Food Elimination Diet and Nutritional Deficiency in Patients with Inflammatory Bowel Disease

Abstract

Certain types of foods are common trigger for bowel symptoms such as abdominal discomfort or pain in patients with inflammatory bowel disease (IBD). But indiscriminate food exclusions from their diet can lead extensive nutritional deficiencies. The aim of this study was to investigate nutritional status, food restriction and nutrient intake status in IBD patients. A total 104 patients (food exclusion group: n = 49; food non-exclusion group: n = 55) participated in the survey. The contents were examined by 3 categories: 1) anthropometric and nutritional status; 2) diet beliefs and food restriction; and 3) nutrient intake. The malnutrition rate was significantly higher in the food exclusion group (p = 0.007) compared to food non-exclusion group. Fifty-nine percent of patients in the food exclusion group held dietary beliefs and reported modifying their intake according to their dietary belief. The most common restricted food was milk, dairy products (32.7%), raw fish (24.5%), deep-spicy foods (22.4%), and ramen (18.4%). The mean daily intake of calcium (p = 0.002), vitamin A (p < 0.001), and zinc (p = 0.001) were significantly lower in the food exclusion group. Considering malnutrition in IBD patients, nutrition education by trained dietitians is necessary for the patients to acquire disease-related knowledge and overall balanced nutrition as part of strategies in treating and preventing nutrition deficiencies.

Inflammatory Bowel Disease: Are Symptoms and Diet Linked?

“…The study was not designed to explore the perceived effects of macronutrients; however, from the other responses received, 8% of participants specified foods with a high fat content, and 5% specified takeaways or deep-fried foods. These findings are in agreement with previous and current studies where patients with IBD have identified fast food [ 35 , 48 ], fatty food [ 15 , 17 , 34 , 36 , 37 ], fried and fatty foods [ 14 ], deep-fried and fatty food [ 16 , 39 ], oily food [ 38 ], and fatty meats [ 58 ] in symptom onset or exacerbation. Furthermore, evaluation of dietary intake changes in over 4200 families in Japan over two decades found positive associations between increasing CD incidence and total fat, animal fat, and omega-6 fatty acids [ 59 ].…”

“…In the current study, a high number of dietary elements were identified with symptom onset and exacerbation, specifically fruit, vegetables and dairy products. These results suggest that self-imposed dietary restrictions could contribute to the high rates of malnutrition seen in the IBD population, a concept recently reported by Lim, Kim, and Hong [ 58 ]. Health providers may be unaware of the extent of patient views regarding diet and symptoms and should be encouraged to offer their patients nutritional counselling not only soon after diagnosis but also when attempts to suppress ongoing disease activity are ineffective.…”

“…Unlike most studies, the perceived effects of coffee and tea were investigated individually, where coffee was frequently associated with symptom onset and exacerbation, and black tea was well tolerated. Generally, tea and coffee appear to be problematic as evidenced by their association with increased risk of relapse [ 15 ], negative effects on symptoms [ 48 ], significantly reduced consumption in CD patients experiencing active disease [ 60 ], and overall avoidance [ 16 , 58 ]. However, taking into account de Vries et al’s [ 32 ] observation that tea is the second most symptom improving food among 294 patients with IBD, and the findings of the present study, coffee and tea should be considered separately when investigating their purported effects on IBD symptoms.…”

Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

“…One of the major manifestations of IBD is food intolerance, which may also be one of the causes of the disease. In our survey, the common poorly tolerated foods among IBD patients were dairy products, fried food, spicy food and cold food, similar to the results of a Korean study. However, the positive percentage of food intolerance in IBD patients (52.4%) in our study was lower than in a report from Spain, which found that 77% of patients avoided some foods to prevent disease relapse.…”

Diets, functional foods, and nutraceuticals as alternative therapies for inflammatory bowel disease: Present status and future trends

“…Recent research evidence suggests that the supplementation of fruits and vegetables, probiotic bacteria, dietary fibers, and fat-soluble vitamins can substantially reduce the symptoms of IBD through their anti-inflammatory functions[ 7 - 11 ]. In contrast, as the high-fat and high-carbohydrate foods are supposedly involved in the etiology of IBD, eliminating these foods from the diet could be an essential tool in the management of IBD[ 12 ]. Bioactive natural compounds and functional foods have been a major focus of research throughout the last decade as potential therapies for IBD, and many research groups have demonstrated positive and outstanding results.…”