Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester.
Department of Gastroenterology, Salford Royal NHS Foundation Trust, Stott Lane, Salford.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e442-e448. doi: 10.1097/MEG.0000000000002130.
The role of diet in inflammatory bowel disease (IBD) remains incompletely understood. Studies have previously examined dietary practices in IBD, but none have specifically focused on older-onset disease. IBD may put vulnerable groups at risk of nutritional deficiency and associated complications, potentially heightened by comorbidities, frailty and polypharmacy. Our objective was to describe dietary practices and beliefs in older-onset IBD.
A questionnaire exploring dietary practices and beliefs was prospectively administered to 137 people with older-onset IBD attending gastroenterology clinics.
Thirty-two percent believed diet was the initiating factor for their IBD. This was significantly more likely in people with Crohn's disease than ulcerative colitis (P = 0.05) and in those who felt limited in their dietary choices due to cost (P = 0.008). Forty-three percent believed diet could trigger IBD relapse and 68% avoided dietary components to avoid relapse. Most frequently avoided were spicy and fatty foods, carbonated drinks, red meat, alcohol and raw fruit and vegetables. Twenty-two percent of participants had tried a whole food exclusion diet, most frequently gluten- or lactose-free. Almost a third avoided eating out (29%) or eating the same meal as their family (32%) to prevent relapse. Respondents rarely relied upon healthcare professionals or patient support organisations for their dietary information.
Individuals with older-onset IBD report dietary practices with a high degree of consistency. Dietary avoidance may impact upon both nutritional and psychosocial wellbeing in this more vulnerable group and, as such, early dietetic assessment could help improve outcomes.
饮食在炎症性肠病（IBD）中的作用仍不完全清楚。此前已有研究检查过 IBD 的饮食实践，但没有一项专门针对发病年龄较大的 IBD。IBD 可能使弱势群体面临营养缺乏和相关并发症的风险，而合并症、虚弱和多种药物治疗可能会进一步加剧这种风险。我们的目的是描述发病年龄较大的 IBD 患者的饮食实践和信念。
前瞻性地向在胃肠病学诊所就诊的 137 名发病年龄较大的 IBD 患者发放了一份探索饮食实践和信念的问卷。
32%的患者认为饮食是其 IBD 的诱发因素。在患有克罗恩病的患者中，这一比例明显高于溃疡性结肠炎患者（P=0.05），而在因费用限制饮食选择的患者中，这一比例更高（P=0.008）。43%的患者认为饮食可引发 IBD 复发，68%的患者避免食用某些饮食成分以避免复发。最常避免的食物是辛辣和油腻食物、碳酸饮料、红色肉类、酒精以及生的水果和蔬菜。22%的参与者曾尝试过全食物排除饮食，最常见的是无麸质或无乳糖饮食。近三分之一的患者避免外出就餐（29%）或与家人吃相同的饭菜（32%）以防止复发。受访者很少依赖医疗保健专业人员或患者支持组织获取饮食信息。
发病年龄较大的 IBD 患者报告的饮食实践具有高度一致性。饮食回避可能会对这一更为脆弱群体的营养和心理社会健康产生影响，因此早期进行饮食评估可能有助于改善结局。
