoghurt, kefir and hard cheeses), fruit, vegetables, legumes, wheat, coffee, tea and honey. Red meat, other dairy products and sugar should be limited. Canned and processed foods, alcohol and sweetened beverages should be avoided. This comprehensive review focuses on anti-inflammatory properties of foods providing IBD patients with the best evidence on which foods they should eat or avoid to reduce flares. This was used to design the GrAID.
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15
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Crooks B, McLaughlin J, Matsuoka K, Kobayashi T, Yamazaki H, Limdi JK. The dietary practices and beliefs of people living with inactive ulcerative colitis. Eur J Gastroenterol Hepatol 2021; 33:372-379. [PMID: 32956176 DOI: 10.1097/meg.0000000000001911] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Diet is implicated in the aetiopathogenesis of inflammatory bowel disease (IBD) and in generating symptoms. Few studies have explored dietary practices in people with IBD, in which participants perceived strong links between diet in triggering flares and maintaining remission. Fewer studies have explored dietary habits in self-reported remission. Our aim was to describe dietary practices and beliefs in those with inactive ulcerative colitis. METHODS A questionnaire was developed and prospectively administered to 208 participants with inactive ulcerative colitis attending IBD clinics. RESULTS Thirty-one percent believed diet was the initiating factor for ulcerative colitis with 37% believing diet could trigger relapse. Fifty-nine percent avoided dietary items to prevent relapse. Most frequently avoided were spicy (43%) and fatty (38%) foods, alcohol (27%), carbonated drinks (26%), coffee (24%) and milk products (21%). Females were more likely to practice dietary avoidance (P = 0.007). Twenty-three percent had used exclusion diets, most commonly gluten- or lactose-free. Those reporting relapse in the previous year were more likely to avoid the same menu as their family (P = 0.01) and females were less likely to eat out in order to prevent relapse (P = 0.004). Information resources guiding food avoidance included participants' own experiences (90%), healthcare professionals' advice (19%) and the internet (11%). CONCLUSION People with inactive ulcerative colitis hold dietary beliefs and display practices with a high level of consistency around perceived triggers. Food avoidance whilst in remission raises the possibility of visceral hypersensitivity or altered physiology alongside psychosocial, neurocognitive or co-existing functional factors.
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Affiliation(s)
- Benjamin Crooks
- Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Stott Lane, Salford
- Section of IBD - Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - John McLaughlin
- Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Stott Lane, Salford
| | - Katsuyoshi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo
| | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jimmy K Limdi
- Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester
- Section of IBD - Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
- Manchester Metropolitan University, Manchester, UK
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16
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Caffeic Acid Modulates Processes Associated with Intestinal Inflammation. Nutrients 2021; 13:nu13020554. [PMID: 33567596 PMCID: PMC7914463 DOI: 10.3390/nu13020554] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022] Open
Abstract
Caffeic acid is one of the most abundant hydroxycinnamic acids in fruits, vegetables, and beverages. This phenolic compound reaches relevant concentrations in the colon (up to 126 µM) where it could come into contact with the intestinal cells and exert its anti-inflammatory effects. The aim of this investigation was to study the capacity of caffeic acid, at plausible concentrations from an in vivo point of view, to modulate mechanisms related to intestinal inflammation. Consequently, we tested the effects of caffeic acid (50–10 µM) on cyclooxygenase (COX)-2 expression and prostaglandin (PG)E2, cytokines, and chemokines (IL-8, monocyte chemoattractant protein-1 -MCP-1-, and IL-6) biosynthesis in IL-1β-treated human myofibroblasts of the colon, CCD-18Co. Furthermore, the capacity of caffeic acid to inhibit the angiotensin-converting enzyme (ACE) activity, to hinder advanced glycation end product (AGE) formation, as well as its antioxidant, reducing, and chelating activity were also investigated. Our results showed that (i) caffeic acid targets COX-2 and its product PGE2 as well as the biosynthesis of IL-8 in the IL-1β-treated cells and (ii) inhibits AGE formation, which could be related to (iii) the high chelating activity exerted. Low anti-ACE, antioxidant, and reducing capacity of caffeic acid was also observed. These effects of caffeic acid expands our knowledge on anti-inflammatory mechanisms against intestinal inflammation.
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17
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Shafiee NH, Manaf ZA, Mokhtar NM, Raja Ali RA. Anti-inflammatory diet and inflammatory bowel disease: what clinicians and patients should know? Intest Res 2021; 19:171-185. [PMID: 33525858 PMCID: PMC8100370 DOI: 10.5217/ir.2020.00035] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 12/03/2020] [Indexed: 12/22/2022] Open
Abstract
Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.
