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. 2023 Feb;36(1):336-377.
doi: 10.1111/jhn.13054. Epub 2022 Jul 21.

British Dietetic Association consensus guidelines on the nutritional assessment and dietary management of patients with inflammatory bowel disease

Miranda C E Lomer  1   2 , Bridgette Wilson  1   2 , Catherine L Wall  2   3
Affiliations

British Dietetic Association consensus guidelines on the nutritional assessment and dietary management of patients with inflammatory bowel disease

Miranda C E Lomer et al. J Hum Nutr Diet. 2023 Feb.

Abstract

Background: Despite increased awareness of diet and nutrition being integral to the management of patients with inflammatory bowel disease (IBD), there are gaps in the knowledge of IBD healthcare providers regarding nutrition. Furthermore, high quality evidence on nutritional assessment and dietary management of IBD is limited. A Delphi consensus from a panel of experts allows for best-practice guidelines to be developed, especially where high quality evidence is limited. The aim was to develop guidelines for the nutritional assessment and dietary management of IBD using an eDelphi online consensus agreement platform.

Methods: Seventeen research topics related to IBD and nutrition were systematically reviewed. Searches in Cochrane, Embase®, Medline® and Scopus® electronic databases were performed. GRADE was used to develop recommendations. Experts from the IBD community (healthcare professionals and patients with IBD) were invited to vote anonymously on the recommendations in a custom-built online platform. Three rounds of voting were carried out with updated iterations of the recommendations and evaluative text based on feedback from the previous round.

Results: From 23,824 non-duplicated papers, 167 were critically appraised. Fifty-five participants completed three rounds of voting and 14 GRADE statements and 42 practice statements achieved 80% consensus. Comprehensive guidance related to nutrition assessment, nutrition screening and dietary management is provided.

Conclusions: Guidelines on the nutritional assessment and dietary management of IBD have been developed using evidence-based consensus to improve equality of care. The statements and practice statements developed demonstrate the level of agreement and the quality and strength of the guidelines.

Keywords: Crohn's disease; diet; inflammatory bowel disease; nutritional assessment; ulcerative colitis.

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Conflict of interest statement

The authors have no conflicts of interest. All members of the eDelphi Consensus Group signed conflicts of interest forms during the development of these guidelines.

References

    1. Sigall‐Boneh R, Levine A, Lomer M, Wierdsma N, Allan P, Fiorino G, et al. Research gaps in diet and nutrition in inflammatory bowel disease. A topical review by D‐ECCO Working Group [Dietitians of ECCO]. J Crohns Colitis. 2017;11(12):1407–19. - PubMed
    1. Tinsley A, Ehrlich OG, Hwang C, Issokson K, Zapala S, Weaver A, et al. Knowledge, attitudes, and beliefs regarding the role of nutrition in IBD among patients and providers. Inflamm Bowel Dis. 2016;22(10):2474–81. - PubMed
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    1. GRADE Working Group . GRADE handbook for grading quality of evidence and strength of recommendations; 2013. Available from: https://www.gradeworkinggroup.org/

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