Results of a large, prospective study published in The Journal of Nutrition suggest a potential benefit of fiber intake in patients with inflammatory bowel disease, particularly among those with Crohn disease.

Inflammatory bowel disease (IBD), which includes Crohn disease and ulcerative colitis, is a lifelong chronic condition. Identifying dietary factors that trigger flare-ups is crucial to IBD management. Patients with IBD are often cautioned to limit their intakes of high fiber foods due to a perception that these types of foods can trigger inflammatory episodes and subsequently increase the risk of IBD-related surgery.  The clinical benefits of dietary fiber in patients with IBD are controversial and there is insufficient evidence to determine whether high-fiber consumption should be recommended in the dietary management of IBD.

To better understand this challenging question, Tain (Central South University) and colleagues utilized data from the UK Biobank, an ongoing nationwide prospective cohort project. Inpatient data and primary care data were used to identify 5580 individuals diagnosed with IBD that met study eligibility criteria.  A 7-item IBD-associated healthy diet score using baseline food questionnaires as an overall measurement of diet quality was calculated. Information regarding IBD-related surgery was ascertained through inpatient data.

Study results suggest an inverse association between fiber intake and surgery risk among individuals with IBD, especially Crohn disease, but not ulcerative colitis. Analyses also demonstrated that the potential benefits of dietary fiber may vary by source. Protective associations were observed between fiber from vegetables, fruit, and some types of fiber in bread.  Although further studies are needed to confirm these findings, patients with IBD may benefit from consuming more fiber from fruits and vegetables, whereas fiber from certain bread and cereals should be consumed with caution. These findings also call for a need to re-evaluate recommendations to limit dietary fiber in IBD.

References

Deng M, Dan L, Ye S, Chen X, Want X, Tian L, Chen J. Higher Fiber Intake is Associated with Reduced Risk of Related Surgery among Individuals with Inflammatory Bowel Diseases in a Prospective Cohort Study. The Journal of Nutrition, Volume 153, Issue 8, August 2023, Pages 2274-2282, doi.org/10.1016/j.tjnut.2023.06.013.

Images via canva.com.

Read the full article

Kathy Beerman, PhD

Dr. Kathy Beerman teaches in the School of Biological Sciences at Washington State University. The author of several published articles, she is interested in research that focuses on the efficacy of a novel approach to treating iron deficiency anemia in rural regions of Guatemala and Ecuador. Dr. Beerman teaches an undergraduate nutrition course for health majors, as well as a course that prepares students to participate in a 10-day medical mission to Guatemala. Since joining the faculty at Washington State University in 1990, she has been the recipient of several teaching awards (the Burlington Northern Faculty Meritorious Achievement in Teaching Award, the R.M. Wade Foundation Award for Excellence in Teaching, and the Sahlin Faculty Excellence Award for Instruction). More recently, she received the CAS Outstanding Achievement Award in International Activities (2017) and the President’s Award for Leadership (2018). Other scholarly activities include co-author of two introductory nutrition textbooks (Nutritional Sciences: From Fundamentals to Food and NUTR).