TAKE HOME POINTS
1. It is important to ask all IBD patients about their diet. Simply asking a patient to take you through a day of eating can help identify many nutritional concerns, such as restrictive eating patterns.
2. All patients with IBD should have micronutrient testing at the time of diagnosis and regularly thereafter. It is important to use the clinical history and exam to determine which vitamins and minerals to test.
A thorough physical exam can be very helpful in identifying micronutrient deficiencies.
3. Fiber is not the enemy in IBD! In fact, when consumed in a safe way, it can be very beneficial for the microbiome. Patients with IBD should modify the texture of their fruits and vegetables instead of restricting them. Patients with strictures and ileostomies need extensive modification to allow them to enjoy these foods without increasing the risk of a bowel obstruction.
4. There are no foods that have been shown to be “inflammatory” and therefore in the absence of other conditions (such as celiac disease and lactose intolerance), patients with IBD can and should consume an overall healthy diet, (Mediterranean style) high in fresh fruits and vegetables, lean proteins (chicken, fish), whole grains, olive oil.
REFERENCES
1: Bischoff, Stephan C., et al. “ESPEN guideline on Clinical Nutrition in Inflammatory Bowel Disease.” Clinical Nutrition (2023).
2 : Gold, Stephanie L., et al. “Micronutrients and their role in inflammatory bowel disease: function, assessment, supplementation, and impact on clinical outcomes including muscle health.” Inflammatory Bowel Diseases 29.3 (2023): 487-501.
3: Fritsch, Julia, et al. “Low-fat, high-fiber diet reduces markers of inflammation and dysbiosis and improves quality of life in patients with ulcerative colitis.” Clinical gastroenterology and hepatology 19.6 (2021): 1189-1199.
nutribytes.org 