Dietary Patterns Are Not Associated With Disease Activity Among Patients With Inflammatory Conditions of the Pouch in a Prospective Cohort.

Background

Evidence-based recommendations regarding the influence of diet on inflammatory conditions of the pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are limited.

Methods

We analyzed dietary patterns at enrollment in a prospective registry of patients with 1 of 4 inflammatory conditions of the pouch (acute pouchitis, chronic antibiotic-dependent pouchitis, chronic antibiotic refractory pouchitis, and Crohn's disease of the pouch). We analyzed dietary intake by disease activity at enrollment and then compared dietary patterns among patients who remained in remission throughout the 12-month follow-up to those patients who experienced a disease relapse. We also compared dietary patterns among patients with inflammatory conditions of the pouch to the United States Department of Agriculture (USDA) recommended daily goals.

Results

Among 308 patients, there were no differences in dietary patterns among patients with 1 of the 4 disease states at enrollment. Additionally, among the 102 patients in remission at baseline, there were no significant differences noted among patients who went on to experience a disease flare in the 12 months after enrollment compared to those patients who remained in remission. However, patients with inflammatory conditions of the pouch demonstrated decreased intake of several food groups and macronutrients including dairy, fruits, vegetables, whole grains, and fiber when compared to USDA recommendations.

Conclusions

In a prospective cohort, we demonstrated no impact of dietary patterns on disease activity. The relative deficiencies in several food groups and macronutrients among patients after IPAA indicate the potential role of targeted nutritional counseling in this population.

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.

Déclaration de conflit d'intérêts

E.L.B. has served as a consultant for AbbVie, Bristol-Meyers Squibb, Eli Lilly, and Target RWE. P.D. has served as a consultant or on an advisory board for Janssen, Pfizer, Prometheus Biosciences, Boehringer Ingelheim, AbbVie, Arena Pharmaceuticals, Takeda Pharmaceuticals LLC, Roche Genentech, Bristol Myers Squibb and Scipher Medicine Corporation. He has also received funding under a sponsored research agreement unrelated to the data in the paper from Takeda Pharmaceutical, Arena Pharmaceuticals, Bristol Myers Squibb-Celgene, Janssen, Landos Pharma, Teva Pharma, Iterative scopes, CorEvitas and Boehringer Ingelheim. P.D. holds the position of Associate Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for the manuscript. P.B.-P. has received honorarium from the Takeda speaker’s bureau. L.R. has served on an advisory board for Janssen. LR holds the position of Associate Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for the manuscript. M.D. has served as a consultant or has received advisory board fees from Abbvie, Arena, BMS, Eli Lilly, Gilead, Janssen, Pfizer, Prometheus Labs, Takeda. She has received grant support from Janssen, Abbvie. She also has the following relationships: Licenser of software: Takeda; Co-Founder, Equity ownership and board of director for Trellus Health Shannon Chang has served as a consultant for AbbVie, BMS, and Pfizer. R.K.C. has participated in advisory boards for AbbVie, Bristol Myers Squibb, Fresenius Kabi, and has served as a consultant for Fzata, Magellan Health, Pfizer, and Samsung Bioepis. He is on the Data Safety Monitoring Board for Adiso, is a member of the Executive Committee for the IBD Education Group and is Co-Director of the CorEvitas Registry. M.D.L. has served as a consultant for AbbVie, UCB, Takeda, Janssen, Pfizer, Salix, Valeant, Target Pharmasolutions and has received research support from Pfizer and Takeda. H.H.H. has served as a consultant for Alivio, AMAG, BMS, ExeGI Finch, Gilead, Janssen, Lycera, Merck, Otsuka, Pfizer, PureTech, Seres and has received research support from Pfizer and Artizan Biosciences. M.K., P.D.R.H., J.B., and C.A. have no relevant disclosures.