Principi Mariabeatrice, Losurdo Giuseppe, Iannone Andrea, Contaldo Antonella, Deflorio Valentina, Ranaldo Nunzio, Pisani Antonio, Ierardi Enzo, Di Leo Alfredo, Barone Michele
Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Italy.
Ann Gastroenterol. 2018 Jul-Aug;31(4):469-473. doi: 10.20524/aog.2018.0273. Epub 2018 May 7.
Although patients with active inflammatory bowel disease (IBD) change their dietary habits according to suggestions from their healthcare team, no restriction is required in the remission phase. Accordingly, we compared eating patterns in IBD patients with drug-induced clinical remission with those in healthy subjects.
A total of 150 IBD patients, 84 with Crohn's disease (CD) and 66 with ulcerative colitis (UC), in clinical remission, receiving immunomodulator/biologic therapy, and 100 healthy volunteers (controls) were enrolled. The IBD diagnosis had previously been established by a combined assessment of symptoms, endoscopy, histology and abdominal imaging. Clinical remission was defined as a Harvey Bradshaw index <5 for CD and a partial Mayo score <2 for UC. An experienced nutritionist guided the compilation of a food diary for 7 days according to current guidelines. Macronutrient and fiber intake was evaluated using dedicated software. Comparison between continuous variables was performed using Student's -test or analysis of variance plus Bonferroni analysis. Categorical variables were tested with the χ test.
No difference in protein and carbohydrate intake was observed. IBD patients ate more calories (1970.7±348.4 vs. 1882.1±280.2 kcal/day, P=0.03), more lipids (68.9±15.2 vs. 59.4±19.0 g/day, P<0.001) and less fibers (11.9±4.7 vs. 15.5±8.3 g/day, P<0.001) than controls. No significant difference in total calories, proteins, lipids, carbohydrates or fibers was seen between CD and UC patients.
IBD patients have a different macronutrient and fiber intake compared to healthy subjects, even when clinical remission and no symptoms do not dictate dietary restrictions. Therefore, psychological issues may be involved.
尽管活动性炎症性肠病（IBD）患者会根据医疗团队的建议改变饮食习惯，但在缓解期无需进行饮食限制。因此，我们比较了药物诱导临床缓解的IBD患者与健康受试者的饮食模式。
共纳入150例处于临床缓解期、接受免疫调节剂/生物治疗的IBD患者，其中84例为克罗恩病（CD）患者，66例为溃疡性结肠炎（UC）患者，以及100名健康志愿者（对照组）。IBD诊断先前已通过症状、内镜检查、组织学和腹部影像学的综合评估确定。临床缓解定义为CD患者的哈维·布拉德肖指数<5，UC患者的梅奥部分评分<2。一名经验丰富的营养师根据现行指南指导编制了一份为期7天的食物日记。使用专用软件评估常量营养素和纤维摄入量。连续变量之间的比较采用学生t检验或方差分析加邦费罗尼分析。分类变量用χ检验。
未观察到蛋白质和碳水化合物摄入量的差异。与对照组相比，IBD患者摄入的热量更多（1970.7±348.4 vs. 1882.1±280.2千卡/天，P = 0.03），脂肪更多（68.9±15.2 vs. 59.4±19.0克/天，P<0.001），纤维更少（11.9±4.7 vs. 15.5±8.3克/天，P<0.001）。CD患者和UC患者之间在总热量、蛋白质、脂肪、碳水化合物或纤维方面未观察到显著差异。
即使临床缓解且无症状表明无需饮食限制，IBD患者与健康受试者相比，其常量营养素和纤维摄入量仍有所不同。因此，可能涉及心理问题。
