Food Science Unit, National Council for Scientific Research-Lebanon (CNRS-Lebanon), Beirut, Lebanon.
Faculty of Public Health, Lebanese University, Beirut, Lebanon.
PLoS One. 2024 Jul 25;19(7):e0305352. doi: 10.1371/journal.pone.0305352. eCollection 2024.
BACKGROUND/AIMS: Chronic inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis are known for a combination of food intolerance, decreased oral intake, and malabsorption which all predispose patients to malnutrition and suboptimal dietary intake. The present study was conducted to 1) examine self-reported food intolerances and dietary supplement use 2) assess nutritional intake 3) assess the nutritional status and screen for malnutrition among patients with chronic inflammatory bowel disease (CIBD).
48 patients with CIBDs (28 Crohn's disease, 15 ulcerative colitis and 7 with atypical forms of IBD) took part in this cross-sectional study. Participants completed a food frequency questionnaire targeting dietary intakes and food trends over time. A questionnaire about food intolerance was also used. The nutritional status of patients with CIBDs was evaluated by a detailed history (medical diagnosis and medications and supplements administered) and by using the subjective global assessment (SGA) tool. Anthropometric data including height, weight, and BMI with body composition assessment using automated scales and stadiometer, while Bio-impedancemetry was used to measure body fat and visceral fat. Statistical analysis was conducted using SPSS 27, employing mean values, standard deviations, absolute and relative frequencies and Pearson's chi-square test, with significance set at p ≤ 0.05.
Food intolerance was equally common in all the types of CIBD specifically for dairy products, spicy foods, and high-fiber food items (beans and raw vegetables). Individuals with CIBD were also complaining about meat and chicken products (68%), followed by alcohol and soda (64%) and fish and sea foods (59%). 17% of the patients were malnourished. A significant percentage of malnourished patients with CIBD had to follow a diet outside the flare, had a nutritional follow up, were currently taking corticosteroids and had a severe form of the disease compared to patients who were well nourished.
This study has contributed valuable insights into the understanding that some food items could be associated to periods of increased disease activity in CIBD patients and that awareness/intervention regarding nutrition must be provided by healthcare professionals (dietitians, physicians…) to decrease the need for second line therapy. In addition, this self-reported food intolerance paper gives an insight for patients on food items usually avoided by CIBD patients during flares.
背景/目的：慢性炎症性肠病（IBD），包括克罗恩病和溃疡性结肠炎，其特点是食物不耐受、口服摄入减少和吸收不良的综合表现，这些都使患者容易发生营养不良和饮食摄入不足。本研究旨在：1）检查自述的食物不耐受和膳食补充剂的使用情况；2）评估营养摄入；3）评估慢性炎症性肠病（CIBD）患者的营养状况并筛查营养不良。
48 名 CIBD 患者（28 名克罗恩病、15 名溃疡性结肠炎和 7 名非典型 IBD 患者）参加了这项横断面研究。参与者完成了一份针对饮食摄入和随时间变化的食物趋势的食物频率问卷。还使用了一份关于食物不耐受的问卷。通过详细的病史（医疗诊断、服用的药物和补充剂）和主观整体评估（SGA）工具来评估 CIBD 患者的营养状况。通过自动秤和测高仪进行人体成分评估，获取身高、体重和 BMI 等人体测量数据，同时使用生物电阻抗法测量体脂肪和内脏脂肪。使用 SPSS 27 进行统计分析，采用平均值、标准差、绝对和相对频率以及皮尔逊卡方检验，显著性水平设为 p≤0.05。
所有类型的 CIBD 患者都同样普遍存在食物不耐受，具体表现为奶制品、辛辣食物和高纤维食物（豆类和生蔬菜）。CIBD 患者还抱怨肉类和鸡肉产品（68%）、酒精和苏打水（64%）以及鱼类和海鲜（59%）。17%的患者存在营养不良。与营养良好的患者相比，营养不良的 CIBD 患者中，有相当比例的患者需要在疾病活动期之外遵循饮食、进行营养随访、目前正在服用皮质类固醇且疾病处于严重阶段。
本研究深入了解了某些食物可能与 CIBD 患者疾病活动期增加有关的情况，并认为医护人员（营养师、医生等）必须提供营养方面的意识/干预，以减少对二线治疗的需求。此外，这份自述的食物不耐受研究报告为 CIBD 患者在疾病活动期通常避免食用的食物项目提供了一些见解。
