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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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Farsi F, Tahvilian N, Heydarian A, Karimi S, Ebrahimi S, Ebrahimi-Daryani N, Tabataba-Vakili S, Heshmati J, Mokhtare M. Evaluating macro- and micronutrients and food groups intake with the risk of developing inflammatory bowel disease: Is there any association? Food Sci Nutr 2022; 10:3920-3930. [PMID: 36348813 PMCID: PMC9632195 DOI: 10.1002/fsn3.2988] [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: 11/16/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022] Open
Abstract
Growing clinical evidence represented that certain dietary components are involved in inflammatory bowel disease (IBD) development and progression. This research, therefore, aimed to evaluate whether there exists any relationship between nutrients and IBD. This case-control study from 2017 to 2019 was performed on 145 newly diagnosed IBD patients and 145 BMI-, sex-, and age-matched healthy controls who were recruited from a hospital clinic. A validated 168-item food frequency questionnaire was completed by each participant. Anthropometric measurements and physical activity levels were measured for all participants. Stata software was used to analyze all data. Of the 234 study individuals who participated, 112 were IBD patients and 122 were healthy people. The higher amount of seafood and cholesterol was related to an increased risk of IBD and ulcerative colitis development; however, individuals who had a higher intake of calcium were less likely to have Crohn's compared to the healthy group. There was a positive relation between honey and jam, seafood, organ meats, salt, fruits on trees, fruit juice, olives, and nuts and the probability of IBD, but there was a negative association between refined grains, potatoes, salty snacks, legumes, dairy, and cruciferous and the probability of IBD. Higher consumption of seafood and cholesterol was positively connected with a higher risk of IBD development in the current case-control study. A substantial association was seen between honey and jam, seafood, organmeats, salt, fruit on trees, fruit juice, olives, and nut consumption and IBD developement.
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Affiliation(s)
- Farnaz Farsi
- Minimally Invasive Surgery Research Center Iran University of Medical Sciences Tehran Iran
| | - Negin Tahvilian
- Nutrition and Food Security Research Center Shahid Sadoughi University of Medical Sciences Yazd Iran
- Department of Nutrition, School of Public Health Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Azadeh Heydarian
- Student Research Committee, Department of Nutrition, School of Public Health Iran University of medical sciences Tehran Iran
| | - Sara Karimi
- 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
| | - Sara Ebrahimi
- The Ritchie Centre Hudson Institute of Medical Research, Monash Medical Centre, Clayton Melbourne VIC Australia
| | - Nasser Ebrahimi-Daryani
- Division of Gastroenterology, Imam Khomeini Hospital, School of Medicine Tehran University of Medical Sciences Tehran Iran
| | | | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran
| | - Marjan Mokhtare
- Rasoul Akram Hospital Clinical Research Development Center Iran University of Medical Sciences Tehran Iran
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Salavatizadeh M, Soltanieh S, Chegini M, Ilesanmi-Oyelere BL, Kord-Varkaneh H, Hekmatdoost A. Micronutrient intake and risk of ulcerative colitis: A meta-analysis of observational studies. Clin Nutr ESPEN 2022; 51:152-159. [DOI: 10.1016/j.clnesp.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/02/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
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Marruganti C, Discepoli N, Gaeta C, Franciosi G, Ferrari M, Grandini S. Dental Caries Occurrence in Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Caries Res 2021; 55:485-495. [PMID: 34469886 DOI: 10.1159/000519170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The present review aimed to systematically evaluate the occurrence of caries in patients with inflammatory bowel disease (IBD), either Crohn's disease (CD) or ulcerative colitis (UC), compared to healthy controls. MATERIALS AND METHODS MEDLINE (PubMed), Embase, Google Scholar, LILACS, and Cochrane Library electronic databases were screened. Caries experience was measured through the Decayed, Missing, Filled Teeth (DMFT) index. The weighted mean difference (WMD) with 95% confidence interval was calculated between IBD patients and healthy controls. RESULTS Six studies were selected for the inclusion in the systematic review, 5 of which were also included in the quantitative synthesis of data. The WMD in the DMFT index between IBD and healthy subjects was 3.04 (1.52, 4.56) (p = 0.10). Subgroup analysis showed no difference (p = 0.31) between CD (2.52 [0.54, 4.49]) and UC (4.01 [1.52, 4.56]) subjects. CONCLUSIONS There is a remarkably higher past and present occurrence of dental caries in subjects with IBD than healthy controls. This result should encourage clinicians to include oral health preventive programs in the overall treatment plan of IBD patients.
