P979 Diet, disease activity and extraintestinal symptoms in IBD outpatients

• Published in: Journal of Crohn's and colitis Vol. 18; no. Supplement_1; pp. i1774 - i1776
• Main Authors: Wilke, E L, Knoedler, L L, Atanasova, K, Ebert, M P, Reindl, W, Thomann, A K
• Format: Journal Article
• Language: English
• Published: 24-01-2024
• ISSN: 1873-9946; 1876-4479
• DOI: 10.1093/ecco-jcc/jjad212.1109

Abstract
Background
Patients with inflammatory bowel disease (IBD) show higher rates of fatigue and symptoms of depression and anxiety. Growing evidence reports a beneficial influence of plant- based diets on IBD as well as psychological disorders. The Mediterranean diet shows favorable characteristics in this regard and is simple to implement. We aimed to examine adherence to a Mediterranean diet as well as its associations with disease activity, quality of life and fatigue or affective symptoms in outpatients with IBD.
Methods
We delivered questionnaires to IBD outpatients, assessing adherence to the Mediterranean diet (MEDAS), symptoms of depression and anxiety (HADS), as well as fatigue (FACIT-F) and quality of life (SHS). Disease activity was measured with HBI or pMS, respectively. Associations between the parameters were determined using spearman correlation.
Results
We collected data of n=281 patients. Adherence to the Mediterranean diet was generally low in our sample with a median MEDAS score of 6 (0-13). The greatest deficit was observed in the regular consumption of fish (10 %) and fruit (16.6 %). However, we found a very high adherence for olive oil as the main source of fat (81.9 %), as well as a preference for white meat over red meat and processed meats (63.7 %). The prevalence of depressive symptoms (HADS-D ≥ 8) was 22.4 %, while symptoms of anxiety (HADS-A ≥ 8) were found in 35.9 % of the participants. Severe fatigue (FACIT < 30) was present in 33.8 % of the patients. Patients with clinically active disease were more likely to experience fatigue (ρ=-.231, p=<.001), symptoms of anxiety (ρ=.132, p=.010), depressive symptoms (ρ=.216 p=<.001), and reduced quality of life (ρ=.359, p<.001), all Figure 1a. There were no significant associations between the MEDAS score and disease activity (ρ=.033, p=.522), fatigue (ρ=-.009, p=.831), anxiety symptoms (ρ=.049, p=.294), or depressive symptoms (ρ=-.035, p=.461). Women showed significantly higher adherence to Mediterranean diet (mean MEDAS score 5.2 vs. 6, p=.003). We found a negative correlation between adherence to Mediterranean diet and level of calprotectin (ρ=-.146, p=.023, Figure 1b).
Conclusion
The preliminary analysis of our sample suggests low levels of adherence to the Mediterranean diet in our patient population. Contrary to our expectation, there were no statistically significant associations between diet and disease activity, quality of life, or psychological complaints. However, the inverse correlation between adherence to Mediterranean diet and level of calprotectin can support the anti-inflammatory characteristics this diet. It remains unclear, to which intent an anti-inflammatory diet can impact the course of disease and clinical symptoms in patients with IBD.