Role of an Exclusion Diet (Reduced Disaccharides, Saturated Fats, Emulsifiers, Red and Ultraprocessed Meats) in Maintaining the Remission of Chronic Inflammatory Bowel Diseases in Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Statistical Analysis
3. Results
3.1. Baseline Patient Characteristics
3.2. IBD Population
3.2.1. Dietary Habits
3.2.2. Disease Activity during Dietary Intervention
3.2.3. Biochemical Markers of Disease Activity
3.3. UC Subpopulation
3.4. CD Subpopulation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Food Group | Consumption |
---|---|
Vegetables >4 portions/day | Yes/no |
Fatty fish—2 portions/week | Yes/no |
Salt low/high | Yes/no |
Sweetened beverages >1 L/day | Yes/no |
Whole grains >3 portions/day | Yes/no |
Seeds >4 portions/week | Yes/no |
Processed meat >2 portions/week | Yes/no |
Cheese daily | Yes/no |
Natural yogurt daily | Yes/no |
Fruit yogurt daily | Yes/no |
Butter daily | Yes/no |
Fatty meat daily | Yes/no |
Margarine daily | Yes/no |
Fried food daily | Yes/no |
Ice cream daily | Yes/no |
Mayonnaise daily | Yes/no |
Chips daily | Yes/no |
Coffee consumption | Yes/no |
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Prohibited Food | ||||
---|---|---|---|---|
Red Meat | Ultraprocessed Food | Fried Foods | High-Lactose Foods | Others |
|
|
|
|
|
The Right Food | ||||
Fruits: 2–3 Servings/Day | Vegetables: 3–5 Servings/Day | Dairy Products | Cereals | Others |
|
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|
|
|
Parameter | All Patients (n = 139) | Exclusion Diet (n = 45) | Control (n = 94) | p-Value * |
---|---|---|---|---|
Sex (male) | 79 (56.8) | 22 (48.9) | 57 (60.6) | 0.205 |
Age (years) | 40 (18–77) | 44 (22–77) | 38 (18–75) | 0.221 |
BMI | ||||
Underweight: | 7 (5) | 2 (4.4) | 5 (5.3) | 0.973 |
Normal: | 69 (49.6) | 23 (51.1) | 46 (48.9) | |
Overweight: | 45 (32.4) | 14 (31.1) | 31 (33) | |
Obesity: | 18 (13) | 6 (13.4) | 12 (12.8) | |
Education level | ||||
0: less than basic education | 0: 2 (1.4) | 0: 0 (0) | 0: 2 (2.1) | 0.177 |
1: basic education | 1: 12 (8.6) | 1: 3(6.7) | 1: 9 (9.6) | |
2: intermediate education | 2: 43 (30.9) | 2: 12 (26.7) | 2: 31 (33) | |
3: advanced education | 3: 82 (59.1) | 3: 30 (66.6) | 3: 52 (55.3) | |
Income | ||||
0: no income | 0: 10 (7.2) | 0: 3 (6.7) | 0: 7 (7.5) | 0.905 |
1: minimum wage | 1: 12 (8.6) | 1: 2 (4.4) | 1: 10 (10.6) | |
2: average wage | 2: 62 (44.6) | 2: 24 (53.3) | 2: 38 (40.4) | |
3: more than average wage | 3: 55 (39.6) | 3: 16(35.6) | 3: 39 (41.5) | |
Non-smokers | 108 (77.7) | 36 (80) | 72 (76.6) | 0.828 |
No alcohol consumption | 82 (59) | 30 (66.7) | 52 (55.3) | 0.269 |
Appendectomy | 14 (10.1) | 6 (13.3) | 8 (8.5) | 0.467 |
Surgical intervention | 32 (23) | 8(17.8) | 24 (25.5) | 0.342 |
Disease type | 0.362 | |||
Ulcerative colitis | 62 (44.6) | 23 (37.1) | 39 (62.9) | |
Crohn’s disease | 77 (55.4) | 22 (28.6) | 55 (71.4) | |
CD age at onset | 0.143 | |||
A1: <17 years | 2 (2.6) | 0 (0) | 2 (3.6) | |
A2: 17–39 years | 55 (71.4) | 14 (63.6) | 41 (74.6) | |
A3: >39 years | 20 (26) | 8 (36.4) | 12 (21.8) | |
CD disease localization | 0.802 | |||
L1: terminal ileum | 21 (27.3) | 7 (31.8) | 14 (25.4) | |
