Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe — An ECCO-EpiCom study

Burisch, Johan; Pedersen, Niels Wisbech; Cukovic-Cavka, S.; Turk, Nikša; Kaimakliotis, Ioannis; Ďuricová, Dana; Bortlík, Martin; Shonová, Olga; Vind, Ida; Avnstrøm, Søren; Thorsgaard, Niels; Krabbe, S.; Andersen, Vibeke; Dahlerup, Jens Frederik; Kjeldsen, Jens; Salupere, Riina; Olsen, John O.; Nielsen, K R; Manninen, Pia; Collin, Pekka; Katsanos, K.; Tsianos, E.V.; Ladefoged, Karin; Lakatos, László; Ragnarsson, Gunnar B.; Bjõrnsson, Einar; Bailey, Yvonne; O’Moráin, Colm; Schwartz, David; Odes, Selwyn; Giannotta, Martina; Girardin, Giulia; Kiudelis, Gediminas; Kupčinskas, Limas; Turcan, Svetlana; Barros, Luísa Leite; Magro, Fernando; Lazăr, Daniela; Goldiş, Adrian; Nikulina, Inna; Belousova, Elena; Martı́nez-Ares, David; Hernández, Vicent; Almér, Sven; Zhulina, Yaroslava; Halfvarson, Jonas; Arebi, Naila; Tsai, Her Hsin; Scheer, Sebastian; Lakatos, P. L.; Langholz, Ebbe; Munkholm, Pia

doi:10.1016/j.crohns.2013.11.021

Cited by 86 publications

(54 citation statements)

References 50 publications

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“…Particularly the consumption of sugary foods is suspected to be increased [18,19]. However, intake of other food components such as fat and protein and fast foods also seem to influence the onset and course of IBD [20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Schink¹,

Mirsch²,

Dieterich³

et al. 2017

J Nutr Food Sci

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Patients with inflammatory bowel diseases (IBD) are often affected by nutrient deficiencies. Besides a limited nutrient intake by disease-related side effects and malabsorption, the influence of diets and dietary changes is much discussed. However, data about food patterns are mostly based on subjective declarations. Therefore, this study aimed to achieve a detailed and objective analysis of nutrient intake and individual food habits in IBD, a prerequisite for an appropriate nutritional intervention in risk patients. One hundred IBD patients (n=70 Crohn's disease (CD), n=30 ulcerative colitis (UC)) and 30 healthy controls (HC) were included in the study. All participants filled in a disease-related and food frequency questionnaire. Fifteen healthy controls and 71 IBD patients additionally completed a questionnaire for self-imposed food restrictions. Most IBD patients and healthy controls showed a normal body mass index. However, within the IBD group, UC patients were more often overweight than CD patients (p=0.007). Food restrictions were common in all participants, but significantly more IBD patients restricted their consumption of fast food (p=0.037), fruits and vegetables (p=0.019). Especially CD patients with acute relapse consumed less fruits and vegetables (p=0.035). Contrary to subjective assessment, an objective survey of dietary intake revealed a significantly higher sugar intake of IBD patients compared to healthy controls (p<0.001) with an increased ingestion of sugar/confectionery (p=0.041), soft/isotonic drinks (p<0.001) and fruit/vegetable juices (p=0.022). Additionally, IBD patients ingested higher amounts of salt than healthy controls (p=0.005). Both groups showed an insufficient ingestion of folate, vitamin D and pantothenic acid.In conclusion, self-managed food restrictions appear to be common in IBD patients. The huge discrepancy between the subjective view of dietary habits and objective evaluation of nutrient intake indicates that nutrient assessment should be based on objective tools. A repetitive professional nutritional counseling is recommended to prevent and treat nutritional deficiencies.

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Section: Introductionmentioning

confidence: 99%

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Schink¹,

Mirsch²,

Dieterich³

et al. 2017

J Nutr Food Sci

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show abstract

“…Ayrıca, ül-seratif kolit hastaları için gerekebilecek bir cerrahi operasyonun zamanını daha öne çektiği vurgulanmıştır. 15 Basit şekerin yüksek miktarlarda alımının hastalığın gelişimini artırdığı bildirilmektedir. 16 Özellikle basit karbonhidratlardan zengin kolalı içeceklerin ve çikolata tüketiminin hastalık riskini artırdığı bildirilmektedir.…”

Section: Tibbi̇ Beslenme Tedavi̇si̇unclassified

Dietary Approach to Ulcerative Colitis Disease: Up to Date: Review

Ülker¹,

Akbulut²

2017

Turkiye Klinikleri J Intern Med

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“…Methodological differences probably also exist, since incidence rates reported from Hungary, although situated in Eastern Europe, are similar to that of Western countries [3]. Interestingly, dietary risk factors of IBD were found higher among Eastern European patients, which may at least partly explain the rapid increase of the disease in this area in recent decades [4]. The increased occurrence of IBD among immigrants from developing countries to high incidence areas also provides evidence that this difference between industrialized and developing countries is not explained purely by genetics [5].…”

Section: Introductionmentioning

confidence: 98%

“…High intake of sugar was also identified as a risk factor of the development of IBD. Furthermore, regular consumption of fast food was associated with an increased risk [113] and a younger age at diagnosis [4] of both UC and CD. IBD patients, especially those suffering from CD, are clearly convinced of the importance of diet; 70% of them rating it to be as important as medical therapy [114].…”

Section: Dietmentioning

confidence: 99%

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

Molnár¹

2014

J Clin Cell Immunol

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The pathogenesis of inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn's disease (CD) is complex, and our knowledge on the topic is constantly growing. The two disorders are distinct, yet overlap in their clinical manifestations and underlying causes. This review aims to provide a broad overview of the numerous pathogenetic factors that can lead to the development of IBD, focusing on novel findings and on the differences between UC and CD. Recent advances in genetics have identified new components in the pathogenesis, as an example, the importance of Th17 lymphocytes and the IL-17/IL-23 pathway have been highlighted in both diseases, apart from the previously known Th1-Th2 driven processes. Genetic background of increased permeability has been explored in UC, and the role of defective autophagy was recently described in CD. Genetic alterations can lead to an exaggerated immune response to the resident microbial flora. This microflora is altered in IBD patients, probably due to their reduced ability to stabilize its bacterial components and due to different environmental factors. An exhaustive exploration of environmental factors is particularly important, as they can be influential in many cases. The impact of smoking is the most established environmental factor, having deleterious effects in CD and protective in UC. Recent opinions on other factors, such as early appendectomy, diet, reduced vitamin D levels, the use of specific medications, breastfeeding, personal hygiene and psychological factors are also discussed. Epigenetics, a new field of research, links environmental factors to genetics. Understanding these factors is of great significance as changing lifestyles and improving life circumstances have started to increase the prevalence of IBD also in developing countries.

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Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe — An ECCO-EpiCom study

Cited by 86 publications

References 50 publications

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Dietary Approach to Ulcerative Colitis Disease: Up to Date: Review

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

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