Habitual Dietary Fibre And Prebiotic Intake In Inadequate In Patients With Inflammatory Bowel Disease

Davis, R1,2, Day, A1,3, Barrett, J4, Vanlint, A1, Andrews, J3,5, Costello, S1,3, Bryant, R1,3

1Inflammatory Bowel Disease Services, The Queen Elizabeth Hospital, CALHN, SA Health, 2 Discipline of Nutrition & Dietetics, College of Nursing & Health Sciences, Flinders University, 3 School of Medicine, Faculty of Health Sciences, University of Adelaide, 4 Dept of Gastroenterology, Monash University Central Clinical School, Victoria, 5Inflammatory Bowel Disease Service, Royal Adelaide Hospital, CALHN, SA Health

 

Background: Recommendations for dietary fibre intake in patients with inflammatory bowel disease are highly variable.1 Despite the potential benefits of prebiotic fibres on the gut microbiome, many patients with inflammatory bowel disease follow a low fibre diet. This study aimed to comprehensively evaluate intakes of total and prebiotic fibres in patients with inflammatory bowel disease, so as to determine the adequacy of fibre intake and factors that may influence intake.

Methods: Outpatients with a formal diagnosis of inflammatory bowel disease were recruited to this multi-centre cross-sectional study. Habitual dietary fibre intake including prebiotic fibre types were measured using a validated comprehensive nutrition assessment questionnaire. Adequacy of total fibre intake was compared to Australian Nutrient Reference Values. Multiple linear regressions were performed to determine factors influencing fibre intake.

Results: Of 92 participants, 52% had Crohn’s disease, 51% were male, and the mean age was 40 years. Overall, only 38% of the cohort consumed adequate total fibre (median 24g/day, interquartile range 18.5-32.9). Adequate fibre consumption was significantly less common in males than females (21.3% vs 55.6%, p= 0.002) (Figure 1). Resistant starch intake (median 2.9g/day, interquartile range 2.1-4.8) was significantly less than proposed recommendations (20g/day). Disease-related factors such as phenotype and disease activity were not found to influence fibre intake.

Conclusions: Patients with inflammatory bowel disease habitually consume inadequate fibre, in particular, the prebiotic fibre resistant starch. The potential deleterious effects of low prebiotic intake on the gut microbiome and disease-related outcomes in inflammatory bowel disease are unknown and warrant further research.


Rachel Davis

Rachel is a clinical dietitian currently employed at the Lyell McEwin hospital working across a number of clinical areas including gastroenterology. Rachel has an interest in gastrointestinal conditions and the impact of diet and nutrition on patient and health related outcomes. Rachel completed her honours research at The Queen Elizabeth Hospital on fibre intake in patients with inflammatory bowel disease and had the opportunity to disseminate this research at both Australian Gastroenterology Week and the Australasian Society of Parenteral and Enteral Nutrition conferences. Rachel has a key interest in food and enjoys opportunities to cook and trial different recipes in her spare time.

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