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Natasha Haskey
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The Mediterranean diet pattern improves diet quality and symptoms in patients with Ulcerative Colitis compared to a habitual diet: A Pilot Study
Names, Organizational Affiliations, and Locations of all Authors
Haskey N1, Shim RK2, Ye J3, Singh S4, Dieleman LA5, Jacobson K6, Gibson DL1,7;
1Department of Biology; University of British Columbia - Okanagan Campus; Kelowna, British Columbia, V1V 1V7, Canada, 2Department of Public Health Sciences, The Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, 3 Diabetes Center, University of California San Francisco, San Francisco, USA, 4Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada, 5Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada,6Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition and British Columbia Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada,7Department of Medicine; University of British Columbia - Okanagan Campus, Kelowna, British Columbia, V1V 1V7, Canada
Background: Compelling evidence suggests that the Mediterranean Diet Pattern (MDP) may benefit inflammatory bowel disease (IBD); however, data on whether patients can comply with this dietary pattern and the nutritional adequacy of this diet in Ulcerative Colitis (UC) is lacking. We compared the effects of the MDP with the Canadian Habitual Diet Pattern (CHD) in a randomized control trial in adult patients with UC.
Objective(s)/Process or Summary of Content
Methods: Adult participants with quiescent UC were randomized to follow a MDP (n=15) or CHD (n=13) for 12 weeks. Demographic, clinical data, quality of life (Short Inflammatory Bowel Disease Questionnaire; SIBDQ), disease activity (Short Clinical Colitis Activity Index; SCCAI), dietary adherence (Mediterranean Diet Serving Score; MDSS), diet quality (Health-Eating Index-2015; HEI-2015) and dietary intake (ASA-24) were assessed at baseline and week 12.
Method(s)/Systemic Approach Used
Results: MDP participants were able to decrease or maintain disease activity versus the CHD participants (87% vs 69%; p=0.001). The MDP had a significant reduction in tenesmus (p=0.04). Health-related quality of life (bowel domain) showed reductions in the passage of large amounts of gas (p=0.01) and improvements in tenesmus (p=0.03). The MDP (n=10) achieved a higher level of adherence (MDSS score between 16-24) versus CDP (n=3), p=0.030. In the participants following the MDP, the HEI-2015 significantly increased from baseline to week 12 (p=0.007). The HEI-2015 score at week 12 for the MDP participants was significantly higher than the participants following the CHD (p=0.0001). Both groups consumed sub-optimal calcium, iron, vitamin E, fibre, and choline intakes.
Conclusions: A MDP is well-tolerated and improved bowel symptoms, including stool frequency, flatulence, and tenesmus in adult participants with quiescent UC. High adherence to the MDP was achieved with support from a Registered Dietitian; however, a focus on tailored messages about nutrients of concern for individual patients following the MDP is recommended to ensure nutritional adequacy. no: NCT030537
Significance to Dietetics
Funded by
Funding: by a Canadian Institutes of Health Research - Frederick Banting and Charles Best Canada Graduate Doctoral Award and a Canadian Association of Gastroenterology PhD Studentship Award. This study was supported by a Crohn's and Colitis Canada Grant-in-Aid and a Canadian Foundation for Dietetic Research Award
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