Dietary Intake Pattern is Associated with Occurrence of Flares in IBD Patients

Abstract

Background Diet is associated with the onset of inflammatory bowel disease [IBD]. Up to half of IBD patients believe that diet contributes to flares. However, studies on this topic are sparse and merely focus on specific nutrients, food items or food groups. We aimed to analyse the association between dietary patterns and flare occurrence in two geographically distinct Dutch cohorts. Methods In this longitudinal study, 724 IBD patients [Northern cohort: n = 486, Southern cohort: n = 238] were included and followed for 2 years. Habitual dietary intake was obtained via semi-quantitative food frequency questionnaires at baseline. Principal component analysis [PCA] was conducted on 22 food groups to identify dietary patterns. Flare occurrence was analysed in 427 patients in remission at baseline, using multivariable Cox proportional hazards. Results Compared to the Southern cohort, patients in the Northern cohort were younger at diagnosis, comprised more females, and had lower overall energy intakes [all p < 0.05]. PCA revealed three dietary patterns explaining 28.8% of the total variance. The most pronounced pattern [explaining 11.6%] was characterized by intake of grain products, oils, potatoes, processed meat, red meat, condiments and sauces, and sugar, cakes and confectionery. Of the 427 patients, 106 [24.8%] developed an exacerbation during follow-up. The above dietary pattern was associated with flare occurrence (hazard ratio [HR]: 1.51, 95% confidence interval [CI]: 1.04–2.18, p = 0.029), as was female sex [HR: 1.63, 95% CI 1.04–2.55, p = 0.032]. Conclusions A dietary pattern, which can be seen as a ‘traditional [Dutch]’ or “Western’ pattern was associated with flare occurrence. Confirmation in prospective studies is needed.

Dietary Patterns and the Risk of Inflammatory Bowel Disease: Findings from a Case-Control Study

“…Regarding the second dietary pattern of this study's focus, high-protein intake, we found a significantly increased risk of IBD at the third and fourth quartiles for the crude and the two adjusted patterns. These findings align with reports made by several other studies that indicate that a high total protein intake (from animal sources) is associated with an increased risk of IBD [26][27][28]. Peters et al (2021) reveal that a dietary pattern loaded by grain products, oils, potatoes, processed meat, red meat, condiments and sauces, and sugar, cakes, and confectionery can exacerbate the flares of IBD significantly (HR: 1.51, 95% CI: 1.04-2.18, p = 0.029) during follow-up [26].…”

“…These findings align with reports made by several other studies that indicate that a high total protein intake (from animal sources) is associated with an increased risk of IBD [26][27][28]. Peters et al (2021) reveal that a dietary pattern loaded by grain products, oils, potatoes, processed meat, red meat, condiments and sauces, and sugar, cakes, and confectionery can exacerbate the flares of IBD significantly (HR: 1.51, 95% CI: 1.04-2.18, p = 0.029) during follow-up [26]. Similarly, a meta-analysis of case-control studies by Hou et al (2011) shows a positive correlation between animal protein consumption and whole protein intake and CD [28].…”

Systematic review with meta‐analysis: dietary intake in adults with inflammatory bowel disease

“…Similarly, Hou et al found that the high intake of total fat, meat and low intake of fibre and fruit was associated with the development of IBD 66 . Recent research has also found in Dutch adults with IBD that a dietary pattern that was high in grains, oils, processed meat, sugars and confectionary was associated with disease exacerbation 67 and a microbial environment characteristic of inflammation 68 . Further research to describe how diet quality may change during the disease course, and how these associations between diet quality and gut microbiota profile change would be useful.…”

Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study

“…High intake of animal protein has been associated with development of IBD [ 33 , 34 ], and in patients with ulcerative colitis (UC), high intake of protein, total, as well as red and processed meat, was positively associated with risk of relapse [ 15 ]. In a recent retrospective study, patients with IBD in clinical remission had a lower total and animal protein intake compared to patients who experienced a relapse after a 2-year follow-up [ 35 ]. In contrast, a recent RCT showed that clinical relapse rates and FC levels did not differ between patients with CD who consumed at least two portions of red and processed meat per week, and others who consumed less than one serving per month [ 36 ].…”