Association Between Change in Inflammatory Aspects of Diet and Change in IBD-related Inflammation and Symptoms Over 1 Year: The Manitoba Living With IBD Study

Abstract

Background We aimed to investigate (1) the stability of inflammatory aspects of diet over 1 year among persons with inflammatory bowel disease (IBD) and (2) the impact of change in diet on changes in inflammation and IBD symptoms over 1 year. Methods Participants were recruited to the Manitoba Living with IBD Study and completed the Harvard Food Frequency Questionnaire (FFQ). The Dietary Inflammatory Index (DII) and the Empirical Dietary Inflammatory Index (EDII) were used to calculate the inflammatory potential of the diet. Inflammation was measured by fecal calprotectin (≥250 µg/g). Symptoms were measured by the IBD Symptom Inventory (IBDSI). All measures were obtained at baseline and 1 year. Dietary Inflammatory Index and Empirical Dietary Inflammatory Index scores >0 and <0 reflect pro- and anti-inflammatory diet, respectively. Variance components analyses were used to describe diet stability. Associations between changes in diet and changes in active inflammation and symptoms were assessed using ordinal logistic regression and multilevel linear regression modeling. Results One hundred thirty-five participants (66% CD) were included. Approximately one third of the variance in EDII (36%) and DII (33%) scores was explained by changes in diet over time. Each unit increase in the change in EDII (baseline to follow-up) was associated with a greater odds of FCAL, indicating active inflammation (>250 µg/g; odds ratio, 3.1; 95% confidence interval [CI], 1.02–9.93; P = 0.04) and with a rise in IBDSI of 6.7 (95% CI, 1.0–12.4; P = 0.022; theoretical IBDSI range, 0–81). There was no association between changes in DII and changes in FCAL or IBDSI. Conclusion The EDII, but not the DII, may have utility to identify the inflammatory potential of diet. This inflammatory potential can contribute to inflammation and/or disease symptoms in persons with IBD.

The complex relationship between diet, symptoms, and intestinal inflammation in persons with inflammatory bowel disease: The Manitoba Living With IBD Study

“…Age and disease duration groups were created for consistency with other studies from the IBD cohort. 22,23…”

“…Informed consent was obtained from all participants after the nature of the procedure(s) had been explained. Participants in the Manitoba Living With IBD Study 22 had experienced IBD‐related symptoms during the 2‐year period before recruitment and were at least 18 years old 23 . Participants were enrolled between June 2015 and May 2017 and completed a web‐based survey every 2 weeks for 1 year.…”

“…Participants in the Manitoba Living With IBD Study 22 had experienced IBD-related symptoms during the 2-year period before recruitment and were at least 18 years old. 23 Participants were enrolled between June 2015 and May 2017 and completed a web-based survey every 2 weeks for 1 year. The survey included factors that may be associated with symptom exacerbation and inflammation in IBD, including diet.…”

Inflammatory Potential of the Diet and Incidence of Crohn’s Disease and Ulcerative Colitis in the EPIC-Spain Cohort

“…There have also been some studies examining the effect of the inflammatory potential of the diet, as measured by a score, on gut inflammation and disease activity in patients already diagnosed with IBD, but both positive and null relationships have been reported [ 38 , 39 ].…”

Dietary inflammatory potential mediated gut microbiota and metabolite alterations in Crohn's disease: A fire-new perspective

“…Two large recent prospective cohort studies indicated an association between dietary patterns with a high inflammatory potential and an increased risk of CD [5,10]. In addition, several other caseecontrol studies have suggested that the inflammatory potential of diet may be associated with the disease severity in patients with CD [11,12], but these studies were observational and did not explore the underlying mechanisms behind the inflammatory potential of diet in CD.…”