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Affiliation(s)
- Crystal Marruganti
- Department of Medical Biotechnologies, Unit of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy.,Department of Medical Biotechnologies, Unit of Periodontology, University of Siena, Siena, Italy
| | - Nicola Discepoli
- Department of Medical Biotechnologies, Unit of Periodontology, University of Siena, Siena, Italy
| | - Carlo Gaeta
- Department of Medical Biotechnologies, Unit of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy
| | - Giovanni Franciosi
- Department of Medical Biotechnologies, Unit of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy
| | - Marco Ferrari
- Department of Medical Biotechnologies, Unit of Prosthodontics, University of Siena, Siena, Italy
| | - Simone Grandini
- Department of Medical Biotechnologies, Unit of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy
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Lambert K, Pappas D, Miglioretto C, Javadpour A, Reveley H, Frank L, Grimm MC, Samocha-Bonet D, Hold GL. Systematic review with meta-analysis: dietary intake in adults with inflammatory bowel disease. Aliment Pharmacol Ther 2021; 54:742-754. [PMID: 34323292 DOI: 10.1111/apt.16549] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/16/2021] [Accepted: 07/14/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Poor dietary intake is associated with the development of malnutrition, micronutrient deficiencies, anaemia and osteoporosis in individuals with inflammatory bowel disease. While trials are underway to manipulate the diet of people with IBD, there has been no comprehensive systematic review of the dietary intake of adults with IBD. AIMS To conduct a systematic evaluation and meta-analysis of the dietary intake of adults with IBD, including macronutrients, micronutrients and food group data. METHODS CINAHL, Embase, Medline and Scopus were searched from 1 January 2000 to 25 September 2020 for cohort, case-control or cross-sectional studies that reported usual dietary intake in adults. Data were pooled and reported as weighted mean intake for: all adults with IBD; Crohn's disease; ulcerative colitis; active disease; remission; males; females. A random-effects meta-analysis model compared intake with healthy individuals. RESULTS Forty studies were identified and 19 were included in the meta-analysis. All subgroups of adults with IBD consumed inadequate energy (mean intake in adults with IBD 1980 ± 130 kcal), fibre (14 ± 4 g), folate (246 ± 33 mg) and calcium (529 ± 114 mg) per day. Intake of breads and cereals, legumes, fruit, vegetables and dairy were inadequate. Compared to healthy individuals, adults with IBD consume significantly less dietary fibre (SMD -0.59; 95% CI: -0.73, -0.46). CONCLUSIONS This review provides improved clarity about the dietary intake of adults with IBD. Future attention is required to improve diet quality and increase understanding of factors influencing dietary intake in IBD.
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Affiliation(s)
- Kelly Lambert
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Daniel Pappas
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Chiara Miglioretto
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Arefeh Javadpour
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Hannah Reveley
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Laura Frank
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michael C Grimm
- University of New South Wales, Sydney, New South Wales, Australia
| | - Dorit Samocha-Bonet
- Dorit Samocha-Bonet, Garvan Institute of Medical Research and University of New South Wales, Sydney, New South Wales, Australia
| | - Georgina L Hold
- University of New South Wales, Sydney, New South Wales, Australia
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Rychter AM, Ratajczak AE, Szymczak-Tomczak A, Michalak M, Eder P, Dobrowolska A, Krela-Kaźmierczak I. Associations of Lifestyle Factors with Osteopenia and Osteoporosis in Polish Patients with Inflammatory Bowel Disease. Nutrients 2021; 13:1863. [PMID: 34070791 PMCID: PMC8227497 DOI: 10.3390/nu13061863] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 01/31/2023] Open
Abstract
Reduced physical activity (PA), smoking, and coffee and alcohol drinking constitute risk factors of osteoporosis in patients with inflammatory bowel disease (IBD). The aim of the study was to measure the bone mineral density (BMD) and frequency of osteopenia and osteoporosis in patients with IBD and their correlation with PA, smoking, coffee, and alcohol. The study group consisted of 208 patients with IBD-103 with Crohn's disease (CD), 105 suffering from ulcerative colitis (UC). Densitometric measurements were performed using the DXA. All patients completed a questionnaire concerning PA, smoking, and coffee and alcohol consumption. The prevalence of osteopenia and osteoporosis (L2-L4) in the IBD group was 48.1%; in the CD group, it amounted to 48.6%, and in the UC group, the prevalence was equal to 33.3%. Patients with CD who were diagnosed with osteopenia and osteoporosis demonstrated reduced PA compared to patients with a normal BMD who exercised regularly (p = 0.0335). A similar observation was made in the group of women with IBD. Women with a normal BMD exercised significantly more often than women suffering from osteopenia and osteoporosis (p = 0.0146). However, no differences in BMD were observed with regard to coffee use, alcohol consumption, or smoking. Thus, since the incidence of osteoporosis in IBD patients is high, it may be dependent on PA.