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Affiliation(s)
- Nor Hamizah Shafiee
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Dietetics Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norfilza M Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Raja Affendi Raja Ali
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Gastroenterology Unit, Department of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia
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18
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Crooks B, McLaughlin J, Limdi J. Dietary beliefs and recommendations in inflammatory bowel disease: a national survey of healthcare professionals in the UK. Frontline Gastroenterol 2020; 13:25-31. [PMID: 34966530 PMCID: PMC8666871 DOI: 10.1136/flgastro-2020-101723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The role of diet in inflammatory bowel disease (IBD) remains incompletely understood. Knowledge around the actual dietary advice healthcare professionals provide to individuals with IBD is scarce. Our objective was to describe the dietary beliefs of healthcare professionals and dietary recommendations made to people with IBD. METHODOLOGY An online survey regarding IBD-related dietary beliefs and advice provided to patients was distributed to gastroenterologists, dietitians and IBD nurses in the UK. RESULTS Two-hundred and twenty-three eligible healthcare professionals participated: 107 (48%) believed that diet was involved in IBD development. The most frequently implicated dietary components were processed foods (78%), additives/preservatives (71%), sweet/sugary foods (36%), red meat (36%) and fatty foods (31%). Views were broadly consistent across professions, however, gastroenterologists were significantly more likely to believe red meat and additives/preservatives initiated IBD. One hundred and thirteen participants (53%) believed that diet could trigger disease relapse and 128 (61%) recommended limiting specific foodstuffs to reduce this risk, most commonly high fibre foods. Forty-six (23%) considered recommending a low Fermentable Oligo-, Di- and Monosaccharides and Polyols diet to reduce relapse risk. IBD nurses and healthcare professionals with <5 years experience were most likely to recommend this. Dietitians felt most comfortable providing dietary advice for functional gastrointestinal symptoms in quiescent IBD. CONCLUSION Dietary advice in IBD is inconsistent reflecting uncertainty among healthcare professionals. While some consensus exists regarding dietary components implicated in IBD development and relapse, dietary recommendations varied. Future research is required to disentangle these complex relationships, alongside better training and education.
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Affiliation(s)
- Benjamin Crooks
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK
- Section of IBD - Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust Gastroenterology, Manchester, UK
| | - John McLaughlin
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Jimmy Limdi
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Section of IBD - Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust Gastroenterology, Manchester, UK
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19
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Inflammatory Bowel Disease: Are Symptoms and Diet Linked? Nutrients 2020; 12:nu12102975. [PMID: 33003341 PMCID: PMC7650696 DOI: 10.3390/nu12102975] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022] Open
Abstract
New Zealand (NZ) has one of the world’s highest incidence rates of Inflammatory Bowel Disease (IBD), a group of chronic inflammatory conditions that affect the gastrointestinal tract. Patients with IBD often believe certain foods influence their disease symptoms and consequently may alter their diet considerably. The objective of this study was to determine foods, additives, and cooking methods (dietary elements) that NZ IBD patients identify in the onset, exacerbation, or reduction of their symptoms. A total of 233 participants completed a self-administered questionnaire concerning symptom behaviour in association with 142 dietary elements. Symptom onset and symptom exacerbation were associated with dietary elements by 55% (128) and 70% (164) of all IBD participants, respectively. Fruit and vegetables were most frequently identified, with dairy products, gluten-containing bread, and foods with a high fat content also considered deleterious. Of all IBD participants, 35% (82) associated symptom reduction with dietary elements. The identified foods were typically low in fibre, saturated fatty acids, and easily digestible. No statistically significant differences were seen between the type or number of dietary elements and disease subtype or recent disease activity. The association between diet and symptoms in patients with IBD and the mechanism(s) involved warrant further research and may lead to the development of IBD specific dietary guidelines.
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20
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Rondanelli M, Lamburghini S, Faliva MA, Peroni G, Riva A, Allegrini P, Spadaccini D, Gasparri C, Iannello G, Infantino V, Alalwan TA, Perna S, Miccono A. A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease. ACTA ACUST UNITED AC 2020; 68:17-46. [PMID: 32499202 DOI: 10.1016/j.endinu.2020.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/14/2019] [Accepted: 01/08/2020] [Indexed: 02/07/2023]
Abstract
Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants: the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat.
