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P211 Association of disease activity and quality of life with dietary habits in patients with inflammatory bowel disease

I. Pefkianaki1*, I. Mouzas1,2, I. Koutroubakis1,2

1University of Crete, School of Medicine, Heraklion, Crete, Greece, 2University Hospital of Heraklion, Department of Gastroenterology, Heraklion, Crete, Greece

Background

Diet may influence intestinal inflammation via various pathways but the evidence regarding the role of fibre or fat intake in patients with inflammatory bowel disease (IBD) is controversial. The aim of this study was to investigate the association between disease activity or quality of life and dietary fibre or fat intake in Greek IBD patients.

Methods

The European Prospective Investigation into Cancer and Nutrition (EPIC) Study Food Frequency Questionnaire (FFQ) for Greek population with the MAFF photographic food atlas were used in order to collect information for dietary habits for one year of consecutive IBD patients. Moreover, disease activity using the Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC) and Harvey‐Bradshaw Index (HBI) for Crohn’s disease (CD) as well as quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) were evaluated. Patients’ demographic, clinical characteristics, nutritional status, laboratory data (C reactive protein, haemoglobin, erythrocyte sedimentation rate, platelets, and albumin) and treatment data were recorded and analysed for all participants.

Results

A total of 200 consecutive IBD patients (78 UC, 122 CD, mean age 47.8 ± 16.1 years, 113 males 87 females, mean BMI 26.7 ± 5.4) were included. Patients’ median daily fibre intake was 21.5 gr (IQR 12.8‐32.9) and median daily total fat was 139.8 gr (105.2‐226.3) with 40.7% energy from fat. Regarding disease activity 48 (24%) patients had active disease whereas 74 (37%) patients had poor quality of life (SIBDQ ≤ 50). There were significant negative correlations between disease activity with total fibre (r = −0.23, p = 0.001), soluble fibre (r = −0.18, p = 0.0095) and insoluble fibre intake (r = −0.24, p = 0.0008). Disease activity had negative significant correlations with total fat (r = −0.15, p = 0.04) and polyunsaturated fat (r = −0.16, p = 0.02) intake but no significant correlations with saturated and monounsaturated fat. SIBDQ score had positive significant correlations with total fibre (r = 0.35, p < 0.0001), soluble fibre (r = 0.26, p = 0.0002) and insoluble fibre intake (r = 0.34, p < 0.0001). There were not significant correlations between SIBDQ and total fat, saturated fat, monounsaturated fat or polyunsaturated fat intake (p > 0.05). No association of fibre or fat consumption with clinical characteristics, measured biomarkers and used medications was found (p > 0.05).

Conclusion

Higher dietary fibre intake overtime is significantly associated with lower disease activity and better quality of life in patients with IBD. Fat consumption seems to play a less important role. These results suggest that the influence of fibre consumption in the disease course of IBD patients should be further investigated.