L2: colon | 33 (42.8) | 8 (36.4) | 25 (45.5) | |
L3: ileocolon | 18 (23.4) | 6 (27.3) | 12 (21.8) | |
L4: upper GI | 5 (6.5) | 1 (4.5) | 4 (7.3) | |
CD behavior | 0.808 | |||
B1: nonconstricting/nonpenetrating | 36 (46.7) | 11 (50) | 25 (45.4) | |
B2: constricting | 20 (26) | 5 (22.7) | 15 (27.3) | |
B3: penetrating | 21 (27.3) | 6 (27.3) | 15 (27.3) | |
+p: perianal disease modifier | 21 (27.3) | 8 (36.4) | 13 (23.6) | 0.271 |
UC extent | 0.974 | |||
E1: proctitis | 10 (16.1) | 4 (17.4) | 6 (15.4) | |
E2: left-side colitis | 34 (54.8) | 12 (52.2) | 22 (56.4) | |
E3: pancolitis | 18 (29.1) | 7 (30.4) | 11 (28.2) | |
Immunosuppressive treatment | 79 (56.9) | 15 (33.3) | 64 (68.1) | <0.001 |
Azathioprine | 76 (54.7) | 14 (31.1) | 62 (66) | |
Methotrexate | 3 (2.2) | 1 (2.2) | 2 (2.1) | |
Biologic treatment | 114 (82) | 33 (73.3) | 81 (86.2) | 0.097 |
Infliximab | 42 (36.8) | 11 (33.3) | 31 (38.3) | |
Adalimumab | 35 (30.7) | 12 (36.4) | 23 (28.4) | |
Vedolizumab | 26 (22.8) | 7 (21.2) | 19 (23.5) | |
Ustekinumab | 8 (7) | 2 (6.1) | 6 (7.4) | |
Tofacitinib | 2 (1.8) | 1 (3) | 1 (1.2) | |
Upadacitinib | 1 (0.9) | 0 (0) | 1 (1.2) | |
Combo therapy | 71 (51.1) | 13 (28.9) | 58 (61.7) | <0.001 |
Other IBD treatment | 44 (31.7) | 19 (42.2) | 25 (26.6) | 0.080 |
Parameter | Exclusion Diet (37.1%) | Control (62.9%) | p-Value * |
---|---|---|---|
Gender | M: 60.9% | M: 61.5% | 1.000 |
Age | Median: 44 (23–77) | Median: 43 (18–72) | 0.662 |
Immunosuppressive treatment | 34.7% | 71.8% | 0.009 |
Biologic treatment | 69.6% | 71.8% | 0.853 |
Sweetened beverages | 26.1% | 5.1% | 0.018 |
Parameter | Exclusion Diet (28.6%) | Control (71.4%) | p-Value * |
---|---|---|---|
Gender | M: 36.4% | M: 60% | 0.079 |
Age | Median: 42.5 (22–72) | Median: 36 (20–75) | 0.394 |
Immunosuppressive treatment | 31.8% | 65.5% | 0.007 |
Biologic treatment | 77.3% | 96.4% | 0.009 |
Sweetened beverages | 4.5% | 5.5% | 0.872 |
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Nitescu, M.; Istratescu, D.; Preda, C.M.; Manuc, T.E.; Louis, E.; Manuc, M.; Stroie, T.; Catrinoiu, M.; Tieranu, C.G.; Badea, L.E.; et al. Role of an Exclusion Diet (Reduced Disaccharides, Saturated Fats, Emulsifiers, Red and Ultraprocessed Meats) in Maintaining the Remission of Chronic Inflammatory Bowel Diseases in Adults. Medicina 2023, 59, 329. https://doi.org/10.3390/medicina59020329
Nitescu M, Istratescu D, Preda CM, Manuc TE, Louis E, Manuc M, Stroie T, Catrinoiu M, Tieranu CG, Badea LE, et al. Role of an Exclusion Diet (Reduced Disaccharides, Saturated Fats, Emulsifiers, Red and Ultraprocessed Meats) in Maintaining the Remission of Chronic Inflammatory Bowel Diseases in Adults. Medicina. 2023; 59(2):329. https://doi.org/10.3390/medicina59020329
Chicago/Turabian StyleNitescu, Maria, Doina Istratescu, Carmen Monica Preda, Teodora Ecaterina Manuc, Edouard Louis, Mircea Manuc, Tudor Stroie, Mihai Catrinoiu, Cristian George Tieranu, Larisa Emanuela Badea, and et al. 2023. "Role of an Exclusion Diet (Reduced Disaccharides, Saturated Fats, Emulsifiers, Red and Ultraprocessed Meats) in Maintaining the Remission of Chronic Inflammatory Bowel Diseases in Adults" Medicina 59, no. 2: 329. https://doi.org/10.3390/medicina59020329