Towards dietary assessment and interventions for patients with Inflammatory Bowel Disease

This thesis clarifies the role of nutrition in the development and progression of IBD including Crohn’s Disease (CD) and Ulcerative Colitis (UC). After analysis of habitual dietary intake of IBD-patients and healthy controls, IBD-patients demonstrated too low protein intakes. 39% of patients in remission did not meet the required 0.8 g/kg protein per day, whereas even 87% of patients with active disease did not achieve the required 1.2 g/kg/day. Patients avoid certain foods, creating potentially nutrient deficiencies. Besides, we found that adherence to a more Western or Carnivorous dietary pattern was associated with higher risk of developing CD and UC. These findings are confirmed by the fact that a relative high diet quality score is associated with a lower risk of developing UC. Furthermore, a Western dietary pattern was associated with higher risk of developing an IBD-flare. Additionally, a food frequency questionnaire was developed specifically for IBD-patients. Furthermore, we studied literature to elucidate the role of different types of fibers in the treatment of IBD. Although evidence is still limited, germinated barley and inulin deserve more research in the field of IBD treatment. Within this thesis, the set-up of a large dietary intervention study has been described. This study will evaluate the effect of an anti-inflammatory diet and a colon-delivered vitamin B2/3 and C supplement versus a placebo on the progression of CD and the changes in microbiome and inflammatory markers in patients and healthy household members. Thus, this dissertation contributes to better dietary treatment of IBD patients