Abstract
The aim of the present study was to investigate the efficacy of the actual consuming n-3 PUFA for remission-maintenance in IBD patients. A questionnaire on the dietary habits of patients one month before hospitalization (Q1) was completed by 24 patients with IBD (10 ulcerative colitis (UC) subjects and 14 Crohn’s disease (CD) subjects) treated at our hospital. We educated the study subjects about an n-3 PUFA diet, and a follow-up survey (Q2) was conducted 6 to 12 months after discharge. Disease activity was evaluated using the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) score and/or the Crohn’s Disease Activity Index (CDAI) score for CD and the partial UCDAI score without endoscopic evaluation for UC. Q1 showed that the average n-3 and n-6 PUFA intakes were 1673 ± 1651 mg and 9146 ± 5217 mg, respectively, and the average n-3/n-6 ratio was 0.27 ± 0.31. In Q2, the intake of n-3 PUFA was significantly higher (3671 ± 1684 mg, p < 0.001), whereas the n-6 PUFA intake decreased significantly (5217 ± 1973 mg, p < 0.001) compared to those in Q1. As a consequence, the dietary n-3/ n-6 ratio was significantly increased (0.87 ± 0.60, p < 0.001). Maintenance of the remission rate was significantly higher in IBD patients who complied with the n-3 diet, and these patients maintained a dietary n-3/n-6 ratio of 0.432 or higher (17 of 23 cases; 70.8%, p < 0.03) compared to that observed for IBD patients who did not comply with the diet. These results emphasize the importance of adjusting dietary PUFA and suggest that the n-3 diet may be effective in maintaining the remission of IBD.
Highlights
In Japan, the intake of milk, animal meat, and vegetable oil began to increase from the 1960s onward, whereas the intake of fish products and cereals has decreased since the 1990s
The role of excessive intake of fat in the Western diet is emphasized in inflammatory bowel disease (IBD), the excessive consumption of n-6 polyunsaturated fatty acids (PUFA), including linoleic acid (LA), an essential fatty acid contained in large amounts in vegetable oil
We previously reported that the n-3/n-6 ratio of vital cell membrane phospholipids influenced the disease activities in IBD patients receiving dietary therapy that aimed to reduce the intake of n-6 PUFA and increase that of n-3 PUFA [4], i.e., the n-3 diet
Summary
In Japan, the intake of milk, animal meat, and vegetable oil began to increase from the 1960s onward, whereas the intake of fish products and cereals has decreased since the 1990s. The Western diet has become more mainstream among the current Japanese population, young people [1] [2], despite traditional Japanese cuisine being added to the UNESCO List of Intangible Cultural Heritage in 2013 With this sudden change in dietary habits, the incidence of inflammatory bowel disease (IBD) [3] has rapidly increased in Japan. The role of excessive intake of fat in the Western diet is emphasized in IBD, the excessive consumption of n-6 polyunsaturated fatty acids (PUFA), including linoleic acid (LA), an essential fatty acid contained in large amounts in vegetable oil These n-6 PUFA increase the release of arachidonic acid (AA)-derived inflammatory mediators such as prostaglandin E2 (PGE2) and leukotriene B4 (LTB4), which exacerbate IBD
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