Multidimensional Impact of Mediterranean Diet on IBD Patients.


Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
01 01 2021
Historique:
received: 30 01 2020
pubmed: 23 5 2020
medline: 16 11 2021
entrez: 23 5 2020
Statut: ppublish

Résumé

Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to ameliorate both obesity and NAFLD, the aim of this study was to analyze the impact of Md on the nutritional state, liver steatosis, clinical disease activity, and quality of life (QoL) in IBD patients. Patients with IBD, both Crohn's disease (CD) and ulcerative colitis (UC), followed Md for 6 months. Their body mass index (BMI), body tissue composition, liver steatosis and function, serum lipid profile, clinical disease activity, and inflammatory biomarkers (C-reactive protein and fecal calprotectin) were collected at baseline (T0) and compared with those obtained after 6 months (T180) to evaluate the impact of Md. One hundred forty-two IBD patients, 84 UC and 58 CD, followed Md for 6 months. At T180, diet-adherent CD and UC improved BMI (UC -0.42, P = 0.002; CD -0.48, P = 0.032) and waist circumference (UC -1.25 cm, P = 0.037; CD -1.37 cm, P = 0.041). Additionally, the number of patients affected by liver steatosis of any grade was significantly reduced in both groups (UC T0 31 of 84 [36.9%] vs T180 18 of 84 [21.4%], P = 0.0016; CD T0 27 of 58 [46.6%] vs T180 18 of 58 [31.0%], P < 0.001) after dietary intervention. Finally, after 6 months of the diet, fewer UC and CD patients with stable therapy had active disease (UC T0 14 of 59 [23.7%] vs T180 4 of 59 [6.8%], P = 0.004; CD T0 9 of 51 [17.6%] vs T180 2 of 51 [3.0%], P = 0.011) and elevated inflammatory biomarkers. Mediterranean diet improved QoL in both UC and CD, but neither serum lipid profile nor liver function were modified by the diet. A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.

Sections du résumé

BACKGROUND & AIMS
Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to ameliorate both obesity and NAFLD, the aim of this study was to analyze the impact of Md on the nutritional state, liver steatosis, clinical disease activity, and quality of life (QoL) in IBD patients.
METHODS
Patients with IBD, both Crohn's disease (CD) and ulcerative colitis (UC), followed Md for 6 months. Their body mass index (BMI), body tissue composition, liver steatosis and function, serum lipid profile, clinical disease activity, and inflammatory biomarkers (C-reactive protein and fecal calprotectin) were collected at baseline (T0) and compared with those obtained after 6 months (T180) to evaluate the impact of Md.
RESULTS
One hundred forty-two IBD patients, 84 UC and 58 CD, followed Md for 6 months. At T180, diet-adherent CD and UC improved BMI (UC -0.42, P = 0.002; CD -0.48, P = 0.032) and waist circumference (UC -1.25 cm, P = 0.037; CD -1.37 cm, P = 0.041). Additionally, the number of patients affected by liver steatosis of any grade was significantly reduced in both groups (UC T0 31 of 84 [36.9%] vs T180 18 of 84 [21.4%], P = 0.0016; CD T0 27 of 58 [46.6%] vs T180 18 of 58 [31.0%], P < 0.001) after dietary intervention. Finally, after 6 months of the diet, fewer UC and CD patients with stable therapy had active disease (UC T0 14 of 59 [23.7%] vs T180 4 of 59 [6.8%], P = 0.004; CD T0 9 of 51 [17.6%] vs T180 2 of 51 [3.0%], P = 0.011) and elevated inflammatory biomarkers. Mediterranean diet improved QoL in both UC and CD, but neither serum lipid profile nor liver function were modified by the diet.
CONCLUSIONS
A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.

Identifiants

pubmed: 32440680
pii: 5841910
doi: 10.1093/ibd/izaa097
pmc: PMC7737160
doi:

Substances chimiques

Biomarkers 0
Leukocyte L1 Antigen Complex 0
Lipids 0
C-Reactive Protein 9007-41-4

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-9

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.

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Auteurs

Fabio Chicco (F)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Salvatore Magrì (S)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Arianna Cingolani (A)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Danilo Paduano (D)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Mario Pesenti (M)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Federica Zara (F)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Francesca Tumbarello (F)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Emanuela Urru (E)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Alessandro Melis (A)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Laura Casula (L)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Massimo Claudio Fantini (MC)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

Paolo Usai (P)

Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy.

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