Abstract
PurposeInadequate oral intake may play an important role in the onset of malnutrition in patients with Crohn’s disease (CD). The aims of this cross-sectional study were: (1) to compare dietary intake in clinically active and quiescent CD patients, and (2) to assess patients’ nutritional adequacy relative to the dietary reference values (DRVs) for the Italian population using LARN (Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana).MethodsPatients aged between 18 and 65 years with a diagnosis of CD were recruited. All participants underwent anthropometry and were instructed to fill in a 3-day food record. Disease activity was clinically defined using the Crohn’s disease activity index (CDAI).ResultsOverall, 117 patients, 71 males and 46 females, with a mean age of 39.6 ± 13.8 years and a mean body weight of 65.4 ± 11.8 kg, were ultimately included. Our findings showed that the amount of nutrients was similar between patients with active and quiescent disease. The mean intake of macronutrients was adequate, except for fiber, while dietary micronutrients were insufficient. Median intakes of sodium, phosphorus, and fluorine met LARN recommendations in both sexes, and the DRVs were accomplished by many patients (53/117; 104/117 and 98/117, respectively). Interestingly, dietary amounts of iron and zinc were barely acceptable in males but not in females. However, a few of the patients (< 15) met the LARN for potassium, calcium, and magnesium, regardless of sex and CDAI. With respect to vitamins, no relevant difference was found between the active and quiescent groups, and none of them met recommended values in both sexes.ConclusionsThis study showed that the assessment of dietary intake can be crucial for optimizing dietary intervention with focused nutrition counseling, to improve nutritional status in CD patients.
Highlights
Crohn’s disease (CD) is an idiopathic chronic inflammatory disease able to affect any segment of the gastrointestinal tract, eliciting persistent transmural inflammation with consequent structural bowel damage and intestinal complications such as strictures, fistulae, and abscesses, which often1 3 Vol.:(0123456789)European Journal of Nutrition require surgery [1, 2]
148 CD patients were recruited for participation, but 31 were ruled out for the following reasons: 8 subjects did not fulfil the inclusion criteria, did not return their 3-day food records, and supplemented with protein and/ or micronutrients during the study
CD patients had a mean age of 39.6 ± 13.8 years and an average body weight of 65.4 ± 11.8 kg
Summary
Crohn’s disease (CD) is an idiopathic chronic inflammatory disease able to affect any segment of the gastrointestinal tract, eliciting persistent transmural inflammation with consequent structural bowel damage and intestinal complications such as strictures, fistulae, and abscesses, which often1 3 Vol.:(0123456789)European Journal of Nutrition require surgery [1, 2]. CD patients are at risk of nutritional deficiencies both during periods of disease exacerbation (due to reduced oral intake, malabsorption, and nutrient losses through the gut) and remission [3,4,5]. Poor and/or inadequate oral intake may play an important role in the onset of malnutrition due to many factors such as voluntary food restrictions, increased satiety, reduced sensation of pleasure related to eating, changes in mood, and even medical advice [6, 7]. Knowledge regarding reduced and/or inadequate food intake in CD patients can contribute to the early identification of nutritional deficiencies. Quantifying nutrient intake in the context of the overall nutrition status assists in determining if patients are meeting recommended levels of nutrient intake and to what extent subjects should require specific supplementation [19]. There are limited published data describing the dietary patterns as well as macro- and micro-nutrient intakes in patients with CD [20, 21] and no data are available in Italian individuals with CD
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