P233 Malnutrition diagnosis based on the GLIM criteria and patients’ dietary beliefs and practices impact negatively the quality of life of IBD patients

Abstract

Abstract Background Inflammatory bowel disease (IBD) is an umbrella term describing unpredictable conditions of the digestive tract, affecting the quality of life (QoL), and nutritional status of patients. It implies, that dietary factors may take part in complex IBD pathogenesis. Furthermore, nutrition is an integral part of the therapeutic strategy in IBD, whereas patients' dietary beliefs and practices, through multiple eliminations may lead to the development or worsening of malnutrition. We aimed to investigate the impact of nutritional status, as well as patients` beliefs and practices on QoL in IBD. Methods The studied group consisted of 109 IBD patients (52 ulcerative colitis; 57 Crohn`s disease) hospitalized in the Department of Gastroenterology and Hepatology, Wroclaw Medical University. QoL was measured by a self-administered Inflammatory Bowel Diseases Questionnaire (IBDQ). Malnutrition was diagnosed and graded with GLIM (Global Leadership Initiative on Malnutrition) criteria. Patients' dietary beliefs and practices were assessed by an adapted eleven items questionnaire [1]. Results Based on the GLIM criteria 54.6% of subjects were malnourished (30.6% mildly to moderately, 24% severely). The mean IBDQ score was 143 points (SD = 41.23). The mean number of eliminated food groups during remission was 5.44 (SD = 2.99), and during flare 7.07 (SD = 3.23). IBDQ score correlated well with GLIM malnutrition assessment for the whole group, as well as in CD and UC patients (r = -0.32, p <0.001; r = -0.31, p = 0.021; r = -0.39, p = 0.005 respectively). Similarly to the total IBDQ score, every IBDQ domain correlated with GLIM: bowel system (r = -0.27, p = 0.005), emotion health (r = -0.25, p = 0.009), systemic system (r = -0.37, p < 0.001), social function (r = -0.32, p <0.001). The number of food groups avoided during remission and flare was correlated with IBDQ total score (r = -0.22, p =0.021 and r = -0.23, p = 0.017 respectively). Higher elimination rate during remission and flares of IBD was also connected with emotion health (r = -0.26, p = 0.006; r = -0.21, p = 0.032 respectively) and social function (r = -0.26, p = 0.006; r = -0.025, p = 0.010). Conclusion Malnutrition negatively affects the quality of life of IBD patients in general as well as in every measured QoL area. Dietary beliefs leading to a high number of eliminated food groups may also influence QoL, especially emotional health and social function. [1] Casanova M.J. et. al. Prevalence of Malnutrition and Nutritional Characteristics of Patients With Inflammatory Bowel Disease. J Crohns Colitis 2017, 11, 1430-1439.