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Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, Pavia, Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Pavia 27100, Italy
| | - Silvia Lamburghini
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Milena A Faliva
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Gabriella Peroni
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Antonella Riva
- Research and Development Unit, Indena, Milan 20146, Italy
| | | | - Daniele Spadaccini
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Clara Gasparri
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Giancarlo Iannello
- General Management, Azienda di Servizi alla Persona "Istituto Santa Margherita", Pavia 27100, Italy
| | - Vittoria Infantino
- University of Bari Aldo Moro, Department of Biomedical Science and Human Oncology, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy.
| | - Tariq A Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Bahrain
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Bahrain
| | - Alessandra Miccono
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
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21
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Levine A, Rhodes JM, Lindsay JO, Abreu MT, Kamm MA, Gibson PR, Gasche C, Silverberg MS, Mahadevan U, Boneh RS, Wine E, Damas OM, Syme G, Trakman GL, Yao CK, Stockhamer S, Hammami MB, Garces LC, Rogler G, Koutroubakis IE, Ananthakrishnan AN, McKeever L, Lewis JD. Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol 2020; 18:1381-1392. [PMID: 32068150 DOI: 10.1016/j.cgh.2020.01.046] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 12/21/2019] [Accepted: 01/24/2020] [Indexed: 02/07/2023]
Abstract
Recent evidence points to a plausible role of diet and the microbiome in the pathogenesis of both Crohn's disease (CD) and Ulcerative Colitis (UC). Dietary therapies based on exclusion of table foods and replacement with nutritional formulas and/or a combination of nutritional formulas and specific table foods may induce remission in CD. In UC, specific dietary components have also been associated with flare of disease. While evidence of varying quality has identified potential harmful or beneficial dietary components, physicians and patients at the present time do not have guidance as to which foods are safe, may be protective or deleterious for these diseases. The current document has been compiled by the nutrition cluster of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) based on the best current evidence to provide expert opinion regarding specific dietary components, food groups and food additives that may be prudent to increase or decrease in the diet of patients with inflammatory bowel diseases to control and prevent relapse of inflammatory bowel diseases.
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Affiliation(s)
- Arie Levine
- Pediatric IBD Center, Wolfson Medical Center Holon, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan M Rhodes
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - James O Lindsay
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Maria T Abreu
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Michael A Kamm
- St Vincent's Hospital and University of Melbourne, Melbourne, Australia
| | - Peter R Gibson
- Monash University and Alfred Health, Melbourne, Australia
| | | | - Mark S Silverberg
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Uma Mahadevan
- University of California, San Francisco, San Francisco, California
| | - Rotem Sigall Boneh
- Pediatric IBD Center, Wolfson Medical Center Holon, Tel Aviv University, Tel Aviv, Israel
| | - Eyton Wine
- Department of Pediatrics, University of Alberta, Alberta, Canada; Department of Physiology, University of Alberta, Alberta, Canada
| | - Oriana M Damas
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Graeme Syme
- The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Gina L Trakman
- St Vincent's Hospital and University of Melbourne, Melbourne, Australia
| | - Chu Kion Yao
- Monash University and Alfred Health, Melbourne, Australia
| | - Stefanie Stockhamer
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | | | - Luis C Garces
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | | | | | | | - Liam McKeever
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - James D Lewis
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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22
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de Castro MM, Corona LP, Pascoal LB, Miyamoto JÉ, Ignacio-Souza LM, de Lourdes Setsuko Ayrizono M, Torsoni MA, Torsoni AS, Leal RF, Milanski M. Dietary Patterns Associated to Clinical Aspects in Crohn's Disease Patients. Sci Rep 2020; 10:7033. [PMID: 32341416 PMCID: PMC7184619 DOI: 10.1038/s41598-020-64024-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/16/2020] [Indexed: 02/07/2023] Open
Abstract
Diet is an important factor in both the pathogenesis and in the clinical course of Crohn's disease (CD). However, data on dietary patterns of CD patients are rather limited in the literature. This cross-sectional study included 60 patients with CD, aged 18-60 years. Dietary intake was assessed using a validated food frequency questionnaire to measure food consumption patterns by principal component analysis (PCA). Multiple regression analysis was performed to investigate the association between dietary patterns and clinical and demographic variables. Three dietary patterns were identified: "Traditional + FODMAP" was associated with symptoms, gender, previous surgeries, and duration of the disease. "Fitness style" was positively associated with physical activity and negatively associated with body mass index and smoking. "Snacks and processed foods" was positively associated with duration of the disease and negatively associated with age. According to the weekly food consumption analysis, patients with active disease consumed less coffee and tea. We found significant associations between the three dietary patterns and the variables, but not with the stage of the disease. Prospective studies are necessary to determine the effects of food consumption patterns on the clinical course of CD.
