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. 2022 May 6;14(9):1945.
doi: 10.3390/nu14091945.

Diet Quality and Dietary Inflammatory Index in Dutch Inflammatory Bowel Disease and Irritable Bowel Syndrome Patients

Marlijne C G de Graaf  1   2 , Corinne E G M Spooren  1   2 , Evelien M B Hendrix  1   2 , Martine A M Hesselink  1   2 , Edith J M Feskens  3 , Agnieszka Smolinska  2   4 , Daniel Keszthelyi  1   2 , Marieke J Pierik  1   2 , Zlatan Mujagic  1   2 , Daisy M A E Jonkers  1   2
Affiliations

Diet Quality and Dietary Inflammatory Index in Dutch Inflammatory Bowel Disease and Irritable Bowel Syndrome Patients

Marlijne C G de Graaf et al. Nutrients. .

Abstract

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) share common culprit foods and potential pathophysiological factors. However, how diet may contribute to disease course and whether this differs between both entities is unclear. We therefore investigated the association of dietary indices with intestinal inflammation and gastrointestinal symptoms in both IBD and IBS patients. Food frequency questionnaires from 238 IBD, 261 IBS and 195 healthy controls (HC) were available to calculate the overall diet quality by the Dutch Healthy Diet-Index 2015 (DHD-2015) and its inflammatory potential by the Adapted Dietary Inflammatory Index (ADII). Intestinal inflammation and symptoms were evaluated by faecal calprotectin and the Gastrointestinal Symptom Rating Scale, respectively. The DHD-2015 was lower in IBD and IBS versus HC (p < 0.001), being associated with calprotectin levels in IBD (b = −4.009, p = 0.006), and with abdominal pain (b = −0.012, p = 0.023) and reflux syndrome (b = −0.016, p = 0.004) in IBS. ADII scores were comparable between groups and were only associated with abdominal pain in IBD (b = 0.194, p = 0.004). In this side-by-side comparison, we found a lower diet quality that was differentially associated with disease characteristics in IBD versus IBS patients. Longitudinal studies are needed to further investigate the role of dietary factors in the development of flares and predominant symptoms.

Keywords: Adapted Dietary Inflammatory Index; Dutch Healthy Diet Index 2015; gastrointestinal disease; gastrointestinal symptoms; intestinal inflammation.

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Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. C.E.G.M.S., D.M.A.E.J. and M.J.P. were in part financed by EU grants FP7 SysmedIBD/305564. D.M.A.E.J., M.C.G.d.G. and M.A.M.H. were in part financed by a public–private partnership Grant of Top Knowledge Institute (Well on Wheat). D.M.A.E.J. reports grants from the Dutch Top Institute of Food and Nutrition (TIFN), the Carbokinetics program as part of the NWO-CCC Partnership Program, by Organic A2BV/Mothersfinest BV and EU/FP7 BIOM/305479 and Character/305676, EU/H2020 DISCOvERIE/848228. D.K. was in part supported by grants from the Rome Foundation, Dutch Foundation of Gastroenterology, Grunenthal, Allergan, EU/H2020 DISCOvERIE/848228 and the United Europe Gastroenterology. D.K. and M.J.P. report grants from the Netherlands Organisation for Health Research and Development (ZonMW). M.J.P. reports grants and non-financial support from Falk Pharma, grants from European commission, grants and non-financial support from Takeda, grants and non-financial support from Johnson and Johnson, grants and non-financial support from Abbvie, consulting fees from Galapagos, non-financial support from Ferring, non-financial support from Immunodiagnostics and non-financial support from MSD, all outside the submitted work. Z.M. reports a grant from the Maag Lever Darm Stichting (MLDS). The other authors (A.S., E.J.M.F., E.M.B.H.) declare no conflict of interest.

Figures

Figure A1
Figure A1
Principle coordinate analysis (PCoA) score plot based on food products. IBD = inflammatory bowel disease; IBS = irritable bowel syndrome; HC = healthy controls; PCo = principle coordinate.
Figure A2
Figure A2
Principle coordinate analysis (PCoA) score plot based on nutrients—PCo1 and PCo2. IBD = inflammatory bowel disease; IBS = irritable bowel syndrome; HC = healthy controls; PCo = principle coordinate.
Figure A3
Figure A3
Principle coordinate analysis (PCoA) score plot based on nutrients—PCo4 and PCo7. IBD = inflammatory bowel disease; IBS = irritable bowel syndrome; HC = healthy controls; PCo = principle coordinate. The most important components that cause the distinction between IBS and the rest are visible along PCo4. It is characterised by, among others, a combination of a lower intake of zinc, caloric intake, selenium, vitamin B12, magnesium and iron in IBS compared to IBD and HC.
Figure 1
Figure 1
Dietary indices for inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and healthy controls (HC). (a) Dutch Healthy Diet Index 2015 (DHD-2015), (b) Adapted Dietary Inflammatory Index (ADII). The difference between subgroups was tested with analysis of variance (ANOVA) and post-hoc Bonferroni correction. ns = not significant, *** p < 0.001 and **** p < 0.0001.
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