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The association between dietary patterns and disease severity in patients with ulcerative colitis

Published online by Cambridge University Press:  02 February 2024

Mohammad Reza Amini Open the ORCID record for Mohammad Reza Amini [Opens in a new window] ,
Zeinab Khademi Open the ORCID record for Zeinab Khademi [Opens in a new window] ,
Marieh Salavatizadeh ,
Niloufar Rasaei ,
Nasser Ebrahimi-Daryani ,
Ahmad Esmaillzadeh  and
Azita Hekmatdoost Open the ORCID record for Azita Hekmatdoost [Opens in a new window]
Mohammad Reza Amini
Affiliation:
Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Clinical Nutrition & Dietetics, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Zeinab Khademi
Affiliation:
Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran
Marieh Salavatizadeh
Affiliation:
Department of Clinical Nutrition & Dietetics, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Niloufar Rasaei
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
Nasser Ebrahimi-Daryani
Affiliation:
Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran, Iran
Ahmad Esmaillzadeh
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular – Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Azita Hekmatdoost*
Affiliation:
Department of Clinical Nutrition & Dietetics, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
*Corresponding author: Azita Hekmatdoost, email a_hekmat2000@yahoo.com
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Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease involving the colon and rectum. One of the most modifiable environmental factors affecting UC severity is the patient’s dietary pattern. Although the role of dietary patterns on UC aetiology has been investigated previously, its relationship with disease severity has not yet been elucidated. This study examined the association between UC patients’ dietary patterns and disease severity. This cross-sectional study was conducted in 340 UC patients. Using an FFQ, food patterns were assessed. Twenty-five food categories were categorised based on the similarity of the nutrient composition of the food using the factor analysis method. A simple clinical colitis activity index was used to determine disease severity. Three dietary patterns were identified based on the factor analysis: healthy, unhealthy and Western dietary pattern. After adjusting for potential confounding factors, patients who were in the highest tertile of healthy dietary pattern compared with the lowest tertile were 92 % less likely to have severe UC (OR: 0·08; 95 % CI: 0·03, 0·22). Also, those in the highest tertile of the Western dietary pattern were 3·86 times more likely to have severe UC than those in the lowest tertile (OR: 3·86; 95 % CI: 1·86, 8·00). Even after controlling for confounding variables, unhealthy dietary pattern did not increase the risk of severe UC. Our data indicate the beneficial role of healthy dietary pattern in amelioration of disease severity in UC patients. To confirm this association, more studies are needed, especially prospective cohort studies.

Keywords

Dietary patternsDisease severityUlcerative colitisPrincipal component analysis
Type
Research Article
Information
British Journal of Nutrition , Volume 131 , Issue 10 , 28 May 2024 , pp. 1803 - 1812
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Satsangi, J, Silverberg, M, Vermeire, S, et al. (2006) The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 55, 749–753.CrossRefGoogle ScholarPubMed
Yamamoto-Furusho, JK (2007) Genetic factors associated with the development of inflammatory bowel disease. World J Gastroenterol: WJG 13, 5594.CrossRefGoogle ScholarPubMed
Peyrin-Biroulet, L, Panés, J, Sandborn, WJ, et al. (2016) Defining disease severity in inflammatory bowel diseases: current and future directions. Clin Gastroenterol Hepatol 14, 348–354.e17.CrossRefGoogle ScholarPubMed
Sung, M-K & Park, M-Y (2013) Nutritional modulators of ulcerative colitis: clinical efficacies and mechanistic view. World J Gastroenterol: WJG 19, 994.CrossRefGoogle ScholarPubMed
Ng, SC, Shi, HY, Hamidi, N, et al. (2017) Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 390, 2769–2778.CrossRefGoogle ScholarPubMed
Xu, J, Chen, X, Ma, K, et al. (2021) Correlation between sleep, life, mood, and diet and severity of inflammatory bowel disease in China: a retrospective study. Med Sci Monit: Int Med J Exp Clin Res 27, e930511–1.CrossRefGoogle Scholar
