The Routine Diets of People with Crohn’s Disease

This study is investigating the routine dietary intake of patients with Crohn’s disease living in the community.

Introduction

Patients with Crohn’s disease often experience symptoms include weight loss and malnutrition due to the malabsorption of nutrients and reduced oral intake. Malnutrition can effect patients even when their symptoms are controlled and  are in clinical remission.

Recent studies indicate that patients restricted their intake of certain foods which they belief trigger their symptoms without consulting their healthcare team. Poor intake and unguided food restriction will increase the risk of malnutrition and worsen the overall health and quality of life.

Recognition of malnutrition and proper dietary advice are major components in Crohn’s disease management to improve the patient's health and prevent further complications such as anaemia and bone diseases. Indeed, according to the James Lind Alliance on Crohn's and Colitis, the role of nutrition in managing people with inactive Crohn’s disease and Ulcerative colitis is one of the priority questions for research.

Study Aims

This study aims to assess available evidence on the dietary intake of energy, carbohydrate, fibre, protein, fat, vitamins and minerals of individuals with inactive Crohn’s disease. The search was conducted on five electronic databases from 2000 to 2020 to identify relevant studies.

Our findings

The electronic search yielded seven studies assessing the dietary intake in individuals with Crohn’s disease who were in remission (not in flare), which had the following results:

  • The sample size of included studies ranged from 16 to 1130 participants.
  • Different dietary assessment methods were used to estimate the food intake including frequency questionnaire and food records.
  • The findings of these studies were inconsistent
    • Some studies observed adequate intake of energy, carbohydrate, protein and fat in people with Crohn’s disease
    • Another study reported higher intake of energy and fat in people with Crohn’s disease compared to healthy individuals.
  • Low fibre intake was frequently observed and the low intake was greater in women in all studies except one.
  • In addition, people with inactive Crohn’s disease did not met the recommended intake of calcium, iron, selenium, vitamin D, vitamin K and vitamin B.

The findings of these studies suggest that even in case of inactive disease, people with Crohn’s disease should be screened for dietary imbalance and insufficient intake should be treated accordingly. However, these studies consist of small number of participants and have several limitations which make it difficult to generalise their findings. More research is therefore needed in this area to reach solid conclusions and shape patient care.