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; Hazel Clarke; Majella O'Keeffe; Patrick Dubois; Peter M Irving; James O Lindsay; Kevin Whelan

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, Hazel Clarke, Majella O'Keeffe, Patrick Dubois, Peter M Irving, James O Lindsay, Kevin Whelan

Nutritional Sciences

KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST (HEATON)

Research output: Contribution to journal › Article › peer-review

29 Citations (Scopus)

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.

Original language	English
Pages (from-to)	2041-2053
Number of pages	13
Journal	Journal Of Crohns & Colitis
Volume	15
Issue number	12
DOIs	https://doi.org/10.1093/ecco-jcc/jjab116
Publication status	Published - 18 Dec 2021

Keywords

Adult
Case-Control Studies
Chronic Disease
Dietary Fiber
Eating
Female
Humans
Inflammatory Bowel Diseases/diet therapy
Male
Nutrients
Quality of Life
Severity of Illness Index

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10.1093/ecco-jcc/jjab116

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Cox, S. R., Clarke, H., O'Keeffe, M., Dubois, P., Irving, P. M., Lindsay, J. O., & Whelan, K. (2021). 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. Journal Of Crohns & Colitis, 15(12), 2041-2053. https://doi.org/10.1093/ecco-jcc/jjab116

@article{f0fcbaf486f844489040a9df97b86a37,

title = "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",

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 = "Adult, Case-Control Studies, Chronic Disease, Dietary Fiber, Eating, Female, Humans, Inflammatory Bowel Diseases/diet therapy, Male, Nutrients, Quality of Life, Severity of Illness Index",

author = "Cox, {Selina R} and Hazel Clarke and Majella O'Keeffe and Patrick Dubois and Irving, {Peter M} and Lindsay, {James O} and Kevin Whelan",

note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn{\textquoteright}s and Colitis Organisation.",

year = "2021",

month = dec,

day = "18",

doi = "10.1093/ecco-jcc/jjab116",

language = "English",

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Cox, SR , Clarke, H , O'Keeffe, M, Dubois, P, Irving, PM, Lindsay, JO & Whelan, K 2021, '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', Journal Of Crohns & Colitis, vol. 15, no. 12, pp. 2041-2053. https://doi.org/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. / Cox, Selina R ; Clarke, Hazel ; O'Keeffe, Majella et al.
In: Journal Of Crohns & Colitis, Vol. 15, No. 12, 18.12.2021, p. 2041-2053.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

AU - Cox, Selina R

AU - Clarke, Hazel

AU - O'Keeffe, Majella

AU - Dubois, Patrick

AU - Irving, Peter M

AU - Lindsay, James O

AU - Whelan, Kevin

N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.

PY - 2021/12/18

Y1 - 2021/12/18

N2 - 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.

AB - 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.

KW - Adult

KW - Case-Control Studies

KW - Chronic Disease

KW - Dietary Fiber

KW - Eating

KW - Female

KW - Humans

KW - Inflammatory Bowel Diseases/diet therapy

KW - Male

KW - Nutrients

KW - Quality of Life

KW - Severity of Illness Index

U2 - 10.1093/ecco-jcc/jjab116

DO - 10.1093/ecco-jcc/jjab116

M3 - Article

C2 - 34216206

SN - 1873-9946

VL - 15

SP - 2041

EP - 2053

JO - Journal Of Crohns & Colitis

JF - Journal Of Crohns & Colitis

IS - 12

ER -

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

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