The Increasing Weight of Crohnʼs Disease Subjects in Clinical Trials

Moran, Gordon W; Dubeau, Marie-France; Kaplan, Gilaad G.; Panaccione, Remo; Ghosh, Subrata

doi:10.1097/mib.0b013e31829936a4

Cited by 84 publications

(69 citation statements)

References 55 publications

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“…Whereas the prevalence of malnutrition and underweight has decreased over the past years [30], patients with IBD are more often overweight or obese now, probably as a result of improved therapeutic options and prolonged remission status [31,32]. Our study data confirmed this trend.…”

Section: Discussionsupporting

confidence: 80%

“…According to the BMI-classification of the World Health Organization (WHO), a BMI less than 18.5 kg/m² was considered as underweight, between 18.5 kg/m² to 25.0 kg/m² as normal weight, between 25.0 kg/ m² to 30.0 kg/m² as overweight (pre-obese) and over 30.0 kg/m² as obese [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45].…”

Section: Nutritional Statusmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 80%

Section: Nutritional Statusmentioning

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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“…2, Table 3). The largest study to date in a treatment-naïve cohort of paediatric patients with CD [61], in whom analysis of mucusol and lumen-associated microbiota was performed, confirms that inflammation 17 % of patients with CD in an Irish cohort were obese compared with 12 % of controls [47] Increased weight of patients with CD enrolling in clinical trials (1991-2008) [48] 23 % of paediatric patients with IBD in the USA were found to be overweight or obese [49] Decreased rate of surgery Cumulative probability of first major surgery at 9 years decreased from 50 % (1979-1986) to 23 % (2003-2011) in patients with CD, and from 14 to 9 % in patients with UC [50] Decreased risk of surgery in patients in whom CD was diagnosed after 1996, associated with increased specialist care [51] Increasing prevalence of elderly-onset IBD Increased proportion of colonic disease and inflammatory behaviour in elderly patients with CD [52,53] Progression of disease behaviour less than in younger patients. Milder disease course [52] BMI body mass index, CD Crohn's disease, UC ulcerative colitis J Gastroenterol (2015) 50:495-507 499 is strongly associated with an overall drop in species diversity and alterations in the abundance of several taxa.…”

Section: Microbiota Studies In Patients With Ibdmentioning

confidence: 88%

“…In that study there were significantly more obese patients with CD than with UC [46]. There has been an increase in weight and disease activity in patients with CD enrolling in clinical trials in the last 20 years [48].…”

Section: The Changing Phenotype Of Ibdmentioning

confidence: 92%

The microbiota in inflammatory bowel disease

2015

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This review explores our current understanding of the complex interaction between environmental risk factors, genetic traits and the development of inflammatory bowel disease. The primacy of environmental risk factors is illustrated by the rapid increase in the incidence of the disease worldwide. We discuss how the gut microbiota is the proximate environmental risk factor for subsequent development of inflammatory bowel disease. The evolving fields of virome and mycobiome studies will further our understanding of the full potential of the gut microbiota in disease pathogenesis. Manipulating the gut microbiota is a promising therapeutic avenue.

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“…What is known is that obesity is being observed more frequently in IBD outpatient clinics (1,6) . This emphasizes the alarm lead by this important paper by Back et al, that demonstrated important rates of overweight and obese patients in an IBD cohort, defined with strict and detailed technical measurements.…”

Section: Dear Sirmentioning

confidence: 99%