Rashvand, S, Behrooz, M, Samsamikor, M, et al. (2018) Dietary patterns and risk of ulcerative colitis: a case–control study. J Hum Nutr Diet 31, 408–412.CrossRefGoogle ScholarPubMed
David, LA, Maurice, CF, Carmody, RN, et al. (2014) Diet rapidly and reproducibly alters the human gut microbiome. Nature 505, 559–563.CrossRefGoogle ScholarPubMed
Bueno-Hernández, N, Núñez-Aldana, M, Ascaño-Gutierrez, I, et al. (2015) Evaluation of diet pattern related to the symptoms of Mexican patients with Ulcerative Colitis (UC): through the validity of a questionnaire. Nutr J 14, 1–8.CrossRefGoogle Scholar
Karimi, S, Tabataba-Vakili, S, Yari, Z, et al. (2019) The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status. Nutr J 18, 1–8.CrossRefGoogle ScholarPubMed
Rahmani, J, Kord-Varkaneh, H, Hekmatdoost, A, et al. (2019) Body mass index and risk of inflammatory bowel disease: a systematic review and dose-response meta-analysis of cohort studies of over a million participants. Obes Rev 20, 1312–1320.CrossRefGoogle Scholar
Durchschein, F, Petritsch, W & Hammer, HF (2016) Diet therapy for inflammatory bowel diseases: the established and the new. World J Gastroenterol 22, 2179.CrossRefGoogle ScholarPubMed
Racine, A, Carbonnel, F, Chan, SS, et al. (2016) Dietary patterns and risk of inflammatory bowel disease in Europe: results from the EPIC study. Inflamm Bowel Dis 22, 345–354.CrossRefGoogle ScholarPubMed
Chiba, M, Nakane, K & Komatsu, M (2019) Westernized diet is the most ubiquitous environmental factor in inflammatory bowel disease. Permanente J 23, 18–107.CrossRefGoogle ScholarPubMed
Rizzello, F, Spisni, E, Giovanardi, E, et al. (2019) Implications of the westernized diet in the onset and progression of IBD. Nutrients 11, 1033.CrossRefGoogle ScholarPubMed
Cox, SR, Lindsay, JO, Fromentin, S, et al. (2020) Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial. Gastroenterology 158, 176–188.e7.CrossRefGoogle Scholar
Cohen, AB, Lee, D, Long, MD, et al. (2013) Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease. Dig Dis Sci 58, 1322–1328.CrossRefGoogle ScholarPubMed
Limketkai, BN, Iheozor-Ejiofor, Z, Gjuladin-Hellon, T, et al. (2019) Dietary interventions for induction and maintenance of remission in inflammatory bowel disease. The Cochrane Database of Systemtic Reviews, issue 2, CD012839.CrossRefGoogle ScholarPubMed
Walmsley, RS, Ayres, RC, Pounder, RE, et al. (1998) A simple clinical colitis activity index. Gut 43, 29–32.CrossRefGoogle ScholarPubMed
Mirmiran, P, Esfahani, FH, Mehrabi, Y, et al. (2010) Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 13, 654–662.CrossRefGoogle ScholarPubMed
Ghaffarpour, M, Houshiar-Rad, A & Kianfar, H (1999) The manual for household measures, cooking yields factors and edible portion of foods. Tehran: Nashre Olume Keshavarzy 7, 42–58.Google Scholar
Azar, M & Sarkisian, E (1980) Food Composition Table of Iran. Tehran: National Nutrition and Food Research Institute, Shaheed Beheshti University. pp. 65.Google Scholar
Moszak, M, Szulińska, M & Bogdański, P (2020) You are what you eat—the relationship between diet, microbiota, and metabolic disorders—a review. Nutrients 12, 1096.CrossRefGoogle ScholarPubMed
Moghaddam, MB, Aghdam, FB, Jafarabadi, MA, et al. (2012) The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J 18, 1073–1080.Google Scholar
Forde, C (2018) Scoring the International Physical Activity Questionnaire (IPAQ). Dublin: University of Dublin. pp. 3.Google Scholar
Hu, FB, Rimm, E, Smith-Warner, SA, et al. (1999) Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 69, 243–249.CrossRefGoogle ScholarPubMed
Bueno-Hernández, N, Núñez-Aldana, M, Ascaño-Gutierrez, I, et al. (2015) Evaluation of diet pattern related to the symptoms of mexican patients with Ulcerative Colitis (UC): through the validity of a questionnaire. Nutr J 14, 25.CrossRefGoogle Scholar
Jowett, SL, Seal, CJ, Pearce, MS, et al. (2004) Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study. Gut 53, 1479–1484.CrossRefGoogle ScholarPubMed
Limdi, JK, Aggarwal, D & McLaughlin, JT (2016) Dietary practices and beliefs in patients with inflammatory bowel disease. Inflamm Bowel Dis 22, 164–170.CrossRefGoogle ScholarPubMed
Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 3–9.CrossRefGoogle ScholarPubMed
Jacques, PF & Tucker, KL (2001) Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr 73, 1–2.CrossRefGoogle ScholarPubMed
Eslamian, G, Amirjannati, N, Rashidkhani, B, et al. (2017) Nutrient patterns and asthenozoospermia: a case–control study. Andrologia 49, e12624.CrossRefGoogle ScholarPubMed