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Affiliation(s)
- Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
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Ratajczak AE, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I. Do Only Calcium and Vitamin D Matter? Micronutrients in the Diet of Inflammatory Bowel Diseases Patients and the Risk of Osteoporosis. Nutrients 2021; 13:nu13020525. [PMID: 33562891 PMCID: PMC7914453 DOI: 10.3390/nu13020525] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
Osteoporosis is one of the most common extraintestinal complications among patients suffering from inflammatory bowel diseases. The role of vitamin D and calcium in the prevention of a decreased bone mineral density is well known, although other nutrients, including micronutrients, are also of extreme importance. Despite the fact that zinc, copper, selenium, iron, cadmium, silicon and fluorine have not been frequently discussed with regard to the prevention of osteoporosis, it is possible that a deficiency or excess of the abovementioned elements may affect bone mineralization. Additionally, the risk of malnutrition, which is common in patients with ulcerative colitis or Crohn's disease, as well as the composition of gut microbiota, may be associated with micronutrients status.
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Affiliation(s)
- Alicja Ewa Ratajczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
| | | | | | | | - Iwona Krela-Kaźmierczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
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Kundra P, Rachmühl C, Lacroix C, Geirnaert A. Role of Dietary Micronutrients on Gut Microbial Dysbiosis and Modulation in Inflammatory Bowel Disease. Mol Nutr Food Res 2021. [DOI: 10.1002/mnfr.201901271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Palni Kundra
- Laboratory of Food Biotechnology Institute of Food Nutrition and Health Schmelzbergstrasse 7 Zürich 8092 Switzerland
| | - Carole Rachmühl
- Laboratory of Food Biotechnology Institute of Food Nutrition and Health Schmelzbergstrasse 7 Zürich 8092 Switzerland
| | - Christophe Lacroix
- Laboratory of Food Biotechnology Institute of Food Nutrition and Health Schmelzbergstrasse 7 Zürich 8092 Switzerland
| | - Annelies Geirnaert
- Laboratory of Food Biotechnology Institute of Food Nutrition and Health Schmelzbergstrasse 7 Zürich 8092 Switzerland
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Skrzypczak D, Ratajczak AE, Szymczak-Tomczak A, Dobrowolska A, Eder P, Krela-Kaźmierczak I. A Vicious Cycle of Osteosarcopeniain Inflammatory Bowel Diseases-Aetiology, Clinical Implications and Therapeutic Perspectives. Nutrients 2021; 13:nu13020293. [PMID: 33498571 PMCID: PMC7909530 DOI: 10.3390/nu13020293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia is a disorder characterized by a loss of muscle mass which leads to the reduction of muscle strength and a decrease in the quality and quantity of muscle. It was previously thought that sarcopenia was specific to ageing. However, sarcopenia may affect patients suffering from chronic diseases throughout their entire lives. A decreased mass of muscle and bone is common among patients with inflammatory bowel disease (IBD). Since sarcopenia and osteoporosis are closely linked, they should be diagnosed as mutual consequences of IBD. Additionally, multidirectional treatment of sarcopenia and osteoporosis including nutrition, physical activity, and pharmacotherapy should include both disorders, referred to as osteosarcopenia.
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Ratajczak AE, Szymczak-Tomczak A, Zawada A, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I. Does Drinking Coffee and Tea Affect Bone Metabolism in Patients with Inflammatory Bowel Diseases? Nutrients 2021; 13:nu13010216. [PMID: 33451170 PMCID: PMC7828660 DOI: 10.3390/nu13010216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 12/16/2022] Open
Abstract
Patients suffering from Crohn’s disease and ulcerative colitis are at higher risk of osteoporosis due to lower bone mineral density. Risk factors of osteoporosis are divided into unmodifiable, namely, age, gender, genetic factors, as well as modifiable, including diet, level of physical activity, and the use of stimulants. Coffee and tea contain numerous compounds affecting bone metabolism. Certain substances such as antioxidants may protect bones; other substances may increase bone resorption. Nevertheless, the influence of coffee and tea on the development and course of inflammatory bowel diseases is contradictory.
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Affiliation(s)
- Alicja Ewa Ratajczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
| | | | | | | | | | - Iwona Krela-Kaźmierczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
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Abstract
PURPOSE OF REVIEW Patients with inflammatory bowel disease (IBD) are always interested in the effects of diet on their disease and are often puzzled by the apparent lack of concern in this regard expressed by their doctors. This lack of concern too often reflects the lack of knowledge but it must be recognized that the evidence base for nutritional interventions is weak and compares poorly with that underlying the use of modern biologic drugs. RECENT FINDINGS The past year has had its usual collection of personal and systematic reviews of the topic and a regrettably large number of poor quality publications on nutrition in IBD. The present contribution aims to highlight some of the more original articles of the past year and to identify areas where useful progress is being made both in cause (sugar perhaps less important than was thought) and habitual diet (where more fruit and less red meat are cautiously promoted). With regard to specific interventions, there is a swing back toward an exclusion diet in children with Crohn's disease and to dietary management of persistent symptoms in IBD patients in whom objective evidence of disease activity is absent or very low. SUMMARY The quality of articles in the field is slowly improving and it is encouraging to find several pertinent publications in the highest caliber journals. Hopefully, this will encourage improvement in clinical practice and further investment in research.
