Department of Nutritional Sciences, King's College London, London, United Kingdom.
Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, London, United Kingdom.
Am J Clin Nutr. 2021 Apr 6;113(4):832-844. doi: 10.1093/ajcn/nqaa395.
Inflammatory bowel disease (IBD) may impact the extent to which food, eating, and drinking bring satisfaction and enjoyment to peoples' lives, and this may impact dietary intake. The prevalence of an impaired food-related quality of life (FR-QoL), its associated factors, and its impact on diet have not been explored.
To measure the prevalence and nature of the burden of impaired FR-QoL in people with IBD, the factors associated with these, and their associations with nutrient intake.
We recruited 1576 outpatients with IBD (≥16 years old) in person from 7 IBD centers across the United Kingdom. Patients completed validated questionnaires to measure their FR-QoL, quality of life (QoL), distress, fatigue, anxiety, and depression. Dietary intake was recorded using the European Prospective Investigation into Cancer FFQ. A health professional recorded disease activity, Montreal classification, blood results, BMI, and malnutrition risk. FR-QoL was regressed onto explanatory variables using univariable and multivariable analyses.
Data from 1221 patients were available (77.4% response; Crohn's disease, 65%; ulcerative colitis, 35%). The FR-QoL mean (± SD) score was 80.8 ± 26.9, with wide ranges (minimum, 29; maximum, 145). Following multivariable regression, the strongest associations with FR-QoL were the number of recent disease flares (5 flares β = -12.7; P < 0.001), the IBD-specific QoL (β = 0.33; P < 0.001), and IBD-related distress (β = -0.26; P < 0.001). Patients with poorer FR-QoL had lower intakes of fiber (nonstarch polysaccharide; Q1 to Q5 difference = 2.1 g/d; 95% CI: 0.4-3.8; P = 0.048), calcium (192.6 mg/d; 95% CI: 112.5-272.6; P < 0.001), phosphorus (167 mg/d; 95% CI: 58-276; P = 0.041), and magnesium (34.4 mg/d; 95% CI: 9.3-59.4; P = 0.041).
Impaired FR-QoL is prevalent in IBD and is associated with recurrent disease flares, a reduced IBD-specific QoL, and greater IBD-related distress. A poorer FR-QoL was associated with lower intakes of key nutrients of importance to IBD, including those relating to gut health and bone mineralization.
炎症性肠病（IBD）可能会影响人们对食物、饮食和饮水带来的满足感和享受感的程度，从而影响饮食摄入。目前尚未探讨 IBD 患者中与食物相关的生活质量（FR-QoL）受损的患病率、相关因素及其对饮食的影响。
测量 IBD 患者 FR-QoL 受损的患病率和性质、与这些因素相关的因素，以及它们与营养摄入的关系。
我们从英国 7 个 IBD 中心招募了 1576 名年龄≥16 岁的 IBD 门诊患者。患者完成了经过验证的问卷，以测量他们的 FR-QoL、生活质量（QoL）、困扰、疲劳、焦虑和抑郁。使用欧洲前瞻性癌症 FFQ 记录膳食摄入量。一名健康专业人员记录疾病活动度、蒙特利尔分类、血液结果、BMI 和营养不良风险。使用单变量和多变量分析将 FR-QoL 回归到解释变量上。
1221 名患者的数据可用（77.4%的应答率；克罗恩病 65%；溃疡性结肠炎 35%）。FR-QoL 的平均（± SD）得分是 80.8 ± 26.9，范围很广（最低 29；最高 145）。在多变量回归后，与 FR-QoL 最强相关的因素是近期疾病发作次数（5 次发作β=-12.7；P<0.001）、IBD 特异性 QoL（β=0.33；P<0.001）和 IBD 相关的困扰（β=-0.26；P<0.001）。FR-QoL 较差的患者膳食纤维（非淀粉多糖）摄入量较低（Q1 到 Q5 的差异=2.1 g/d；95%CI：0.4-3.8；P=0.048），钙（192.6 mg/d；95%CI：112.5-272.6；P<0.001）、磷（167 mg/d；95%CI：58-276；P=0.041）和镁（34.4 mg/d；95%CI：9.3-59.4；P=0.041）摄入量较低。
IBD 患者中 FR-QoL 受损较为普遍，与反复发作、IBD 特异性 QoL 降低和 IBD 相关困扰增加有关。FR-QoL 较差与关键营养素摄入不足有关，包括与肠道健康和骨矿化有关的营养素。