Eslamian, G, Amirjannati, N, Rashidkhani, B, et al. (2016) Adherence to the western pattern is potentially an unfavorable indicator of Asthenozoospermia risk: a case-control study. J Am Coll Nutr 35, 50–58.CrossRefGoogle Scholar
Zallot, C, Quilliot, D, Chevaux, JB, et al. (2013) Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm Bowel Dis 19, 66–72.CrossRefGoogle ScholarPubMed
Crooks, B, McLaughlin, J, Matsuoka, K, et al. (2021) The dietary practices and beliefs of people living with inactive ulcerative colitis. Eur J Gastroenterol Hepatol 33, 372–379.CrossRefGoogle ScholarPubMed
Lambert, K, Pappas, D, Miglioretto, C, et al. (2021) Systematic review with meta-analysis: dietary intake in adults with inflammatory bowel disease. Aliment Pharmacol Ther 54, 742–754.CrossRefGoogle ScholarPubMed
Bodirsky, BL, Dietrich, JP, Martinelli, E, et al. (2020) The ongoing nutrition transition thwarts long-term targets for food security, public health and environmental protection. Sci Rep 10, 19778.CrossRefGoogle ScholarPubMed
Esmaillzadeh, A & Azadbakht, L (2008) Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr 138, 358–363.CrossRefGoogle ScholarPubMed
Oikonomou, E, Psaltopoulou, T, Georgiopoulos, G, et al. (2018) Western dietary pattern is associated with severe coronary artery disease. Angiology 69, 339–346.CrossRefGoogle ScholarPubMed
Drake, I, Sonestedt, E, Ericson, U, et al. (2018) A western dietary pattern is prospectively associated with cardio-metabolic traits and incidence of the metabolic syndrome. Br J Nutr 119, 1168–1176.CrossRefGoogle ScholarPubMed
Limketkai, BN, Hamideh, M, Shah, R, et al. (2022) Dietary patterns and their association with symptoms activity in inflammatory bowel diseases. Inflamm Bowel Dis 28, 1627–1636.CrossRefGoogle ScholarPubMed
Peters, V, Spooren, C, Pierik, MJ, et al. (2021) Dietary intake pattern is associated with occurrence of flares in IBD patients. J Crohns Colitis 15, 1305–1315.CrossRefGoogle ScholarPubMed
Feng, J, Chen, Y, Liu, Y, et al. (2023) Efficacy and safety of fecal microbiota transplantation in the treatment of ulcerative colitis: a systematic review and meta-analysis. Sci Rep 13, 14494.CrossRefGoogle ScholarPubMed
Keshteli, AH, Valcheva, R, Nickurak, C, et al. (2022) Anti-inflammatory diet prevents subclinical colonic inflammation and alters metabolomic profile of ulcerative colitis patients in clinical remission. Nutrients (Internet) 14, 3294.CrossRefGoogle ScholarPubMed
Rapozo, DC, Bernardazzi, C & de Souza, HS (2017) Diet and microbiota in inflammatory bowel disease: the gut in disharmony. World J Gastroenterol 23, 2124–2140.CrossRefGoogle ScholarPubMed
Rogler, G, Biedermann, L & Scharl, M (2018) New insights into the pathophysiology of inflammatory bowel disease: microbiota, epigenetics and common signalling pathways. Swiss Med Wkly 148, w14599.Google ScholarPubMed
Minihane, AM, Vinoy, S, Russell, WR, et al. (2015) Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr 114, 999–1012.CrossRefGoogle ScholarPubMed
Nikkhah-Bodaghi, M, Darabi, Z, Agah, S, et al. (2019) The effects of Nigella sativa on quality of life, disease activity index, and some of inflammatory and oxidative stress factors in patients with ulcerative colitis. Phytother Res 33, 1027–1032.CrossRefGoogle ScholarPubMed
Murtagh, A, Cooney, L, Higginbotham, C, et al. (2023) Dietary practices, beliefs, behaviours of adults with inflammatory bowel disease: a cross-sectional study. Irish J Med Sci (1971) 192, 1115–1124.CrossRefGoogle Scholar
Balestrieri, P, Ribolsi, M, Guarino, MPL, et al. (2020) Nutritional aspects in inflammatory bowel diseases. Nutrients 12, 372.CrossRefGoogle ScholarPubMed
Scaldaferri, F, Pizzoferrato, M, Lopetuso, LR, et al. (2017) Nutrition and IBD: malnutrition and/or Sarcopenia? A practical guide. Gastroenterol Res Pract 2017, 8646495.CrossRefGoogle ScholarPubMed
Takaoka, A, Sasaki, M, Nakanishi, N, et al. (2018) Nutritional screening and clinical outcome in hospitalized patients with Crohn’s disease. Ann Nutr Metab 71, 266–272.CrossRefGoogle Scholar
Jansen, I, Prager, M, Valentini, L, et al. (2016) Inflammation-driven malnutrition: a new screening tool predicts outcome in Crohn’s disease. Br J Nutr 116, 1061–1067.CrossRefGoogle ScholarPubMed
Martínez, ME, Marshall, JR & Sechrest, L (1998) Invited commentary: factor analysis and the search for objectivity. Am J Epidemiol 148, 17–19.CrossRefGoogle ScholarPubMed
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