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Intestinal Research 2003;1(2):168-178.
Published online November 27, 2003.
Analysis of Dietary Patterns and Cytokine levels in Patients with Inflammatory Bowel Disease in Korea
Han Soo Kim, Yeon Ju Shin, Mi Ran Cho, Hyo Jong Kim, Beong Ou Lim, Ryowon Choue
Department of Medical Nutrition, Graduate School of East-West Medical Science, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
한국인 염증성 장질환 환자의 영양상태, 식이 형태와 혈청내의 항체 및 사이토카인 분석
김한수, 신연주, 조미란, 김효종, 임병우, 조여원
경희대학교 동서의학대학원 임상영양연구소, 의과대학 소화기내과
The cause of inflammatory bowel disease (IBD) is unclear. Dietary factor, however, has been considered as a possible risk factor for IBD. There is an increasing amount of evidence showing that the immune system may play a critical role in the development and perpetuation of IBD. The purpose of this study was to investigate nutritional status, dietary patterns, and cytokine levels of IBD patients in Korea. Methods: Patients with Crohn's disease (CD) and ulcerative colitis (UC) and gender-matched healthy controls were studied in case-control design. Anthropometry, blood and immunological analysis were used to evaluate the patient's nutritional status. Dietary patterns of the patients before and after diagnosis were analyzed by the semi-quantitative food frequency questionnaire. Current nutrient intake status was determined by 3-day recall method. Results: Patients with CD were in the mild-malnutrition status, showing that their body weight, percent of ideal body weight (%IBW), lean body mass (LBM), triceps skinfold thickness (TSF), mid-upper arm muscle circumference (MAMC) were lowest among the 3 groups. The serum levels of hemoglobin (Hb.), hematocrit (Hct.), white blood cell count (WBC), total lymphodyte count (TLC), and albumin were also low in patients with CD and UC. In addition, interferon-gamma (IFN-Г) tumor necrosis factor alpha (TNF-α) contents was significantly higher in patients with CD and UC than in the control. Before diagnosis, patients with CD ate less fishes, vegetables and fruits, and patients with UC ate more fruits and fast foods. After diagnosis, patients with CD ate fewer cereals, meats, vegetables and fats, and patients with UC ate less meats and vegetables. The current intake of patients with UC and CD for calorie, calcium, iron and vitamin B was lower than recommended dietary allowance (RDA) for each nutrient. The ratios of Polyunsaturated fatty acids (P): Monosaturated fatty acids (M): Saturated fatty acids (S) in patients with CD, UC and control group were 2.1:1.9:1, 1.9:1.7:1 and 1.5:1.1:1, respectively. The ratios of n-6/n-3 were 15.8:1 for patients with CD, 13.1:1 for patients with UC, and 11.2:1 for control group, respectively. Conclusions: Most patients with IBD, particularly patients with CD, were malnourished because of their poor food intake. Dietary intake patterns of patients with IBD were low in dietary fiber and high in refined carbohydrate. (Intestinal Research 2003;2:168-178)
Key Words: Inflammatory bowel diseases, Crohn's disease, Ulcerative colitis, Nutritional status, Dietary patterns, Food frequency
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