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P203. Inflammatory bowel disease and compliance with the Mediterranean diet

V. Teixeira1, S. Velho1, J. Torres2, L. Glória2, 1Hospital Beatriz Ângelo, Serviço de Dietética e Nutrição, Lisboa, Portugal, 2Hospital Beatriz Ângelo, Serviço de Gastrenterologia, Lisboa, Portugal

Background

Several studies have suggested that chronic inflammation may be reduced with a diet containing a high content of n-3 fatty acids, antioxidants and fiber, and a low content in sugars and saturated fats. The Mediterranean Diet (MD) comprises all the former nutrients, and thus it has been hypothesized that it could be beneficial for patients with Inflammatory Bowel Disease (IBD). The purpose of our study was to evaluate compliance of IBD patients with the MD and assess its impact on disease activity.

Methods

A total of 59 patients [41 with Crohn's disease (CD) and 18 with ulcerative colitis (UC)] with IBD were enrolled in this cross-sectional study. Clinical data and anthropometric measures were recorded. Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Conversion of foodstuffs to nutrient intake was accomplished with the software Food Processor Plus (ESHA Research, Salem, Oregon). Compliance to MD, was analyzed using the Mediterranean Adequacy Index (MAI), which is calculated as a ratio between foodstuffs consumed that characterize MD and others that are not consistent with MD. MAI enables comparison between the estimated nutrient intake and Healthy Reference National Mediterranean Diet. Disease activity was measured using Harvey–Bradshaw Index (HBI) for CD and Cinical Activity Index for UC (CAI). Data analysis was performed with SPSS 20 (IBM SPSS statistics).

Results

37.3% (n = 22) of the studied population were overweight, 10.2% (n = 6) obese, 47.5% (n = 28) normal weight and 5% (n = 3) had a low BMI. Patients with no relapse during the last year showed a higher intake of red meat (40.57±20.3 g/d vs 26.4±20.7 g/d; p = 0.022), canned food (12.9±12.9 g/d vs 8.1±11.9 g/d; p = 0.022), and cured meats (5.6±4.2 g/d vs 4.3±6.8 g/d, p = 0.063). Also, patients in remission had a lower intake of skim milk (6.6±40.3mL vs 55.1±151.2mL; p = 0.082) and a higher intake of canned food (12.4±13.2 g/d vs 5.7±9.9 g/d; p = 0.007), sugar (18.1±16.3 g/d vs 11.0±13.4 g/d; p = 0.098) and coffee (78.3±57.5 vs 51.19±60.9; p = 0.052). Only 14% (n = 8) of our population was classified as compliant with MD (MAI ≥4.6), whereas the mean MAI was 2.46±5.21. Moreover, no correlation was found between MAI and HBI (r = 0.242; p = 0.304) or CAI (r = 0.201; p = 0.44).

Conclusion

The studied population with IBD showed a high prevalence of overweight/obesity and only a small number of patients were compliant with the MD. No association was found between MAI and disease activity. Future interventional nutritional studies aiming at investigating the role of MD in the maintenance of remission or relapse frequency are warranted.