Unveiling the Culinary Connection: How Diet Shapes the Landscape of IBD

Photo Credit: Champpixs

Several studies were presented at Crohn’s & Colitis Congress 2024, covering the impacts on IBD of malnutrition, dietary supplements, and various diets. 

Here, we summarize several studies presented at Crohn’s & Colitis Congress 2024 that focused on diet and IBD.

Supplements Can Shorten Length of Stay for Patients With IBD Undergoing Surgery

Malnutrition is prevalent in inflammatory bowel disease (IBD) and worsens outcomes, such as prolonged hospital stays, increased readmission rates, and higher postoperative complications. For a study, Stacey Collins and colleagues investigated the impact of malnutrition and perioperative nutrition supplementation on surgical outcomes for patients with IBD undergoing a prehabilitation program. The retrospective study involved patients with IBD aged 18-80 undergoing surgery after participating in a 10-week prehabilitation program. Patients received nutrition counseling and oral nutrition supplements (ONS) prior to surgery. Results showed that malnutrition—though not significantly associated with severe complications, longer hospital stays, or increased opioid use—was prevalent among 40% of patients. However, higher consumption of ONS, particularly for carbohydrate loading and immunonutrition, was linked to shorter hospital stays. The findings suggest that ONS supplementation, particularly before and after surgery, may help reduce hospital stays for patients with IBD undergoing surgery. Further research with larger sample sizes is recommended to better understand the role of malnutrition and ONS in surgical outcomes for this patient population. 

Micronutrient Deficiency High in Older Adults With Ulcerative Colitis

For a study, Zoe Memel and colleagues aimed to assess malnutrition and micronutrient deficiencies in older adults who underwent bowel surgery for ulcerative colitis (UC), a population with limited existing data. Conducted at a single center, the retrospective study included patients with UC aged 65 and older. Malnutrition was defined by the European Society for Clinical Nutrition and Metabolism (ESPEN), and micronutrient deficiencies were assessed along with nutrition-related outcomes. Results from 88 patients with an average age of 74.7 revealed low malnutrition prevalence (8%) but high incidence of at least one micronutrient deficiency (74%), notably vitamin D (42%) and iron (32%) deficiencies. Bone-related diseases affected one-third of patients. Despite lacking statistical significance, likely due to the study’s small size, findings highlight the importance of monitoring older patients with UC post-bowel surgery for potential micronutrient deficiencies, necessitating regular lab assessments to prevent nutrition-related complications. 

Low-Residue Diet Helpful But Restrictive

Jingzhou Wang and colleagues conducted a study to explore the practice and perception of low-residue diet recommendations among patients with inflammatory bowel disease (IBD) within a large US academic medical system. A survey was distributed electronically between August and October 2023 to adult patients with established IBD diagnoses. Among 132 respondents (59 with Crohn’s disease, 68 with ulcerative colitis, five with IBD-unclassified) with a median age of 54 and a median disease duration of 15 years, 36% reported current or past adherence to a low-residue diet. While some respondents (up to 65%) perceived benefits, such as reduced abdominal pain and bloating, the majority (90% to 96%) reported significant limitations on enjoying food and maintaining a healthy diet due to the diet’s restrictions. Although 67% were advised by healthcare providers to follow the diet, few were instructed not to continue it indefinitely. These findings highlight a need for better education among healthcare professionals to appropriately assess the indication for low-residue diets in patients with IBD, mitigating their adverse impact on quality of life while ensuring their potential benefits are maximized. 

Dietary Approaches Require Tailoring for Patients With IBD

A review completed by Rebekah Preston and colleagues examined how different dietary interventions impact the quality of life (QOL) of adults with inflammatory bowel disease (IBD), acknowledging the detrimental effects of IBD symptoms on QOL and the potential for dietary changes to alleviate them. Thirteen studies were analyzed, investigating various dietary patterns, including the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet, Immunoglobulin G (IgG) diet, Autoimmune Protocol Diet (AIP), Mediterranean diet, and high fiber diet. QOL was measured using validated questionnaires, revealing inconsistent results across studies. While significant QOL improvements were noted with AIP, Dietary Modified Program (DMP), Mediterranean, and high-fiber diets, findings varied for low FODMAP and IgG diets. Notably, the Dietary Modified Framework (DMF) did not significantly enhance QOL. Limitations, such as small sample sizes, lack of diversity among participants, and short study durations, were observed, emphasizing the necessity for larger, more diverse studies with longer follow-up periods. Despite the complexity of implementing dietary changes, the involvement of registered dietitians is crucial for tailoring dietary interventions to meet individual needs and lifestyle preferences of adults with IBD, according to the authors. Further research is warranted to explore the long-term effects and optimal dietary strategies for enhancing QOL in this population, they added. 

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