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. 2021 Dec 18;15(12):2041-2053.
doi: 10.1093/ecco-jcc/jjab116.

Nutrient, Fibre, and FODMAP Intakes and Food-related Quality of Life in Patients with Inflammatory Bowel Disease, and Their Relationship with Gastrointestinal Symptoms of Differing Aetiologies

Selina R Cox  1 , Hazel Clarke  1 , Majella O'Keeffe  1 , Patrick Dubois  2 , Peter M Irving  3 , James O Lindsay  4 , Kevin Whelan  1
Affiliations

Nutrient, Fibre, and FODMAP Intakes and Food-related Quality of Life in Patients with Inflammatory Bowel Disease, and Their Relationship with Gastrointestinal Symptoms of Differing Aetiologies

Selina R Cox et al. J Crohns Colitis. .

Abstract

Background and aims: Certain foods are reported as gut symptom triggers in inflammatory bowel disease [IBD], and fructans are shown to worsen non-inflammatory symptoms in inactive IBD, which may result in self-imposed dietary restrictions. The aim of this study was to investigate nutrient and FODMAP intakes, and the relationship between gut symptoms and dietary intake, in IBD.

Methods: Nutrient, fibre, and FODMAP intakes were estimated using 7-day food records in patients with active IBD [Active IBD], inactive IBD with non-inflammatory gut symptoms [Inactive IBD-GI], inactive IBD without gut symptoms [Inactive IBD], and healthy controls. Nutrient intakes, numbers of participants achieving national recommendations, and food-related quality of life [FR-QoL] were compared across study groups.

Results: Food diaries were obtained from 232 patients with IBD [65 Active IBD, 86 Inactive IBD-GI, 81 Inactive IBD] and 84 healthy controls. Patients with Active IBD had significantly lower intakes of numerous micronutrients, including iron, folate, and vitamin C, compared with controls. All IBD groups consumed less total fibre [4.5 to 5.8 g/day] than controls [p = 0.001], and total FODMAP and fructan intakes were lower in Active IBD compared with controls. Strikingly, FR-QoL was significantly lower in all IBD groups compared with controls [all p = 0.001].

Conclusions: This study revealed lower intakes of fibre, FODMAPs, and micronutrients, in addition to poorer FR-QoL, in Active IBD and Inactive IBD-GI with gut symptoms compared with healthy controls. Future research should address dietary restrictions responsible for these differences.

Keywords: FR-QoL; Inflammatory bowel disease; diet; food-related quality of life; nutrition.

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Figures

Figure 1.
Figure 1.
Diagram of patient flow through the study.
Figure 2.
Figure 2.
Proportion of participants achieving recommended nutrient intakes across study groups. [A] Proportion of participants achieving recommended macronutrient and mineral intakes. [B] Proportion of participants achieving recommended vitamin intakes. For nutrients marked with an asterisk, the proportion achieving recommendations were significantly different across groups following post-hoc correction.
Figure 3.
Figure 3.
FR-QoL scores across study groups [p = 0.001]. Data presented are mean [SD]. FR-QoL, food-related quality of life; SD, standard deviation,
See this image and copyright information in PMC

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