TOPLINE:

Only about a quarter of patients with inflammatory bowel disease (IBD) consumed high-fiber diets. Dietary fiber intake was lower among patients with active IBD vs inactive disease, particularly among patients with ulcerative colitis.

METHODOLOGY:

• Although fiber is known to support gut microbiome and mucosal health, limited evidence exists on how habitual fiber intake differs by IBD disease type and state.
• Researchers conducted a prospective cross-sectional study at two US academic gastroenterology practices. They recruited adults with IBD and assessed disease activity using fecal calprotectin, endoscopy, or cross-sectional imaging records.
• The study involved 117 patients (71 with Crohn’s disease, 43 with ulcerative colitis, and 3 with undetermined IBD). Of them, 77 had active disease (mean age, 37.8 years; 55.8% men), and 40 had inactive disease (mean age, 40.3 years; 40% men).
• Patients completed a five-item food frequency questionnaire, which estimated habitual fiber intake over the past 12 months. Low fiber intake was defined as < 22 g/d for men and < 18 g/d for women, whereas high intake was defined as ≥ 30 g/d for men and ≥ 25 g/d for women.
• Researchers compared fiber intake among people with and without disease activity, and a sub-analysis assessed intake levels in those with ulcerative colitis and those with Crohn’s disease separately. Potential predictors of high dietary fiber intake, such as IBD type and activity level, patients’ income and education levels, and sources of nutrition education, also were analyzed.

TAKEAWAY:

• Only 26% of all participants consumed high-fiber diets. Thirty-one percent of patients with Crohn’s disease consumed a high-fiber diet compared with 14% of patients with ulcerative colitis.
• Daily fiber intake was lower in patients with active vs inactive disease (mean, 19 g vs 24 g; P = .0048).
• Among patients with ulcerative colitis, mean fiber intake was lower in those with active vs inactive disease (13 g vs 22 g; P = .0044). Fiber intake did not differ significantly by disease activity in patients with Crohn's disease.
• Only disease type (Crohn’s disease) and source of nutrition education (the internet) were significant predictors of high fiber intake. Exposure to each additional source of nutrition education was linked to 20% increased odds of eating a high-fiber diet (P = .036).

IN PRACTICE:

“While we await more randomized trials that evaluate the role of dietary fiber in patients with active disease, given the other health benefits of a high-fiber diet, including improved cardiovascular health and reduced cancer risk, these data should empower us to continue to strive for healthier high-fiber diets for our patients with IBD, which can be driven through patient education on this topic,” the authors wrote.

SOURCE:

This study, led by Jaya Vasudevan, MD, of the University of Texas at Austin, was published online in Journal of Clinical Gastroenterology.

LIMITATIONS:

The findings may be less generalizable to patients at nonacademic centers. The food frequency questionnaire relied on recall over the past year and was not specifically validated in patients with IBD. The cross-sectional analysis precluded causal relationships between dietary fiber and disease activity. 

DISCLOSURES:

This study was supported with institutional funds from Ascension Seton under a partnership with Dell Medical School at The University of Texas at Austin. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.