Abstract
BackgroundIn animal models, excess luminal iron exacerbates colonic inflammation and cancer development. Moreover, in inflammatory bowel disease (IBD) patients with mild to moderate disease activity dietary fortificant iron intake is inversely related to quality of life. Here we sought to determine whether dietary iron intakes were also related to quality of life in IBD patients in remission.MethodsForty eight patients with ulcerative colitis (UC), 42 of which had quiescent disease during this observational study, and 53 healthy control subjects completed quality of life questionnaires and 7-day food diaries. For comparative analysis, 34/group were matched and the linear relationship between dietary iron intakes (total, haem, non-haem or fortificant) and EuroQol quality of life measures was investigated. For UC patients the linear relationship between dietary iron intakes and the scores from the disease specific inflammatory bowel disease questionnaire (IBDQ) was also considered.ResultsThe intake of dietary iron, and its various sub-fractions, were not associated with quality of life (EuroQol) in patients with quiescent disease or in healthy control subjects. The picture was similar for the 42 quiescent UC patients when disease-specific IBDQ was used. However, the 6 patients who relapsed during the study again showed an inverse association between IBDQ and dietary iron intake (p = 0.03).ConclusionsOur data suggest that dietary iron does not impact on quality of life in quiescent UC patients but support that, once the disease is triggered, luminal iron may be a permissive factor for exacerbation of disease activity resulting in lower quality of life.
Highlights
In animal models, excess luminal iron exacerbates colonic inflammation and cancer development
In the absence of clinical disease activity (i.e. Simple Clinical Colitis Activity Index (SCCAI) < 5), there was no measurable linear association between dietary iron intakes and quality of life which is consistent with earlier preliminary findings [13]
The small dataset showed that mean dietary iron intakes were lower in the ulcerative colitis (UC) patients with mild-moderate active disease compared with their counterparts in remission and this is in agreement with previous studies in inflammatory bowel disease (IBD) [29]
Summary
Excess luminal iron exacerbates colonic inflammation and cancer development. In inflammatory bowel disease (IBD) patients with mild to moderate disease activity dietary fortificant iron intake is inversely related to quality of life. We sought to determine whether dietary iron intakes were related to quality of life in IBD patients in remission. The only human study in IBD is our own recently published data indicating a detrimental effect of dietary iron, in particular from Fe-fortified products, on the quality of life of IBD patients with mild-moderately active disease [13]. The aim of the observational study presented was to determine the effect of dietary iron intakes on the quality of life of ulcerative colitis (UC) patients with inactive (i.e. quiescent) disease for at least 1 month. As a reference group we studied healthy controls and they, for analysis, were matched to subjects with UC
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