Influence of Diet on the Course of Inflammatory Bowel Disease

While the importance of diet in the pathogenesis of inflammatory bowel disease (IBD) is generally recognized, influence of food on the course of IBD is little understood.

The purpose of this study was to assess the association between food intake and course of disease in patients with IBD.

We performed a cross-sectional study on 103 adult patients (50 with active disease and 53 in remission, divided by their calprotectin level), who completed a food frequency questionnaire on their intake of several foods over 1 year. Diet, as assessed using a 146-item self-administered food frequency questionnaire, was correlated with objective evidence of disease based on fecal calprotectin levels.

Legumes and potato were inversely associated with disease relapse (p value for trend 0.023) with patients in the highest quartile for legume and potato consumption carrying a 79% lower risk of active disease (adjusted OR 0.21, 95% CI 0.57-0.81). A positive association emerged between meat intake and disease relapse, the highest quartile for meat consumption coinciding with a higher risk of active disease (OR 3.61, 95% CI 1.15-11.38), though this was not significant in the adjusted analysis. No statistically significant associations were found between disease relapse and the intake of vegetables, cereals, dairy products, or fish.

Our results suggest a potentially protective role of legumes and potato and a detrimental influence of meat in maintaining clinical remission in IBD patients. These findings have important public health implications, but further interventional studies will be needed to demonstrate these associations.