Nutritional adequacy in surgical IBD patients.


Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
02 2021
Historique:
received: 11 12 2020
accepted: 14 12 2020
entrez: 25 1 2021
pubmed: 26 1 2021
medline: 25 9 2021
Statut: ppublish

Résumé

Despite little evidence available to date, the dietary intake assessment is considered a useful tool to optimize dietary intervention for the improvement of the nutritional status of IBD patients. The primary aim was to compare the dietary intake of IBD patients scheduled for surgery with the dietary reference values (DRVs) for the Italian population (LARN) and the ESPEN guidelines for clinical nutrition in IBD. The secondary aim was to describe the dietary patterns of patients with CD and UC in relation to the disease-specific and nutritional parameters and to compare these results to a control group in order to evaluate if similar nutritional intakes than in oncologic patients are found in IBD. Between January 2019 and March 2020, 62 consecutive IBD patients (46 CD and 16 UC) with age from 18 to 79 years scheduled for surgery were recruited. Patients received a comprehensive nutritional assessment, including food or nutrition-related history, anthropometric and body composition measurements. A group of 61 oncologic patients scheduled for colorectal cancer (CRC) surgery was used as control. IBD patients showed a higher caloric and nutritional intake than CRC group, despite a higher frequency of underweight, and a lower prevalence of overweight and obesity. IBD patients showed an inadequate intake of proteins, n-3 PUFA, fiber, iron, calcium, potassium, magnesium, zinc, vitamin D and vitamin B12 according to ESPEN guidelines for clinical nutrition in IBD and LARN. Oral intake was not influenced by gender, IBD subtype, longer duration of disease and previous surgery. In CD, fistulizing behaviour negatively influenced oral intake. in IBD patients, the evaluation of macronutrients and micronutrients intake before surgery, can contribute to evaluate and to correct the onset of nutritional deficiencies. Specific dietary recommendations seem required, in order to integrate specific nutritional inadequacies. IBD patients referred to surgery have to be considered at high nutritional risk like oncologic patients are.

Sections du résumé

BACKGROUND & AIMS
Despite little evidence available to date, the dietary intake assessment is considered a useful tool to optimize dietary intervention for the improvement of the nutritional status of IBD patients. The primary aim was to compare the dietary intake of IBD patients scheduled for surgery with the dietary reference values (DRVs) for the Italian population (LARN) and the ESPEN guidelines for clinical nutrition in IBD. The secondary aim was to describe the dietary patterns of patients with CD and UC in relation to the disease-specific and nutritional parameters and to compare these results to a control group in order to evaluate if similar nutritional intakes than in oncologic patients are found in IBD.
METHODS
Between January 2019 and March 2020, 62 consecutive IBD patients (46 CD and 16 UC) with age from 18 to 79 years scheduled for surgery were recruited. Patients received a comprehensive nutritional assessment, including food or nutrition-related history, anthropometric and body composition measurements. A group of 61 oncologic patients scheduled for colorectal cancer (CRC) surgery was used as control.
RESULTS
IBD patients showed a higher caloric and nutritional intake than CRC group, despite a higher frequency of underweight, and a lower prevalence of overweight and obesity. IBD patients showed an inadequate intake of proteins, n-3 PUFA, fiber, iron, calcium, potassium, magnesium, zinc, vitamin D and vitamin B12 according to ESPEN guidelines for clinical nutrition in IBD and LARN. Oral intake was not influenced by gender, IBD subtype, longer duration of disease and previous surgery. In CD, fistulizing behaviour negatively influenced oral intake.
CONCLUSIONS
in IBD patients, the evaluation of macronutrients and micronutrients intake before surgery, can contribute to evaluate and to correct the onset of nutritional deficiencies. Specific dietary recommendations seem required, in order to integrate specific nutritional inadequacies. IBD patients referred to surgery have to be considered at high nutritional risk like oncologic patients are.

Identifiants

pubmed: 33487265
pii: S2405-4577(20)31127-X
doi: 10.1016/j.clnesp.2020.12.021
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

198-207

Informations de copyright

Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest No Conflicts of Interest were present and Ethical Adherence was applied. On behalf of all authors, the corresponding author states that there is no conflict of interest. The authors declare that the manuscript has not been submitted to any other journal.

Auteurs

Camilla Fiorindi (C)

Department of Health Science, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: camilla.fiorindi@unifi.it.

Gabriele Dragoni (G)

Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: gabriele.dragoni@unifi.it.

Giovanna Alpigiano (G)

Department of Health Science, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: alpigianog@aou-careggi.toscana.it.

Guya Piemonte (G)

Intensive Care Unit - Ospedale Del Mugello, Azienda Unità Sanitaria Locale Toscana Centro, Florence, Italy. Electronic address: guya.piemonte@unifi.it.

Stefano Scaringi (S)

Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: stefano.scaringi@unifi.it.

Fabio Staderini (F)

Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: fabio.staderini@unifi.it.

Anita Nannoni (A)

Department of Health Science, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: nannonia@aou-careggi.toscana.it.

Ferdinando Ficari (F)

Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: ferdinando.ficari@unifi.it.

Francesco Giudici (F)

Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. Electronic address: francesco.giudici@unifi.it.

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