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Affiliation(s)
- Marina Moreira de Castro
- School of Applied Sciences, University of Campinas (UNICAMP), Limeira, Brazil
- School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ligiana Pires Corona
- School of Applied Sciences, University of Campinas (UNICAMP), Limeira, Brazil
- School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | | | | | | | | | - Raquel Franco Leal
- School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Marciane Milanski
- School of Applied Sciences, University of Campinas (UNICAMP), Limeira, Brazil.
- School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
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Habitual dietary intake of IBD patients differs from population controls: a case-control study. Eur J Nutr 2020; 60:345-356. [PMID: 32333097 PMCID: PMC7867519 DOI: 10.1007/s00394-020-02250-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since evidence-based dietary guidelines are lacking for IBD patients, they tend to follow "unguided" dietary habits; potentially leading to nutritional deficiencies and detrimental effects on disease course. Therefore, we compared dietary intake of IBD patients with controls. METHODS Dietary intake of macronutrients and 25 food groups of 493 patients (207 UC, 286 CD), and 1291 controls was obtained via a food frequency questionnaire. RESULTS 38.6% of patients in remission had protein intakes below the recommended 0.8 g/kg and 86.7% with active disease below the recommended 1.2 g/kg. Multinomial logistic regression, corrected for age, gender and BMI, showed that (compared to controls) UC patients consumed more meat and spreads, but less alcohol, breads, coffee and dairy; CD patients consumed more non-alcoholic drinks, potatoes, savoury snacks and sugar and sweets but less alcohol, dairy, nuts, pasta and prepared meals. Patients with active disease consumed more meat, soup and sugar and sweets but less alcohol, coffee, dairy, prepared meals and rice; patients in remission consumed more potatoes and spreads but less alcohol, breads, dairy, nuts, pasta and prepared meals. CONCLUSIONS Patients avoiding potentially favourable foods and gourmandizing potentially unfavourable foods are of concern. Special attention is needed for protein intake in the treatment of these patients.
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Han MK, Anderson R, Viennois E, Merlin D. Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015. PLoS One 2020; 15:e0232157. [PMID: 32324818 PMCID: PMC7179926 DOI: 10.1371/journal.pone.0232157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/09/2020] [Indexed: 12/20/2022] Open
Abstract
Various diets and food components have been implicated as one of the environmental factors associated with inflammatory bowel disease (IBD). Patients are often recommended nutritional guidelines to manage disease symptoms. However, the current food consumption pattern of US adults with IBD that are nationally representative is unclear. A secondary analysis of National Health Interview Survey 2015 was performed to characterize the estimated US adults with IBD and their food intake and consumption frequency using bivariate and multivariate logistic regression. Fries were consumed by a greater number of people with IBD. IBD population drank less 100% fruit juice and ate more cheese and cookies than non-IBD population. Intake of fries (OR 1.60, 95% CI 1.14-2.25) and sports and energy drinks (OR 1.46, 95% CI 1.07-1.97) and more frequent drinking of regular soda were significantly associated with the likelihood of having been told one have IBD, while popcorn (OR 0.73, 95% CI 0.548-0.971) and milk (OR 0.70, 95% CI 0.497-0.998) were associated with smaller odds, adjusting for covariates. Foods typically labeled as junk food were positively associated with IBD. Nonetheless, of the assessed 26 foods, we found eating patterns between IBD and non-IBD population to be mostly analogous. It is unclear whether the results reflect potential change in food intake in IBD population long before the survey interview. Understanding the role of food intake in IBD risk/prevalence would benefit from identifying other environmental factors (i.e. food desert), food processing (i.e. frying), and potential bioactive food components that can induce intestinal inflammation that can increase the individual's susceptibility to IBD.
