Dietary Beliefs and Behaviours in Inflammatory Bowel Disease

Abstract

The role of diet in the development and control of inflammatory bowel disease (IBD) remains incompletely understood. Epidemiological studies have implicated the western diet in IBD aetiopathogenesis but data from clinical studies are yet, in the main, to fully support this. People living with IBD can be left frustrated by the lack of consistent dietary advice they receive resulting in self-imposed dietary restriction and alterations in eating behaviour. For the first element of this project, we collected data from healthcare professionals regarding the dietary advice they provide to people with IBD. The results demonstrated frequent inconsistencies in the dietary recommendations provided. Beliefs regarding the role of diet in the control of inflammation and functional gastrointestinal symptoms were variable. Following this, we report the results of three studies addressing the dietary practices and beliefs of people with inactive ulcerative colitis (UC), South Asian people living with IBD and those with older-onset IBD. The study of inactive UC highlighted that, even when in remission, people demonstrated fairly consistent dietary beliefs and patterns of food avoidance. Furthermore, the study of British South Asian people with IBD showed more extreme alterations in dietary behaviour than similar studies in the Caucasian population. Finally, the cohort with older-onset IBD continued to report frequent food avoidance and use of whole food exclusion diets which may be of concern in this at risk population. The final element of this project involved conducting a novel feasibility study investigating neurocognitive aspects of appetite and dietary behaviour. Whilst recruitment was terminated early due to the COVID-19 pandemic, the results showed promise for the use of the experimental paradigm in future studies. Overall, this work has helped highlight how the current dearth of credible evidence for the role of diet in IBD may impact on both those living with this disease and the healthcare professionals who help manage them. Alterations in food related beliefs and behaviours can impact upon physical and psychosocial well-being. In the future, well-constructed, interventional dietary studies should aim to gain a better understanding of the complex relationship between diet, functional symptoms and generation of intestinal inflammation, thus allowing optimisation of IBD care.

Date of Award	31 Dec 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	John Mclaughlin (Supervisor) & Jimmy Limdi (Supervisor)