Sauer Patrícia, Luft Vivian Cristine, Dall'Alba Valesca
Graduate Program in Gastroenterology and Hepatology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Nutrition Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Nutrition Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Graduate Program in Food, Nutrition and Health, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Clin Nutr ESPEN. 2024 Jun;61:420-426. doi: 10.1016/j.clnesp.2024.04.010. Epub 2024 Apr 20.
Exclusion diets are common practices among individuals with Inflammatory Bowel Disease (IBD). Reports that certain foods trigger or worsen symptoms are recurrent but lack evidence. The aim of the study was to identify which foods were most frequently avoided by patients with Crohn's Disease (CD) and Ulcerative Colitis (UC) and whether the consumption of any food group was associated with disease activity.
Cross-sectional study with adult patients seen at an outpatient clinic in a tertiary public hospital. Dietary intake and eating habits were accessed through questionnaires administered via telephone interview. Disease activity and symptoms were assessed using the Harvey-Bradshaw Index (IHB) for CD and the Lichtiger Index (LI) for UC. Poisson regression with a robust variance estimator was used to estimate prevalence ratios. Analyzes were performed using SPSS - Statistical Package for the Social Sciences.
The study included 145 patients. Of these, 69.7% avoided certain foods, with citrus fruits and raw vegetables among the most avoided (16.8% and 13.8%, respectively). Regular consumption of fruits (PR = 0.56; CI 95% 0.32-0.97; p = 0.042) and vegetables (PR = 0.56; CI 95% 0.32-0.98; p = 0.045) was associated with a 44% lower prevalence of the active phase of the disease, compared to those who do not consume these foods, adjusted for age, sex and type of disease. Other food items did not present significant associations in the adjusted model.
Fruit and vegetable intake appears to have a protective role in the recurrence of IBD. Excluding foods is a common practice, even among patients in remission, and this should be combated as it can lead to nutritional losses. It is important to reinforce with patients the benefits of a varied and less restrictive diet.
排除性饮食是炎症性肠病(IBD)患者的常见做法。关于某些食物会引发或加重症状的报道屡见不鲜,但缺乏证据。本研究的目的是确定克罗恩病(CD)和溃疡性结肠炎(UC)患者最常避免食用的食物,以及食用任何食物组是否与疾病活动相关。
对一家三级公立医院门诊的成年患者进行横断面研究。通过电话访谈问卷获取饮食摄入量和饮食习惯。使用哈维 - 布拉德肖指数(IHB)评估CD的疾病活动和症状,使用利希蒂格指数(LI)评估UC的疾病活动和症状。采用具有稳健方差估计器的泊松回归来估计患病率比。使用社会科学统计软件包(SPSS)进行分析。
该研究纳入了145名患者。其中,69.7%的患者避免食用某些食物,柑橘类水果和生蔬菜是最常被避免的食物(分别为16.8%和13.8%)。与不食用这些食物的患者相比,在调整年龄、性别和疾病类型后,经常食用水果(PR = 0.56;95%置信区间0.32 - 0.97;p = 0.042)和蔬菜(PR = 0.56;95%置信区间0.32 - 0.98;p = 0.045)与疾病活动期患病率降低44%相关。在调整模型中,其他食物项目未呈现显著关联。
水果和蔬菜摄入似乎对IBD复发具有保护作用。排除食物是一种常见做法,即使在缓解期患者中也是如此,应加以纠正,因为这可能导致营养流失。向患者强调多样化和限制较少的饮食的益处很重要。