Impact of dietary beliefs and practices on patients with inflammatory bowel disease: An observational study from India

Abstract

Background and AimPatients with inflammatory bowel disease (IBD) are at a risk of nutritional deficits because of poor dietary beliefs and practices. There are no data on this aspect from Asia, which is experiencing a rise in IBD incidence. We aimed to establish dietary beliefs and practices in patients of IBD from India.MethodsPatients with ulcerative colitis (UC) and Crohn's disease (CD) followed up between November 2016 and March 2017 were included. A questionnaire extracted information on the patients' sociodemographic, nutritional and disease profile, smoking and drinking habits, dietary beliefs and practices, current dietary preferences, intake and avoidance, dietary changes made after diagnosis of IBD, dietary changes made during relapse, frequency of consumption of major food groups, and the attitudes toward dietary advice.ResultsA total of 316 patients (218 UC and 98 CD; mean age: 38.5 ± 12.2 years) were included. Forty‐four percent patients perceived food as a risk factor for IBD, 52% felt dietary habits to have a more important role than medicines in disease control, 77% reported certain foods improve symptoms during relapse, 86% had modified their diet since the diagnosis of IBD (UC > CD, P = 0.04), 90% imposed food restrictions, and <50% had received dietary counseling. About 40% of patients could not meet their dietary requirements and 66% had decreased their dietary intake since diagnosis, which further decreased during relapse (85%).ConclusionDietary beliefs and practices play a central role in perception of disease in IBD patients. A large majority of them make dietary changes which can lead to undernutrition. Proper dietary counseling is required in these patients to prevent malnutrition.

An assessment of dietary intake, food avoidance and food beliefs in patients with ulcerative colitis of different disease status

“…6,31 Besides, food avoidance may also one of the contributing factors to poorer dietary intake among patients in the active state. [15][16][17] However, in our study, overall we found that most of the "trigger foods" avoided were less than 30%, which are similar with several studies that reported the avoidance of milk products and red meat was 29% and 27%, respectively, 8 whereas avoidance towards oily/ fatty foods and sweetened beverages accounted for 20% and 27%, respectively. 32 Although the data just showed a small percentage of UC patients who avoided the "possible harmful foods," our study found that the practice of food avoidances was more frequent in those with clinically active disease.…”

“…There are however a few studies available on the dietary beliefs and practices among IBD patients. [15][16][17] To the best of our knowledge, this is the first study conducted in Malaysia to assess the nutritional intake of UC patients according to disease states and food avoidance practices. Findings from this study can be used in formulating nutritional guidelines for UC patients in the future.…”

Patient’s Dietary Beliefs and Behaviours in Inflammatory Bowel Disease

“…This new fact prompts IBD patients with a nutritional demand to be supervised and treated by a professional. Tomar et al [22] also concluded that proper dietary counselling is required in these patients to prevent malnutrition. From our results, however, it seems that finding a good diet for IBD patients is combining patient's own experiences (personalized diet) with external advice by a professional.…”

Diet and inflammatory bowel disease: The Asian Working Group guidelines

“…Most patients with IBD are unaware of the importance of diet in the management of IBD. In addition to this, common misperceptions can result in dietary changes leading to undernutrition in patients with IBD [ 105 ]. Nutritional deficiencies are more common in small bowel CD than colonic CD or UC, and therefore, nutritional care is important in the management of patients with IBD and in the prevention and treatment of malnutrition and micronutrient deficiencies and prevention of osteoporosis in adults and promotion of growth and development in children [ 27 , 106 – 109 ].…”

“…A large majority of patients with IBD perceive food as a risk factor and impose dietary restrictions without proper counseling, which results in malnutrition [ 3 , 105 , 117 – 119 ]. However, there is little evidence from interventional studies to support specific dietary restrictions in IBD [ 120 ].…”