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Affiliation(s)
- Alastair Forbes
- Norwich Medical School, University of East Anglia, Norwich, UK
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Vitamin C Deficiency and the Risk of Osteoporosis in Patients with an Inflammatory Bowel Disease. Nutrients 2020; 12:nu12082263. [PMID: 32751086 PMCID: PMC7468713 DOI: 10.3390/nu12082263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 12/13/2022] Open
Abstract
Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn’s disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as SLC23A1 and SLC23A2 genes, encoding sodium-dependent vitamin C transporters and GSTM1, GSTP1 and GSTT1 genes which encode glutathione S-transferases. Furthermore, ascorbic acid may modify the composition of gut microbiota which plays a role in the pathogenesis of an inflammatory bowel disease.
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Ratajczak AE, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I. Nutrients in the Prevention of Osteoporosis in Patients with Inflammatory Bowel Diseases. Nutrients 2020; 12:E1702. [PMID: 32517239 PMCID: PMC7352179 DOI: 10.3390/nu12061702] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022] Open
Abstract
The chronic character of inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, results in various complications. One of them is osteoporosis, manifested by low bone mineral density, which leads to an increased risk of fractures. The aetiology of low bone mineral density is multifactorial and includes both diet and nutritional status. Calcium and vitamin D are the most often discussed nutrients with regard to bone mineral density. Moreover, vitamins A, K, C, B12; folic acid; calcium; phosphorus; magnesium; sodium; zinc; copper; and selenium are also involved in the formation of bone mass. Patients suffering from inflammatory bowel diseases frequently consume inadequate amounts of the aforementioned minerals and vitamins or their absorption is disturbed, resulting innutritional deficiency and an increased risk of osteoporosis. Thus, nutritional guidelines for inflammatory bowel disease patients should comprise information concerning the prevention of osteoporosis.
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Affiliation(s)
- Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland; (A.M.R.); (A.Z.); (A.D.)
| | | | | | | | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland; (A.M.R.); (A.Z.); (A.D.)
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Therapeutic Potential of Proanthocyanidins in Ulcerative Colitis in Remission. J Clin Med 2020; 9:jcm9030771. [PMID: 32178368 PMCID: PMC7141196 DOI: 10.3390/jcm9030771] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 12/19/2022] Open
Abstract
A number of bioactive components of diet are indicated as potential dietary factors for the management of ulcerative colitis, while the recent study conducted in an animal model revealed that proanthocyanidins from grape seeds exert a broadly positive impact. The aim of the study was to verify the influence of dietary proanthocyanidins intake on the symptoms of ulcerative colitis in remission in human subjects. The study was conducted in a group of 55 participants (19 males, 36 females) in remission of ulcerative colitis confirmed based on both the Mayo Scoring system and Rachmilewitz index. Their habitual dietary intake of proanthocyanidins and intake recalculated per 1000 kcal of diet was assessed and it was verified whether they are associated with symptoms of ulcerative colitis. The energy value of diet and intake of other nutrients were analyzed as potential interfering factors. Participants declaring the presence of mucus in their stool compared with other participants were characterized by higher proanthocyanidins intake (142 vs. 75 mg; p = 0.0441) and intake per 1000 kcal (91 vs. 37 mg/1000 kcal; p = 0.0092), while for no other nutrient such association was stated. Participants declaring constipation compared with other participants were characterized by higher proanthocyanidins intake (214 vs. 82 mg; p = 0.0289) and intake per 1000 kcal (118 vs. 41 mg/1000 kcal; p = 0.0194). Similar association for constipation was observed in the case of energy value of diet and protein intake, but only for proanthocyanidins intake, it was confirmed in the logistic regression model (p = 0.0183; OR = 1.01; 95% CI 1.00-1.02). The positive influence of habitual dietary intake of proanthocyanidins was confirmed in the studied group of patients with ulcerative colitis in remission, as this intake may have increased the production of mucus, which is beneficial for intestinal healing, and may have reduced the frequency of bowel movements. However, further experimental human studies are necessary to confirm the potential influence of proanthocyanidins intake in patients with ulcerative colitis in remission.
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