Dietary Patterns and Self-Reported Associations of Diet with Symptoms of Inflammatory Bowel Disease
There are insufficient data to make firm dietary recommendations for patients with inflammatory bowel disease (IBD). Yet patients frequently report that specific food items influence their symptoms. In this study, we describe patients’ perceptions about the benefits and harms of selected foods and patients’ dietary patterns.
CCFA Partners is an ongoing internet-based cohort study of patients with IBD. We used a semi-quantitative food frequency questionnaire to measure dietary consumption patterns and open-ended questions to elicit responses from patients about food items they believe ameliorate or exacerbate IBD. We categorized patients into four mutually exclusive disease categories: CD without an ostomy or pouch (CD), UC without an ostomy or pouch (UC), CD with an ostomy (CD-ostomy), and UC with a pouch (UC-pouch).
Yogurt, rice, and bananas were more frequently reported to improve symptoms whereas non-leafy vegetables, spicy foods, fruit, nuts, leafy vegetables, fried foods, milk, red meat, soda, popcorn, dairy, alcohol, high-fiber foods, corn, fatty foods, seeds, coffee, and beans were more frequently reported to worsen symptoms. Compared to CD patients, CD-ostomy patients reported significantly greater consumption of cheese (odds ratio [OR] 1.56, 95 % CI 1.03–2.36), sweetened beverages (OR 2.14, 95 % CI 1.02–1.03), milk (OR 1.84, 95 % CI 1.35–2.52), pizza (OR 1.57, 95 % CI 1.12–2.20), and processed meats (OR 1.40; 95 % CI 1.04–1.89).
Patients identified foods that they believe worsen symptoms and restricted their diet. Patients with ostomies ate a more liberal diet. Prospective studies are needed to determine whether diet influences disease course.
KeywordsInflammatory bowel disease Crohn’s disease Ulcerative colitis Diet
This work was supported by a grant from the Crohn’s and Colitis Foundation of America for development of the CCFA Partners cohort (RSS) and in part by a Career Development Award from the Crohn’s and Colitis Foundation of America (MDL) and grants from the National Institutes of Health: K08 DK088957 (MDK), K24 DK DK078228 (JDL), and T32-DK007740 (DL).
Conflict of interest
- 1.Hwang C, Ross V, Mahadevan U. Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm Bowel Dis. 2012. doi: 10.1002/ibd.22906. [Epub ahead of print]
- 14.Long MD, Kappelman MD, Martin CF, et al. Development of an internet-based cohort of patients with inflammatory bowel diseases (CCFA Partners): methodology and initial results. Inflamm Bowel Dis. 2012. doi: 10.1002/ibd.22895.
- 21.Zallot C, Quilliot D, Chevaux JB, et al. Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm Bowel Dis. 2012. doi: 10.1002/ibd.22965. [Epub ahead of print]