P891 Estimating diet’s quality in patients with Crohn’s disease during remission
Karachaliou, A.(1)*;Yannakoulia, M.(1);Bletsa, M.(2);Mantzaris, G.J.(3);Tzouvala, M.(4);Bamias, G.(5);Kontogianni, M.D.(1);
(1)Department of Nutrition & Dietetics- School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece;(2)Department of Nutrition and Dietetics, ’Sotiria’’ Thoracic Diseases Hospital, Athens, Greece;(3)Department of Gastroenterology, ‘’Evangelismos-Ophthalmiatreion Athinon-Polykliniki’’ General Hospital, Athens, Greece;(4)Department of Gastroenterology, General Hospital of Nikaia Piraeus “Agios Panteleimon”-General Hospital Dytikis Attikis “Agia Varvara”, Athens, Greece;(5)GI-Unit- 3rd Academic Department of Internal Medicine, “Sotiria’’ Thoracic Diseases Hospital- Medical School- National and Kapodistrian University of Athens, Athens, Greece;
Background
Patients with Crohn’s disease (CD) experience inadequate energy and nutrients’ intake and food restrictions especially during active disease, but in remission it is recommended to follow guidelines for the general population. However, sparce data support patients’ reluctance to abandon restrictions they usually follow during disease flare-ups. The aim of the study was to evaluate dietary intake in terms of macronutrients, food groups and adherence to healthy dietary patterns in a sample of patients with CD in remission.
Methods
Disease activity was assessed endoscopically and using the Harvey-Bradshaw Index (HBI<5 indicates remission). Nutrients’ intake was assessed through two non-consecutive 24-hour dietary recalls and food groups consumption through a validated food frequency questionnaire. Dietary intake was compared to relevant recommendations (ESPEN’s guidelines for protein intake, EFSA’s recommendations for healthy adults for other macronutrients’ intake and national dietary guidelines for adult Greek population for food groups’ consumption). Adherence to the Mediterranean diet was estimated using MedDietScore (values 0-55, higher values indicate higher adherence) and to the European dietary guidelines for cardiovascular disease prevention with CVD-score (values 0-11, higher values indicate higher adherence).
Results
148 patients (50.7% males, 40.8±13.7 years) were evaluated. 14% reported lower protein intake than recommended. Carbohydrate intake was lower (42.3±8.3 %), sugars intake was higher than the recommended threshold of 10% [13.1 (9.3, 16.4) %] and total fat (39.3±7.5%) and saturated fat [12.7 (10.5, 14.6) %] intakes were higher than recommended. Also, fibers intake was lower than the recommended values of 25-30g/day [15.7 (11.5, 21.2) g/day] and remained low even when excluding those with structuring disease (n=71) [median intake 15.2 (11.1, 21.5) g/day]. Regarding food groups’ consumption, patients reported lower dairy [1.60 (0.96, 2.28) portions/day], non-refined cereals [0.21 (0.02, 0.70) portions/day], fruits [1.06 (0.42, 1.92) portions/day], vegetables [1.11 (0.64, 1.84) portions/day] and legumes [1.26 (0.00, 3.71) portions/week] consumption and higher total red meat [4.23 (2.94, 6.22) portions/week] and sweets [4.97 (1.96, 8.96) portions/week] consumption than the recommended. Mean MedDietScore was 28.7±5.5 and mean CVD-score was 5.42±1.39, both reflecting a low-to-moderate diet’s quality.
Conclusion
Contrary to European dietary guidelines encouraging patients with CD to follow a healthy, without restrictions, dietary pattern during remission, patients fail to adhere to these recommendations and follow a diet of low-to moderate quality.