Dietary Patterns and Self-Reported Associations of Diet with Symptoms of Inflammatory Bowel Disease

Abstract

Background There are insufficient data to make firm dietary recommendations for patients with inflammatory bowel disease (IBD). Yet patients frequently report that specific food items influence their symptoms. In this study, we describe patients’ perceptions about the benefits and harms of selected foods and patients’ dietary patterns. Methods CCFA Partners is an ongoing internet-based cohort study of patients with IBD. We used a semi-quantitative food frequency questionnaire to measure dietary consumption patterns and open-ended questions to elicit responses from patients about food items they believe ameliorate or exacerbate IBD. We categorized patients into four mutually exclusive disease categories: CD without an ostomy or pouch (CD), UC without an ostomy or pouch (UC), CD with an ostomy (CD-ostomy), and UC with a pouch (UC-pouch). Results Yogurt, rice, and bananas were more frequently reported to improve symptoms whereas non-leafy vegetables, spicy foods, fruit, nuts, leafy vegetables, fried foods, milk, red meat, soda, popcorn, dairy, alcohol, high-fiber foods, corn, fatty foods, seeds, coffee, and beans were more frequently reported to worsen symptoms. Compared to CD patients, CD-ostomy patients reported significantly greater consumption of cheese (odds ratio (OR) 1.56, 95% CI 1.03–2.36), sweetened beverages (OR 2.14, 95% CI 1.02–1.03), milk (OR 1.84, 95% CI 1.35–2.52), pizza (OR 1.57, 95% CI 1.12–2.20), and processed meats (OR 1.40; 95% CI 1.04–1.89). Conclusions Patients identified foods that they believe worsen symptoms and restricted their diet. Patients with ostomies ate a more liberal diet. Prospective studies are needed to determine whether diet influences disease course.

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

“…Often leafy or non-leafy vegetables, fruits, dairy, alcohol, red meat or fast food were avoided [12,33]. This is in accordance with our data, since 35% of our patients with IBD stated to have reduced the consumption of fast food compared to only 7% in the healthy control group.…”

“…However, several studies showed different effects in patients with IBD on disease course [34], depending on disease type and status [12]. The avoidance of raw fruits and vegetables to reduce gastrointestinal afflictions varied between 8% and 71% [11,33].…”

“…malabsorption and maldigestion can interfere with nutrient uptake and nutrition. In particular, patients with active disease status may suffer from a nutrient deficiency [9][10][11][12][13][14]. Malnutrition can also be caused by a reduced food intake, e.g.…”

“…Interestingly, Zallot et al showed that about 67% of IBD patients restrict the consumption of certain foods to avoid a disease relapse [11]. Fiber-rich foods, fruits and vegetables, dairy, alcohol or processed meat were often suspected by patients with IBD to worsen their symptoms [11,12].…”

Association of Dietary Factors With Ulcerative Colitis in India

“…Similarly it is interesting to note the dietary factors implicated in causation of UC in Western studies mentioned above are the predominant food consumed in these countries. But diet definitely affects symptom and course after IBD onset [7][8] .…”