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Affiliation(s)
- Moon K. Han
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
| | - Raeda Anderson
- Department of Research and Engagement, Georgia State University, Atlanta, Georgia, United States of America
| | - Emilie Viennois
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
| | - Didier Merlin
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
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A Survey on Nutritional Knowledge in Coeliac Disease Compared to Inflammatory Bowel Diseases Patients and Healthy Subjects. Nutrients 2020; 12:nu12041110. [PMID: 32316215 PMCID: PMC7230195 DOI: 10.3390/nu12041110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 02/08/2023] Open
Abstract
Background and aim: Nutritional deficiencies are frequent in coeliac disease (CeD), mostly because of the nutritional deficits in gluten-free foods and because of wrong behaviors. We aimed to investigate the level of nutritional knowledge in a cohort of CeD patients in comparison with patients with inflammatory bowel disease (IBD) and healthy subjects. Materials and methods: We consecutively recruited CeD patients and matched-sex and -age IBD patients between April and December 2019 at the University Hospital of Padua outpatient clinic. Healthy subjects were also recruited from family and friends of the hospital staff. The CeD patients were asymptomatic on a gluten-free diet, whereas the IBD patients were in remission. All of the subjects completed the Moynihan validated questionnaire to measure their nutritional knowledge. Results: We included 96 CeD patients, 96 IBD patients, and 65 healthy controls. We found that CeD patients were less aware of nutritional recommendations compared with healthy subjects (HS), and were less able to identify nutrient sources compared with IBD patients and to choose healthy food compared with both groups. The Moynihan questionnaire mean total score was not significantly different between CeD and IBD groups (mean 22.5 ± 2.3 for CeD, 22.0 ± 2.2 for IBD), while it was statistically significantly worse in CeD compared with healthy subjects (mean 21.2 ± 2.3 for HS, p = 0.001). Conclusions: CeD patients tend to focus their diet on gluten avoidance, while IBD patients tend to follow a healthier diet, probably because they believe that diet plays a major role in regulating inflammation and, therefore, their symptoms. A dietitian consultation at CeD diagnosis is recommended.
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Chiba M, Nakane K, Tsuji T, Tsuda S, Ishii H, Ohno H, Watanabe K, Obara Y, Komatsu M, Sugawara T. Relapse Prevention by Plant-Based Diet Incorporated into Induction Therapy for Ulcerative Colitis: A Single-Group Trial. Perm J 2020; 23:18-220. [PMID: 31050638 DOI: 10.7812/tpp/18-220] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT No known previous study has focused on plant-based diet (PBD) to prevent relapse of ulcerative colitis (UC) except our previous educational hospitalization study. OBJECTIVE To describe the relapse rate in a large case series of UC after incorporation of PBD into induction therapy. DESIGN All patients with UC between 2003 and 2017 were admitted for induction therapy. Patients receiving educational hospitalization or treated with infliximab were excluded. A lacto-ovo-semivegetarian diet (PBD) together with medication prescribed according to UC guidelines was provided during hospitalization. MAIN OUTCOME MEASURES The primary endpoint was relapse during follow-up. The secondary endpoint was change over time in the plant-based diet score (PBDS), which evaluated adherence to the PBD. RESULTS Ninety-two cases were studied, of which 51 were initial episodes and 41 were relapses. Cases varied in severity (31 mild, 48 moderate, 13 severe) and extent (15 proctitis, 22 left-sided colitis, 55 extensive colitis). More severe cases existed among the relapse cases than among the initial episode cases. Cumulative relapse rates at 1- and 5-year follow-up (Kaplan-Meier analysis) were 14% and 27%, respectively, for the initial episode cases, and 36% and 53%, respectively, for relapse cases. At long-term follow-up (6 years 4 months), PBDS was significantly higher than baseline PBDS (p < 0.0001). CONCLUSION Relapse rates in UC after induction therapy with PBD were far lower than those previously reported with conventional therapy. Adherence to PBD was significantly higher than baseline even at 6-year follow-up. We conclude PBD is effective for preventing UC relapse.(Study identification no.: UMIN000019061: Registration: www.umin.ac.jp).
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Affiliation(s)
- Mitsuro Chiba
- Inflammatory Bowel Disease Section, Akita City Hospital, Japan
| | - Kunio Nakane
- Gastroenterology Division, Akita City Hospital, Japan
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Mirmiran P, Moslehi N, Morshedzadeh N, Shivappa N, Hébert JR, Farsi F, Daryani NE. Does the inflammatory potential of diet affect disease activity in patients with inflammatory bowel disease? Nutr J 2019; 18:65. [PMID: 31684946 PMCID: PMC6829821 DOI: 10.1186/s12937-019-0492-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/02/2019] [Indexed: 12/15/2022] Open
Abstract
