Zeitschrift für Ernährung und Lebensmittelwissenschaften
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Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Monic Schink, Hannah SM Mirsch, Walburga Dieterich, Raphaela Schwappacher, Raja Atreya, Markus F Neurath and Yurdagül Zopf

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.