In the Journals

Dietary fiber associated with reduced Crohn's disease flares

Researchers suggested re-evaluating recommendations to limit dietary fiber due to recent evidence that disease flares in patients with Crohn’s disease may be reduced with the intake of dietary fiber. However, in the study, the reduced flares were not observed in patients with ulcerative colitis.

Using the Crohn’s and Colitis Foundation of America Partners Internet cohort, Carol S. Brotherton, PhD, of the School of Nursing, George Mason University, Fairfax, Va., and colleagues examined the association of dietary fiber intake with flares in patients with chronic inflammatory bowel diseases. 

For the study, 1,619 patients were identified; 1,130 were patients with Crohn’s disease (CD), and 489 were patients with UC/indeterminate colitis. Completed dietary surveys were collected from the patients at baseline and at 6-month follow-up. Consumption of fiber and whole grains was classified into quartiles and deciles. At the 6-month follow-up period, the researchers considered a disease flare to be a disease activity index score above remission cut-off values. IBD-related surgical procedures or hospitalizations that occurred from the time of the baseline survey to follow-up were also considered a disease flare.

The risk for disease flare differed by type of disease. Patients with CD were about 40% less likely to have a disease flare when they did not avoid high fiber foods compared to those who reported that they did avoid high fiber foods (adjusted OR, 0.59; 95% CI, 0.43-0.81). Patients with CD in the highest quartile of fiber intake were significantly less likely to have a flare (crude OR = 0.57; 95% CI 0.38-0.86). For patients with UC, researchers found no link between dietary fiber intake and disease flare (aOR, 1.82; 95% CI, 0.92-3.6). 

“The results of this study support findings reported in investigations occurring in the 1980s – low fiber eating does not result in improved outcomes for individuals with CD compared to individuals with CD not restricting fiber intake,” the researchers wrote. “More research is needed to explore the causes of fiber restriction in CD. More prospective studies are needed to explore the potential benefits of fiber-containing foods in the diet of individuals with IBD, especially in specific phenotypes. As suggested by the authors of a recent IBD diet review, it is unlikely that a single diet will be found to be sufficient to manage all IBD phenotypes; however, it will be remarkable progress if a diet is found to be sufficient alone for some and adjunctive therapy for others.” – by Suzanne Reist

Disclosures: Brotherton reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

Researchers suggested re-evaluating recommendations to limit dietary fiber due to recent evidence that disease flares in patients with Crohn’s disease may be reduced with the intake of dietary fiber. However, in the study, the reduced flares were not observed in patients with ulcerative colitis.

Using the Crohn’s and Colitis Foundation of America Partners Internet cohort, Carol S. Brotherton, PhD, of the School of Nursing, George Mason University, Fairfax, Va., and colleagues examined the association of dietary fiber intake with flares in patients with chronic inflammatory bowel diseases. 

For the study, 1,619 patients were identified; 1,130 were patients with Crohn’s disease (CD), and 489 were patients with UC/indeterminate colitis. Completed dietary surveys were collected from the patients at baseline and at 6-month follow-up. Consumption of fiber and whole grains was classified into quartiles and deciles. At the 6-month follow-up period, the researchers considered a disease flare to be a disease activity index score above remission cut-off values. IBD-related surgical procedures or hospitalizations that occurred from the time of the baseline survey to follow-up were also considered a disease flare.

The risk for disease flare differed by type of disease. Patients with CD were about 40% less likely to have a disease flare when they did not avoid high fiber foods compared to those who reported that they did avoid high fiber foods (adjusted OR, 0.59; 95% CI, 0.43-0.81). Patients with CD in the highest quartile of fiber intake were significantly less likely to have a flare (crude OR = 0.57; 95% CI 0.38-0.86). For patients with UC, researchers found no link between dietary fiber intake and disease flare (aOR, 1.82; 95% CI, 0.92-3.6). 

“The results of this study support findings reported in investigations occurring in the 1980s – low fiber eating does not result in improved outcomes for individuals with CD compared to individuals with CD not restricting fiber intake,” the researchers wrote. “More research is needed to explore the causes of fiber restriction in CD. More prospective studies are needed to explore the potential benefits of fiber-containing foods in the diet of individuals with IBD, especially in specific phenotypes. As suggested by the authors of a recent IBD diet review, it is unlikely that a single diet will be found to be sufficient to manage all IBD phenotypes; however, it will be remarkable progress if a diet is found to be sufficient alone for some and adjunctive therapy for others.” – by Suzanne Reist

Disclosures: Brotherton reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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