Do patients living with ulcerative colitis adhere to healthy eating guidelines? A cross-sectional study

Walton, Michelle R.; Alaunyte, I.

doi:10.1017/s0007114514002074

Cited by 38 publications

(31 citation statements)

References 26 publications

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“…Up to 71% of patients with IBD believe diet affects their disease symptoms, with 90% of CD patients and 71% of UC patients employing elimination diets while in remission [14,15]. Dietary modification can be of concern if patients drastically reduce or completely avoid nutritionally important foods/food groups, as this may place them at increased risk for developing nutritional deficiencies [16], as well as poorer quality of life. Up to 77.1% of patients with IBD report avoidance of particular foods [14].…”

Section: Introductionmentioning

confidence: 99%

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

Haskey

Gibson

2017

Nutrients

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Diet has been speculated to be a factor in the pathogenesis of inflammatory bowel disease and may be an important factor in managing disease symptoms. Patients manipulate their diet in attempt to control symptoms, often leading to the adoption of inappropriately restrictive diets, which places them at risk for nutritional complications. Health professionals struggle to provide evidence-based nutrition guidance to patients due to an overall lack of uniformity or clarity amongst research studies. Well-designed diet studies are urgently needed to create an enhanced understanding of the role diet plays in the management of inflammatory bowel disease. The aim of this review is to summarize the current data available on dietary management of inflammatory bowel disease and to demonstrate that dietary modulation may be an important consideration in managing disease. By addressing the relevance of diet in inflammatory bowel disease, health professionals are able to better support patients and collaborate with dietitians to improve nutrition therapy.

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Section: Introductionmentioning

confidence: 99%

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

Haskey

Gibson

2017

Nutrients

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“…These findings are supported in a UK survey of patients with ulcerative colitis, in which adherence to national dietary guidelines was poor and food avoidance strategies led to nutritional inadequacy. 4 The risk of nutritional imbalance should encourage clin icians to monitor dietary intake of their patients with IBD and help guide them through the labyrinth of ideas and concepts to which they are being exposed. Besides the use of exclusive enteral nutrition (EEN), most 'best-evidence' guidelines offer no recommendations for the use of diet in IBD.…”

Section: Introductionmentioning

confidence: 99%

Dietary management of IBD—insights and advice

Halmos

Gibson

2015

Nat Rev Gastroenterol Hepatol

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The current general interest in the use of food choice or diet in maintaining good health and in preventing and treating disease also applies to patients with IBD, who often follow poor or nutritionally challenging dietary plans. Unfortunately, dietary advice plays only a minor part in published guidelines for management of IBD, which sends a message that diet is not of great importance. However, a considerable evidence base supports a focused and serious attention to nutrition and diet in patients with IBD. In this Review, a step-wise approach in the evaluation and management of these patients is proposed. First, dietary intake and eating habits as well as current nutritional state should be documented, and corrective measures instituted. Secondly, dietary strategies as primary or adjunctive therapy for the reduction of inflammation and/or prevention of relapse of IBD should be seriously contemplated. Thirdly, use of diet to improve symptoms or lessen the effects of complications should be considered. Finally, dietary advice regarding disease prevention should be discussed when relevant. An increasing need exists for applying improved methodologies into establishing the value of current and new ways of using food choice as a therapeutic and preventive tool in IBD.

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“…Introduction : Recent studies have shown that food avoidance in people with inflammatory bowel disease (IBD) is far more common than in the general population, and adherence to dietary guidelines is poor. These factors may contribute to both under‐ and over‐nutrition . Furthermore, studies report that limited dietary guidance is provided to this population .…”

Section: Exploring Food Avoidance Behaviors In Outpatients With Inflamentioning

confidence: 99%

Nutrition

Marsh

Kinneally

Lord

et al. 2017

J of Gastro and Hepatol

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Introduction: Bariatric surgery (BS) using restrictive and malabsorptive techniques remains the most effective treatment option for morbid obesity. Intestinal failure (IF) and decompensated chronic liver disease (CLD) are rare post-operative complications of BS. We reviewed a cluster of three post-bariatric surgery patients presenting to our center with IF and decompensated CLD to identify perioperative factors that may be associated with these life-threatening complications. Methods: A retrospective review of referrals to our IF unit in 2016 was performed to identify patients with a history of BS. Patient demographics, anthropometry, nutritional indices, liver function and investigations, nutritional management, and outcomes were reviewed. Results: Three of 10 patients who commenced home parenteral nutrition (HPN) at our institute in 2016 presented with IF and decompensated CLD following BS. All patients were female (aged 49-60 years) with co-existing liver failure (two non-alcoholic steatohepatitis [NASH] and one hepatitis C virus [HCV]). All operative procedures were malabsorptive: jejunoileal bypass (n = 2) and biliopancreatic diversion (n = 1). The mean body mass index at surgery was 44 kg/m 2 . Mean time between BS and liver disease diagnosis was 9.6 years; development of decompensated CLD occurred on average 2.3 years later, and referral to our service with rapid weight loss and IF arose on average 2.4 years thereafter. At presentation, patients exhibited severe malnutrition, sarcopenia, and micronutrient deficiencies. Parenteral nutrition and vitamin/mineral supplementation were implemented in each patient. All patients underwent diet modification and medical therapy to enhance enteral absorption, and two of three patients remain HPN-dependent. Postulated mechanisms for decompensated CLD and IF are the following: (i) malabsorption from BS resulted in rapid weight loss and progression to cirrhosis in patients already suffering NASH-or HCV-related liver fibrosis; (ii) the increased energy demands of liver disease precipitated liver decompensation due to malabsorption; and (iii) IF developed as patients were unable to meet their CLD-driven energy demands. Conclusion: IF and decompensated CLD are rare but life-threatening complications of malabsorptive BS. The risk of these complications likely relates to the degree of pre-operative fibrosis. Such patients should be monitored closely post-operatively, as CLD and IF can occur many years after surgery. Management options should be tailored to the severity of CLD and degree of malnutrition. Early diagnosis may avert liver disease progression via "prophylactic" reversal surgery alone in well patients. In malnourished patients with advanced liver disease, total parenteral nutrition followed by reversal surgery may be required. Liver transplant and reversal should only be reserved for those with irreversible liver disease. Background and Aim: The use of home parenteral nutrition (HPN) for patients with intestinal failure (IF) varies widely among countries. Robust...

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Do patients living with ulcerative colitis adhere to healthy eating guidelines? A cross-sectional study

Cited by 38 publications

References 26 publications

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

Dietary management of IBD—insights and advice

Nutrition

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