Background Diet is an important modulator of inflammation, which is associated with inflammatory bowel disease (IBD). In this study, we examined whether the inflammatory properties of diets are associated with disease activity in patients with IBD. Methods A cross-sectional study was conducted on 143 IBD patients, including 32 patients with Crohn’s disease (CD) and 111 patients with ulcerative colitis (UC). Dietary intakes were assessed by a valid 168-item food frequency questionnaire (FFQ). The inflammatory potential of the diet was assessed by calculating the two scores of Dietary Inflammatory Index (DII®), and the Empirical Dietary Inflammatory Pattern (EDIP), and CD and UC disease activity were determined by the Crohn’s disease activity index (CDAI) and the Mayo score, respectively. Associations of the inflammatory indices as median and as tertiles with disease activity were analyzed using logistic regression in a univariate model and after adjusting for total energy intake (continuous), type of disease (CD and UC) and drug consumption (no drugs, single drug, and multiple drugs). Results Sixty-four IBD patients (44.8%) in this study had active disease.The DII® score and the EDIP did not differ significantly between active and inactive patients (− 1.45 ± 1.04 vs.− 1.20 ± 1.24; 0.56 ± 0.22 vs. 0.53 ± 0.28, respectively). After adjusting for energy intake, drug use, and IBD type, the odds (95%CIs) of active disease among patients in tertile 3 compared to those in tertile 1 were 0.84 (0.32–2.17) for DII and 1.50 (0.61–3.72) for EDIP; neither of which were statistically significantly different from the rates in tertile 1. Conclusions Although point estimates were in the expected direction of increased risk, the inflammatory potential of diet, assessed using DII or EDIP, was not associated with severity of disease in IBD patients. Whether diet-related inflammation affects disease activity in patients with IBD deserves further investigations.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nava Morshedzadeh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Farnaz Farsi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Ebrahimi Daryani
- Department of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Uscanga-Domínguez L, Orozco-García I, Vázquez-Frias R, Aceves-Tavares G, Albrecht-Junnghans R, Amieva-Balmori M, Bazaldua-Merino L, Bernal-Reyes R, Camacho-de León M, Campos-Gutiérrez J, Carmona-Sánchez R, Castro-Marín L, Coss-Adame E, Cuevas-Estrada A, Escobedo-Martínez J, González-Franco L, Huerta-Iga F, Lozano-Lozano R, Martínez-Vázquez S, Milke García M, Nogueira-de Rojas J, Padilla-González M, Pérez y López N, Silva-Campechano F, Treviño-Mejía M, Velázquez-Alva M. Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2019. [DOI: 10.1016/j.rgmxen.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Uscanga-Domínguez LF, Orozco-García IJ, Vázquez-Frias R, Aceves-Tavares GR, Albrecht-Junnghans RE, Amieva-Balmori M, Bazaldua-Merino LA, Bernal-Reyes R, Camacho-de León ME, Campos-Gutiérrez JA, Carmona-Sánchez RI, Castro-Marín LV, Coss-Adame E, Cuevas-Estrada AJ, Escobedo-Martínez JA, González-Franco LR, Huerta-Iga FM, Lozano-Lozano R, Martínez-Vázquez SE, Milke García MP, Nogueira-de Rojas JR, Padilla-González M, Pérez Y López N, Silva-Campechano F, Treviño-Mejía MC, Velázquez-Alva MC. Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2019; 84:357-371. [PMID: 31167744 DOI: 10.1016/j.rgmx.2019.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/09/2019] [Accepted: 03/31/2019] [Indexed: 06/09/2023]
Abstract
Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed.
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Affiliation(s)
- L F Uscanga-Domínguez
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | - R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
| | - G R Aceves-Tavares
- Departamento de Gastroenterología, Hospital General del Estado Dr. Ernesto Ramos Bours, Hermosillo, Sonora, México
| | | | - M Amieva-Balmori
- Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, México
| | - L A Bazaldua-Merino
- Sistema Nacional DIF, CNMACIG «Vicente García Torres», Ciudad de México, México
| | - R Bernal-Reyes
- Sociedad Española de Beneficencia, Pachuca, Hidalgo, México
| | | | - J A Campos-Gutiérrez
- Casa de Retiro Teresa de Calcuta S.C., San Nicolás de los Garza, Nuevo León, México
| | | | - L V Castro-Marín
- Hospital Adolfo López Mateos ISSSTESON, Ciudad Obregón, Sonora, México
| | - E Coss-Adame
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | | | - L R González-Franco
- Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | | | | | - S E Martínez-Vázquez
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - M P Milke García
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | | | - N Pérez Y López
- Servicio de Gastroenterología, Hospital Juárez de México, Ciudad de México, México
| | | | - M C Treviño-Mejía
- Universidad Iberoamericana Tijuana, Tijuana, Baja California, México
| | - M C Velázquez-Alva
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Ciudad de México, México
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Zhao M, Burisch J. Impact of Genes and the Environment on the Pathogenesis and Disease Course of Inflammatory Bowel Disease. Dig Dis Sci 2019; 64:1759-1769. [PMID: 31073736 DOI: 10.1007/s10620-019-05648-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Crohn's disease and ulcerative colitis constitute two major subgroups of inflammatory bowel diseases (IBD), a group of complex polygenic diseases characterized by chronic and progressive inflammation in the gastrointestinal tract. In recent years, methodological advances in genetic analysis have greatly expanded our understanding of the genetic background of IBD. So far, more than 240 genetic risk loci have been identified for IBD. However, these risk alleles explain less than 30% of the susceptibility to disease development, suggesting that environmental factors contribute considerably. The increasing occurrence of IBD in Eastern countries following their 'westernization', as well as the increased risk of disease among those who migrate to high-incidence regions, also suggest that the environment is key in the pathogenesis of IBD. In this review, we summarize the current evidence on the role of genetic and environmental factors in the susceptibility to, and disease course of, IBD, and we suggest how these findings might be applied to clinical practice.
