D2 | Abstract 18

Annual NUTRIM Symposium 18 November 2020

APPLIED SCIENCE

Dietary Intake Pattern is Associated with Occurrence of Flares in IBD Patients.

C.E.G.M. Spooren1,2,†, V. Peters3,4,†, R.J. Almeida5,6, M.J. Pierik1,2, R.K. Weersma3, H.M. van Dullemen3,E.A.M. Festen3, M.C.Visschedijk3, A.A.M. Masclee1,2, E.M.B. Hendrix1,2, C.W.M. Perenboom7, E.J.M. Feskens7, G. Dijkstra3, M.J.E. Campmans-Kuijpers3,‡, D.M.A.E. Jonkers1,2‡

† Shared first author; ‡ Shared last author

1 Department of Internal Medicine, Division Gastroenterology-Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
2 School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
3 Department of Gastroenterology and Hepatology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
4 Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
5 Department of Quantitative Economics, School of Business and Economics, Maastricht University, Maastricht, The Netherlands.
6 Department of Data Analytics and Digitalization, Maastricht University, Maastricht, The Netherlands.
7 Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
Background:
 Diet is associated with onset of inflammatory bowel disease (IBD). Up to half of IBD patients believe that diet contributes to flares. However, studies on this topic are sparse and merely focus on specific nutrients, food items or food groups. We aimed to analyze the association between dietary patterns and flare occurrence in two geographically distinct Dutch cohorts.

Methods:
In this longitudinal study, 724 IBD patients (Northern cohort: n=486, Southern cohort: n=238) were included and followed for two years. Habitual dietary intake was obtained via semi-quantitative food frequency questionnaires at baseline. Principal component analysis (PCA) was conducted on 22 food groups to identify dietary patterns. Flare occurrence was analyzed in 427 patients in remission at baseline, using multivariable COX proportional hazards. 

Results:
Compared to the Southern cohort, patients in the Northern cohort were younger at diagnosis, comprised more females, and had lower overall energy intakes (all p<0.05). PCA revealed three dietary patterns explaining 28.8% of the total variance. The most pronounced pattern (explaining 11.6%) was characterized by intake of grain products, oils, potatoes, processed meat, red meat, condiments and sauces, and sugar, cakes and confectionery. Of the 427 patients in remission at baseline, 106 (24.8%) developed an exacerbation during follow-up. The above dietary pattern was associated with flare occurrence (HR: 1.51, 95% CI: 1.04-2.18, p=0.029), as was female sex (HR: 1.63, 95% CI 1.04-2.55, p=0.032). 

Conclusions:
A dietary pattern, which can be seen as a characterized by grains, oils, potatoes, processed meat, red meat, condiments, and confectionery comports with a “traditional (Dutch)” or ”Western” pattern and was associated with flare occurrence. Further research is needed to confirm causality.
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NUTRIM aims to contribute to health maintenance and personalised medicine by unraveling lifestyle and disease-induced derangements in metabolism and by developing targeted nutritional, exercise and drug interventions. This is facilitated by a state of the art research infrastructure and close interaction between scientists, clinicians, master and PhD students.
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