Effects of comprehensive dietary advice on the physical and mental health of patients with ulcerative colitis during the remission phase: a parallel randomized controlled clinical trial

Abstract

The impact of food on physical and mental co-complications of ulcerative colitis (UC) has not been clearly defined. The current study aimed to evaluate the effects of a dietary modification program (DMP) on fatigue, mental health, quality of life, fasting blood glucose, and lipid profile of UC patients during the remission phase. To conduct this parallel, randomized controlled trial study, 80 UC patients were recruited and allocated randomly to an intervention or a control group. Participants were provided dietary guidelines in the form of an educational booklet and a dedicated diet that was recommended for use for 12 weeks. The DMP consisted of recommendations that participants eat often and little (4-6 times per day), consume foods at a balanced temperature, decrease consumption of spicy foods, decrease excess intake of fat, decrease simple carbohydrates and drink adequate fluids. Moreover, increase goodquality protein and eliminate dairy products in the presence of lactose intolerance. Furthermore, it included avoidance of margarine, limiting alcohol, caffeine, and commercially prepared foods such as fast foods, ready meals, and canned foods. Baseline and post-intervention measurements of primary and secondary outcomes were recorded for final analysis. Overall, 76 patients completed the study. The participants in the DMP group consumed higher amounts of protein, zinc, vitamin C, and D and lower amounts of dietary energy, carbohydrate, saturated fat, sodium, and lactose compared to the control group (all P values <.05). Recommendations to follow the DMP resulted in a significant improvement of fatigue and mental health (depression, anxiety, and stress) in the intervention group compared with usual recommendations and a significant increase in some aspects of quality of life, including bodily pain and general health (all P values <.05). No significant changes were found in fasting blood glucose and lipid profile (all P values >.05). The study suggests that there is likely to be a link between the provided dietary advice with physical and mental improvements. The effect of diet does not arise through the elimination or the addition of specific nutrients; rather, each food syndicate many nutrients that let for a synergistic or an antagonistic action when present in a certain composition.