炎症性肠病患者饮食情况调查及饮食营养评估

Diet investigation and nutrition assessment of patients with inflammatory bowel disease

目的肠道菌群与炎症性肠病密切相关,饮食是影响肠道菌群最重要的环境因素之一,本文旨在了解IBD患者进食的食物种类、营养素并探讨其与IBD的相关性。方法调查107例溃疡性结肠炎(UC)患者、173例克罗恩病(CD)患者和42例正常对照者的饮食情况,将食物分类整理并输入营养计算器,得到研究对象各大食物种类摄入情况及各种膳食中的营养摄入量。结果CD组BMI<18的患者比UC组多。三组人群中,蔬菜类、鱼虾类、奶类的摄入量有差异。三组患者的谷类、蛋白质、脂肪的摄入量是足够的,但膳食纤维摄入量远未达到推荐摄入量。在维生素的摄入中,叶酸、烟酸、维生素C、维生素D三组间的摄入量有显著差异。在矿物质的摄入中,三组间钙、硒的摄入量有显著差异。进一步做相关性分析,我们发现在食物种类上,蔬菜类、畜禽肉类、鱼虾类与IBD存在负相关,奶类与IBD正相关;营养素方面,蛋白质、叶酸、烟酸、维生素C、钙、钾、镁、锌、硒、锰均与IBD存在负相关,维生素D存在正相关。结论通过调查IBD患者的饮食情况,我们了解了IBD患者的饮食摄入和营养素摄入情况,为IBD患者的饮食建议、营养治疗提供依据。

Objective The pathogenesis of IBD is unclear and gut microbiota is getting more and more attention.Diet is one of the most important environmental factors affecting gut microbiota.To find out if dietary components and nutrients are different in IBD patients and the association of IBD and diet are important.Methods Participants were investigated how often and how much at a time they had consumed food or beverage items on an average during the past year.The mini nutritional assessment(MNA)was used as a screening and assessment tool to identify subjects at risk of malnutrition.Results The percentage of CD patients whose BMI<18 was higher than UC patients.Diet investigation showed that daily intake of vegetables,fish and shrimp,milk and dairy products were significantly different.Daily intake of mainly nutrient as carbohydrate,protein and fat were enough except dietary fiber.Daily intake of folic acid,niacin,vitamin C,and vitamin D were significantly different in the three groups.Significant differences were observed in calcium and selenium intake.Further correlation analysis showed that there was a negative correlation between IBD and vegetables,meat,fish and shrimp,and a positive correlation between milk and IBD.Then protein,folic acid,niacin,vitamin C,Calcium,potassium,magnesium,zinc,selenium and manganese were negatively correlated with IBD,while vitamin D was positively correlated.Conclusion Through the investigation of IBD patients′dietary components,we learned about the abundance of diet and nutrient intake.Then we could provide advice on diet and nutrition treatment for IBD patients.