Intestinal Research

Review

IBD

Anti-inflammatory diet and inflammatory bowel disease: what clinicians and patients should know?: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2021;19(2):171-185. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00035

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

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Original Articles

Functional bowel disorder

An evaluation of dietary adequacy among patients with constipation-predominant irritable bowel syndrome in Malaysia: Nor Hamizah Shafiee, Nurul Huda Razalli, Norfilza M. Mokhtar, Eunice Tan, Raja Affendi Raja Ali; Intest Res 2022;20(1):124-133. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00050

Abstract PDF PubReader ePub

Background/Aims
Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls.
Methods
A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls.
Results
A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B₁, B₂, B₆, folate, B₁₂, E, K, and potassium) among IBS-C patients did not meet the standard RNI.
Conclusions
Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

Citations

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Kwang Woo Kim
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Inflammatory bowel diseases

An assessment of dietary intake, food avoidance and food beliefs in patients with ulcerative colitis of different disease status: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2020;18(4):447-458. Published online June 2, 2020; DOI: https://doi.org/10.5217/ir.2019.00042

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Ulcerative colitis (UC) is a chronic, relapsing and remitting inflammation of the gastrointestinal tract. Little is known about the link between dietary intake, food avoidance, and beliefs among UC patients of different disease severity. Therefore, this study aimed to assess the dietary intake, food avoidance, and beliefs among active and inactive UC patients.
Methods
A cross-sectional study was conducted among UC patients from a tertiary medical center in Kuala Lumpur, Malaysia. Demographic, anthropometric, dietary intake, food avoidance and beliefs were assessed. Disease activity of UC patients was evaluated using the Powell Tuck Index.
Results
UC patients were recruited (64.1% inactive UC and 35.9% active UC). As compared to inactive UC patients, active UC patients were likely to lose weight (75.0% vs. 0%), possess certain food beliefs (95.7% vs. 39.0%), and frequently practiced dietary avoidance (95.7% vs. 43.9%). The dietary intake among inactive UC patients was higher than active UC patients. However, neither of them met the standard nutrients recommendation for protein, calcium, iron, folate, zinc, vitamin D, vitamin B₁₂, and vitamin E.
Conclusions
Active UC patients had poorer dietary intake, were more prone to practicing food avoidance and exhibited certain food beliefs as compared to inactive UC patients. Both macro- and micronutrients intakes were inadequate regardless of patient’s disease status. These findings emphasized the importance for patients to be provided with the nutrition-related knowledge as part of strategies to avoid nutritional inadequacies.

Citations

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