Abstract
A number of bioactive components of diet are indicated as potential dietary factors for the management of ulcerative colitis, while the recent study conducted in an animal model revealed that proanthocyanidins from grape seeds exert a broadly positive impact. The aim of the study was to verify the influence of dietary proanthocyanidins intake on the symptoms of ulcerative colitis in remission in human subjects. The study was conducted in a group of 55 participants (19 males, 36 females) in remission of ulcerative colitis confirmed based on both the Mayo Scoring system and Rachmilewitz index. Their habitual dietary intake of proanthocyanidins and intake recalculated per 1000 kcal of diet was assessed and it was verified whether they are associated with symptoms of ulcerative colitis. The energy value of diet and intake of other nutrients were analyzed as potential interfering factors. Participants declaring the presence of mucus in their stool compared with other participants were characterized by higher proanthocyanidins intake (142 vs. 75 mg; p = 0.0441) and intake per 1000 kcal (91 vs. 37 mg/1000 kcal; p = 0.0092), while for no other nutrient such association was stated. Participants declaring constipation compared with other participants were characterized by higher proanthocyanidins intake (214 vs. 82 mg; p = 0.0289) and intake per 1000 kcal (118 vs. 41 mg/1000 kcal; p = 0.0194). Similar association for constipation was observed in the case of energy value of diet and protein intake, but only for proanthocyanidins intake, it was confirmed in the logistic regression model (p = 0.0183; OR = 1.01; 95% CI 1.00–1.02). The positive influence of habitual dietary intake of proanthocyanidins was confirmed in the studied group of patients with ulcerative colitis in remission, as this intake may have increased the production of mucus, which is beneficial for intestinal healing, and may have reduced the frequency of bowel movements. However, further experimental human studies are necessary to confirm the potential influence of proanthocyanidins intake in patients with ulcerative colitis in remission.
Highlights
Ulcerative colitis is classified as one of the inflammatory bowel diseases, defined as a chronic inflammatory condition resulting in diffuse friability and superficial erosions of the colonic wall, associated with bleeding [1]
- Being Caucasian; - Being aged 18–80 years; - Being nonhospitalized for any disease; - Endoscopically diagnosed ulcerative colitis confirmed in the clinic records; - Having confirmed remission of ulcerative colitis—endoscopic remission: image without any changes or disappearance of vascular network, erythema, inflammatory polyps allowed; clinical remission: assessed based on the Mayo Scoring System; and the Rachmilewitz index for the assessment of the ulcerative colitis activity [15], as described previously [16]; - Having been in clinical remission for at least six weeks; - Having had constant drugs doses for at least six weeks confirmed by patient
The energy value of diets was assessed to estimate the proanthocyanidins intake recalculated per 1000 kcal of diet and to verify it as a potential interfering factor
Summary
Ulcerative colitis is classified as one of the inflammatory bowel diseases, defined as a chronic inflammatory condition resulting in diffuse friability and superficial erosions of the colonic wall, associated with bleeding [1]. There are numerous symptoms of this disease, including abdominal pain, diarrhea, or rectal bleeding [3], which may be experienced even in remission [4] and may reduce the general quality of life of patients [5]. Considering these aspects, patients with ulcerative colitis need adequate care during both relapses and remissions [6]. Proper nutrition is one of the most important issues that should be addressed in patients with ulcerative colitis [7]. For the period of remission, there are no defined dietary guidelines associated with a specific nutritional value of diet, but rather more general recommendations associated with food products that should be avoided, reduced, or increased in the everyday diet [9]
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