Jatkowska Aleksandra, White Bernadette, Jaskolski Paige, Nichols Ben, Brownson Emily, Clowe Jennifer, Seenan John Paul, Gerasimidis Konstantinos, MacDonald Jonathan
Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Department of Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK.
Crohns Colitis 360. 2024 Feb 6;6(1):otae008. doi: 10.1093/crocol/otae008. eCollection 2024 Jan.
Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) remain the only established dietary therapies in Crohn's disease (CD) management. We conducted a questionnaire survey to evaluate the perceptions of adults with CD toward established and emerging food-based dietary therapies.
A 26-question anonymous survey was mailed to 300 adults receiving biologic treatment. Two researchers independently conducted a thematic analysis of open-ended responses. Machine learning with the Random Forest-Recursive Feature Elimination algorithm identified predictors of willingness to try dietary therapies.
One hundred and sixty patients (53% female) completed and returned the survey. Forty-two percent were following some form of exclusion diet, with low-spice and low-fiber diets being the most popular. Although only a quarter of patients believed that EEN/PEN could help with their CD, more than half believed that diet could help, with another 13% already using diet for CD management. While half of the patients were willing to try EEN, the majority were willing to try PEN instead (51% vs. 79%; < .001). Forty-two percent of patients preferred food-based dietary plans prepared at home over EEN/PEN options. The most important predictors for willingness to try dietary therapies were age (25-65 years), recent symptoms, previous exposure to EEN/PEN, and current exclusion diet use. The top concerns about PEN were taste/palatability, satiety/hunger, and taste fatigue.
Most adults preferred to follow a food-based dietary therapy over EEN/PEN. The majority would try PEN though which allows for more flexibility to incorporate in habitual diet and may be easier to comply with than the EEN.
全肠内营养（EEN）和部分肠内营养（PEN）仍然是克罗恩病（CD）管理中唯一既定的饮食疗法。我们进行了一项问卷调查，以评估成年CD患者对既定的和新兴的基于食物的饮食疗法的看法。
向300名接受生物治疗的成年人邮寄了一份包含26个问题的匿名调查问卷。两名研究人员独立对开放式回答进行了主题分析。使用随机森林递归特征消除算法的机器学习确定了尝试饮食疗法意愿的预测因素。
160名患者（53%为女性）完成并返回了调查问卷。42%的患者遵循某种形式的排除饮食，低香料和低纤维饮食最受欢迎。虽然只有四分之一的患者认为EEN/PEN有助于治疗他们的CD，但超过一半的患者认为饮食会有帮助，另有13%的患者已经使用饮食来管理CD。虽然一半的患者愿意尝试EEN，但大多数患者更愿意尝试PEN（51%对79%；P<0.001）。42%的患者更喜欢在家中准备的基于食物的饮食计划，而不是EEN/PEN选项。尝试饮食疗法意愿的最重要预测因素是年龄（25 - 65岁）、近期症状、以前接触过EEN/PEN以及目前使用排除饮食。对PEN最主要的担忧是味道/适口性、饱腹感/饥饿感和味觉疲劳。
大多数成年人更喜欢遵循基于食物的饮食疗法，而不是EEN/PEN。大多数人会尝试PEN，因为它在纳入日常饮食方面具有更大的灵活性，并且可能比EEN更容易遵守。
