Philipp Schreiner1, Bahtiyar Yilmaz2, Jean-Benoît Rossel3, Yannick Franc3, Benjamin Misselwitz1, Michael Scharl1, Jonas Zeitz4, Pascal Frei5, Thomas Greuter1, Stephan R Vavricka6, Valérie Pittet3, Alexander Siebenhüner7, Pascal Juillerat8, Roland von Känel9, Andrew J Macpherson2, Gerhard Rogler1, Luc Biedermann1. 1. Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. 2. Maurice Müller Laboratories (Department for Biomedical Research), University Clinic of Visceral Surgery and Medicine, University of Bern, Bern, Switzerland. 3. Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland. 4. Center of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland. 5. Bethanien, Department of Gastroenterology, Zurich, Switzerland. 6. Center of Gastroenterology and Hepatology, Zurich, Switzerland. 7. Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland. 8. Gastroenterology, University Clinic of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern, Switzerland. 9. Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.
Abstract
Background: Many inflammatory bowel disease (IBD) patients follow a restrictive diet due to perceived positive effects on their symptoms. We assessed the prevalence of vegetarian (VD) and gluten-free diets (GFDs) in IBD patients, the reasons for following such a diet, and whether nutrition has an impact on disease activity and microbiota composition. Methods: We included 1254 patients from the Swiss Inflammatory Bowel Disease Cohort Study with prospective acquisition of clinical data and psychosocial, disease-related and lifestyle factors between 2006 and 2015. Dietary habits were assessed through a self-report questionnaire. In 92 patients, we analysed intestinal mucosa-associated microbial composition using high-throughput sequencing. Results: Overall, 4.1% (n = 52) of the patients reported following a VD and 4.7% (n = 54) a GFD. No differences regarding disease activity, fistula, hospitalization or surgery rates were observed. Patients on a VD or GFD had significantly higher levels of post-traumatic stress symptoms. Furthermore, GFD patients had significantly higher anxiety and depression symptom levels. The gut microbiota composition in IBD patients following a VD or GFD was significantly different compared to that of omnivores. Conclusions: Although we did not identify a relevant impact of a specific diet on the course of the disease, there was a significant association with lower psychological well-being in VD and GFD patients.
Background: Many inflammatory bowel disease (IBD) patients follow a restrictive diet due to perceived positive effects on their symptoms. We assessed the prevalence of vegetarian (VD) and gluten-free diets (GFDs) in IBDpatients, the reasons for following such a diet, and whether nutrition has an impact on disease activity and microbiota composition. Methods: We included 1254 patients from the Swiss Inflammatory Bowel Disease Cohort Study with prospective acquisition of clinical data and psychosocial, disease-related and lifestyle factors between 2006 and 2015. Dietary habits were assessed through a self-report questionnaire. In 92 patients, we analysed intestinal mucosa-associated microbial composition using high-throughput sequencing. Results: Overall, 4.1% (n = 52) of the patients reported following a VD and 4.7% (n = 54) a GFD. No differences regarding disease activity, fistula, hospitalization or surgery rates were observed. Patients on a VD or GFD had significantly higher levels of post-traumatic stress symptoms. Furthermore, GFD patients had significantly higher anxiety and depression symptom levels. The gut microbiota composition in IBDpatients following a VD or GFD was significantly different compared to that of omnivores. Conclusions: Although we did not identify a relevant impact of a specific diet on the course of the disease, there was a significant association with lower psychological well-being in VD and GFD patients.
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