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Affiliation(s)
- Mirabella Zhao
- Gastro Unit, Hvidovre University Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark
| | - Johan Burisch
- Gastro Unit, Hvidovre University Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark.
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Implications of the Westernized Diet in the Onset and Progression of IBD. Nutrients 2019; 11:nu11051033. [PMID: 31072001 PMCID: PMC6566788 DOI: 10.3390/nu11051033] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/02/2019] [Accepted: 05/04/2019] [Indexed: 02/07/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are currently considered multifactorial pathologies in which various combined environmental factors act on a genetic background, giving rise to a chronic inflammation of the gastrointestinal tract. Among the various environmental factors, it now seems clear that the diet plays the major role in IBD onset and progression. Several clinical studies have attempted to understand the impact of diet in the development and progression of these diseases in order to establish useful guidelines for their management. However, the modest and sometimes contradictory results did not lead to the definition of shared dietary suggestions. On the other hand, food fads and recommendations based on anecdotal episodes are often followed by IBD patients to improve their diet. This review provides a critical overview of existing data on the role of diet as a risk factor for IBD. The methodology used was that of analyzing the results of clinical studies conducted on diet and IBD over the last 12 years through PubMed, as well as analyzing the most relevant studies on nutrients and their possible roles in IBD through the knowledge of the mechanisms by which they can modulate the microbiota or the intestinal physiology.
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Dietary intake of fish, n-3 polyunsaturated fatty acids, and risk of inflammatory bowel disease: a systematic review and meta-analysis of observational studies. Eur J Nutr 2019; 59:1-17. [PMID: 30680455 DOI: 10.1007/s00394-019-01901-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/10/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Fish consumption and dietary intake of n-3 polyunsaturated acids (PUFAs) may be associated with inflammatory bowel disease (IBD). We aimed to conduct a systematic review and summarize published articles on the association between fish consumption and dietary intake of n-3 PUFAs with the risk of IBD. METHODS PubMed, Scopus, and Web of Science databases were used to conduct a comprehensive search and identify eligible literature published prior to January 2019. Fixed-effects model or random-effects models (DerSimonian-Laird method) were applied to pool the effect sizes. Cochrane Q test was used to trace the potential source of heterogeneity across studies. RESULTS 12 studies (5 prospective and 7 case-control) were included in the systematic review, which ten of them were eligible for inclusion in the meta-analysis. Studies were included a total sample size of 282610 participants which 2002 of them were cases of IBD [1061 Crohn's disease (CD) and 937 ulcerative colitis (UC)]. A negative association was found between fish consumption and the incidence of CD (pooled effect size: 0.54, 95%CI: 0.31-0.96, P = 0.03). There was no relationship between total dietary n-3 PUFAs intake and IBD (pooled effect size: 1.17, 95%CI: 0.80-1.72, P = 0.41). A significant inverse association was observed between dietary long-chain n-3 PUFAs and the risk of UC (pooled effect size: 0.75, 95%CI: 0.57-0.98, P = 0.03). Moreover, no association was found between α-Linolenic acid (ALA) and IBD (pooled effect size: 1.17, 95%CI: 0.63-2.17, P = 0.62). CONCLUSIONS Findings showed a negative association between fish consumption and the risk of CD. Moreover, there was a significant inverse association between dietary long-chain n-3 PUFAs and the risk of UC.
