Authors: Małgorzata Godala, Ewelina Gaszyńska, Łukasz Durko, Ewa Małecka-Wojciesko
Journal: Journal of Clinical Medicine
Year: 2023
Volume: 12
Article number: 3455
DOI: 10.3390/jcm12103455
Study at a Glance
- Study type: Prospective questionnaire study
- Participants: 82 adults with inflammatory bowel disease (IBD)
- Population studied: 48 people with Crohn’s disease and 34 with ulcerative colitis
- Intervention or approach studied: Questionnaire examining dietary beliefs, behaviours and food exclusions
- Comparison group: None
- Follow-up duration: Not applicable
- Main outcome(s): Dietary beliefs, dietary behaviours, and foods avoided during disease relapse and remission
Why Was This Study Done?
People with IBD often restrict foods without clear, uniform dietary guidelines. Patients frequently make dietary decisions based on personal experiences and beliefs about which foods trigger symptoms. Godala and colleagues investigated dietary beliefs and behaviours in people with IBD, comparing these practices with current scientific evidence. They particularly examined which foods patients avoid during active disease and remission.
How Was the Study Performed?
Researchers recruited 82 adults attending the Department of Digestive Tract Diseases at the Medical University of Lodz in Poland. All had endoscopically and histologically confirmed IBD: 48 with Crohn’s disease and 34 with ulcerative colitis. A questionnaire based on previous IBD dietary research examined personal details, disease characteristics, dietary beliefs, behaviours, and food avoidance patterns. A trained interviewer collected responses between June and December 2022.
What Did the Researchers Find?
Most participants held strong beliefs about diet’s role in IBD. Just under one third believed diet could start the disease itself, whilst 85.4% believed diet could trigger flares. Most patients (81.7%) thought they should avoid certain foods to prevent relapses. Commonly avoided foods included spicy and fatty foods, raw fruits and vegetables, alcohol, pulses, cruciferous vegetables, and dairy products.
Three quarters changed their diet after diagnosis, and 81.7% imposed food restrictions to prevent flares. Among those restricting foods, just over half always did this, whilst around 30% often did. Over half (53.7%) followed a special diet. Most following special diets chose lactose-free options, although none had confirmed lactose intolerance. Around two thirds thought their diet might cause nutritional deficiencies. Just under half took supplements without consulting a doctor.
Most participants (75.6%) said IBD affected their appetite and eating enjoyment. Average appetite scores on a 0-10 scale were 3.3 during flares but 8.7 during remission.
During flares, 90.2% eliminated foods, most commonly spicy foods (67.6%), fatty foods (66.2%), and dairy (63.5%). During remission, 87.8% continued avoidance, most frequently spicy foods (56.9%), dairy (54.2%), and fatty foods (52.8%).
Despite widespread restriction, only 30.5% had received professional nutritional advice. The majority (67.1%) searched for information independently, mainly online. Among those without professional advice, over 90% wanted dietary consultations.
People with Crohn’s disease were more likely than those with ulcerative colitis to follow lactose-free diets and believe diet could start the disease. Women were more likely to change their diet after diagnosis and believe their diet could cause deficiencies. Those with higher education were more likely to believe diet could cause deficiencies but less likely to believe diet could cause the disease.
What Did the Authors Conclude?
The authors concluded that most people with IBD avoid foods during flares and remission based on personal beliefs rather than scientific evidence. This approach risks unnecessary nutritional deficiencies without guaranteeing improvement. Only one third received professional dietary advice, despite vast majority interest in such guidance. They emphasised that patient education and disease knowledge should be priorities in IBD care, and that self-imposed restrictions may increase deficiency risk whilst access to professional guidance remains limited.
Key Takeaways
- Most people with IBD believe diet can trigger flares; many think it can start the disease, though scientific evidence for the latter is lacking.
- The majority avoid spicy and fatty foods, dairy, raw fruits and vegetables, and alcohol during both flares and remission.
- Three quarters changed their diet after diagnosis, often without professional guidance, and many follow restrictive diets potentially causing nutritional deficiencies.
- Only one third received dietary advice from healthcare professionals, but over 90% of those without advice wanted it.
- Better patient education about diet in IBD is needed to prevent unnecessary restrictions unsupported by current evidence.
This Scientific Publication Summary is an objective summary of the published study for personal and educational use. It does not constitute medical advice, endorsement of the intervention, or a recommendation to alter clinical practice.