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Taylor L, Almutairdi A, Shommu N, Fedorak R, Ghosh S, Reimer RA, Panaccione R, Raman M. Cross-Sectional Analysis of Overall Dietary Intake and Mediterranean Dietary Pattern in Patients with Crohn's Disease. Nutrients 2018; 10:E1761. [PMID: 30441814 PMCID: PMC6266729 DOI: 10.3390/nu10111761] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/07/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023] Open
Abstract
The primary objective of this study was to explore the macro- and micro-nutrient intakes and dietary patterns of patients with Crohn's disease (CD). Secondary objectives were to (a) compare the micronutrient intakes of CD patients with a representative sample of individuals, (b) describe the macro- and micronutrient intakes of male and female CD patients, and (c) describe Mediterranean diet scores (P-MDS) of male and female CD patients in remission that were recruited from an inflammatory bowel disease (IBD) clinic in Calgary, AB. Consecutive patients with ileal and/or colonic CD in endoscopic remission were recruited for participation in this cross-sectional study. Sixty-seven patients were enrolled with a mean age of 45, and a Body Mass Index (BMI) ≥ 25. Compared with the representative sample, patients with CD had similar energy, protein, carbohydrate, and total fat intake. However, polyunsaturated fats (PUFA), omega-6 and 3, and monounsaturated fats (MUFA) were lower in CD patients and dietary fiber intake was higher (p < 0.05). Vitamins C, D, thiamin, niacin, magnesium, phosphorus, zinc, and potassium were all significantly lower in all CD patients when compared to the representative sample (p < 0.05). Few patients with CD met the P-MDS criteria and overall scores were low (mean 4.5, Standard Deviation (SD) = 1.1 in males and 4.7, SD = 1.8 in females). The CD patients in this study had suboptimal dietary intakes and patterns and these data may be used to inform future dietary interventions in this population to improve intake.
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Affiliation(s)
- Lorian Taylor
- Department of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | | | - Nusrat Shommu
- Department of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Richard Fedorak
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada.
| | - Subrata Ghosh
- Institute of Translational Medicine, NIHR Biomedical Research Centre, University of Birmingham and Birmingham University Hospitals, Birmingham B15 2TT, UK.
| | - Raylene A Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
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Giménez-Bastida JA, Laparra-Llopis JM, Baczek N, Zielinski H. Buckwheat and buckwheat enriched products exert an anti-inflammatory effect on the myofibroblasts of colon CCD-18Co. Food Funct 2018; 9:3387-3397. [PMID: 29870039 PMCID: PMC6597957 DOI: 10.1039/c8fo00193f] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Buckwheat (BW) constitutes a good source of bioactive components that show anti-inflammatory effects in vitro and in vivo. The use of functional foods in the prevention and treatment of inflammatory bowel diseases (IBDs) has aroused increasing interest. This study investigates the effect of in vitro digested BW and BW-enriched products (BW-enriched wheat breads, roasted BW groats -fermented and non-fermented-, and BW sprouts) on colon myofibroblasts, the cells involved in the regulation of inflammatory response in the intestine. The cells were treated with different digested-BW products, alone or together with TNF-α (20 ng mL-1), and the effects on the cell migration, mitochondrial membrane potential and cell cycle, processes altered during intestinal inflammation, were investigated. A significant reduction in TNF-α-induced migration (25.5%, p < 0.05) and attenuation of the TNF-α-altered cell cycle (p < 0.05) was observed in myofibroblasts treated with BW-enriched white wheat bread. These results contribute to extend the beneficial effects derived from BW bioactive compounds, and suggest that BW consumption can exert beneficial effects on IBDs.
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Affiliation(s)
- J A Giménez-Bastida
- Department of Pharmacology. Vanderbilt University School of Medicine, RRB 514, 23rd Ave. S. at Pierce, Nashville, TN 37232-6602, USA
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Dietary n-3 PUFA May Attenuate Experimental Colitis. Mediators Inflamm 2018; 2018:8430614. [PMID: 29670469 PMCID: PMC5833476 DOI: 10.1155/2018/8430614] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/13/2017] [Accepted: 10/31/2017] [Indexed: 02/06/2023] Open
Abstract
Background Inflammatory bowel diseases (IBD) occurred in genetically predisposed people exposed to environmental triggers. Diet has long been suspected to contribute to the development of IBD. Supplementation with n-3 polyunsaturated fatty acids (PUFA) protects against intestinal inflammation in rodent models while clinical trials showed no benefits. We hypothesized that intervention timing is crucial and dietary fatty acid pattern may influence intestinal environment to modify inflammation genesis. The aim of this study was to evaluate the dietary effect of PUFA composition on intestinal inflammation. Methods Animals received diet varying in their PUFA composition for four weeks before TNBS-induced colitis. Colon inflammatory markers and gut barrier function parameters were assessed. Inflammatory pathway PCR arrays were determined. Results n-3 diet significantly decreased colon iNOS, COX-2 expression, IL-6 production, and LTB4 production but tended to decrease colon TNFα production (P = 0.0617) compared to control diet. Tight junction protein (claudin-1, occludin) expressions and MUC2 and TFF3 mRNA levels were not different among groups. n-9 diet also decreased colon IL-6 production (P < 0.05). Conclusions Dietary n-3 PUFA influence colitis development by attenuating inflammatory markers. Further research is required to better define dietary advice with a scientific rationale.
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