Nutrient intake, dietary patterns and relationship to symptoms and comorbidities in hypermobile Ehlers-Danlos syndrome

IF 7.9 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI:10.1016/j.clnu.2025.11.022

Rabia Topan , Shraya Pandya , Paula Chance , Natalia Zarate-Lopez , Qasim Aziz , Paul Bassett , Janet Kyle , Kevin Whelan , Asma Fikree

{"title":"Nutrient intake, dietary patterns and relationship to symptoms and comorbidities in hypermobile Ehlers-Danlos syndrome","authors":"Rabia Topan , Shraya Pandya , Paula Chance , Natalia Zarate-Lopez , Qasim Aziz , Paul Bassett , Janet Kyle , Kevin Whelan , Asma Fikree","doi":"10.1016/j.clnu.2025.11.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><div>Hypermobile Ehlers Danlos Syndrome (hEDS) patients have a high prevalence of Disorders of Gut–Brain Interaction (DGBI) and can pose complex nutritional challenges, yet little is known about their dietary intake, adequacy or dietary patterns and how this relates to clinical presentation. We aimed to assess this.</div></div><div><h3>Methods</h3><div>In a cross-sectional study, patients with hEDS completed a food frequency questionnaire and questionnaires characterizing: DGBI, gastrointestinal (GI) symptoms, Avoidant Restrictive Food Intake Disorder (ARFID), and use of nutrition support. Principal component analysis and cluster analysis classified patients into dietary patterns.</div></div><div><h3>Results</h3><div>425 participants were included (mean: 41 years, 96 % female); 46.4 % were overweight/obese. Patients consumed high protein (77.2 g ± 37.8), high fat (79.1 g ± 36.9) diets that were low in calories, Vitamin B and D; only 24.7 % achieved fibre requirements. Four dietary patterns existed: (1) ‘low food intake’ (n = 149), with highest nutrient inadequacy, highest ARFID scores (p < 0.001), most likely to use nutrition support (24 %, p = 0.02); (2) ‘vegetarian/health conscious’ (n = 120), with highest fibre intake (p < 0.001); (3) ‘low residue’ (n = 35), mostly seen in tertiary clinics (46 %, p < 0.001) and (4) ‘refined/highly processed’, with highest BMI (27.3 kg/m<sup>2</sup> p < 0.001) and presence of dyspepsia (p = 0.007) and least likely to have a dietetic consultation (p = 0.02).</div></div><div><h3>Conclusion</h3><div>This is the first study to measure nutrition intake, adequacy and dietary patterns in hEDS. Patients with either restrictive or highly processed food intake have more GI symptoms. Further research is needed to establish how these dietary patterns can best be managed in clinical practice, to optimize intake and minimize the use of artificial nutrition support.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106538"},"PeriodicalIF":7.9000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0261561425003176","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/12/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background and aims

Hypermobile Ehlers Danlos Syndrome (hEDS) patients have a high prevalence of Disorders of Gut–Brain Interaction (DGBI) and can pose complex nutritional challenges, yet little is known about their dietary intake, adequacy or dietary patterns and how this relates to clinical presentation. We aimed to assess this.

Methods

In a cross-sectional study, patients with hEDS completed a food frequency questionnaire and questionnaires characterizing: DGBI, gastrointestinal (GI) symptoms, Avoidant Restrictive Food Intake Disorder (ARFID), and use of nutrition support. Principal component analysis and cluster analysis classified patients into dietary patterns.

Results

425 participants were included (mean: 41 years, 96 % female); 46.4 % were overweight/obese. Patients consumed high protein (77.2 g ± 37.8), high fat (79.1 g ± 36.9) diets that were low in calories, Vitamin B and D; only 24.7 % achieved fibre requirements. Four dietary patterns existed: (1) ‘low food intake’ (n = 149), with highest nutrient inadequacy, highest ARFID scores (p < 0.001), most likely to use nutrition support (24 %, p = 0.02); (2) ‘vegetarian/health conscious’ (n = 120), with highest fibre intake (p < 0.001); (3) ‘low residue’ (n = 35), mostly seen in tertiary clinics (46 %, p < 0.001) and (4) ‘refined/highly processed’, with highest BMI (27.3 kg/m² p < 0.001) and presence of dyspepsia (p = 0.007) and least likely to have a dietetic consultation (p = 0.02).

Conclusion

This is the first study to measure nutrition intake, adequacy and dietary patterns in hEDS. Patients with either restrictive or highly processed food intake have more GI symptoms. Further research is needed to establish how these dietary patterns can best be managed in clinical practice, to optimize intake and minimize the use of artificial nutrition support.

查看原文本刊更多论文

营养摄入、饮食模式及其与多动症患者症状和合并症的关系

背景和目的：高血压综合征（hEDS）患者具有高患病率的肠脑相互作用紊乱（DGBI），并可能带来复杂的营养挑战，但对其饮食摄入量、充足性或饮食模式及其与临床表现的关系知之甚少。我们的目的是评估这一点。方法：在一项横断面研究中，hEDS患者完成了一份食物频率问卷和问卷，问卷的特征包括：DGBI、胃肠道（GI）症状、回避性限制性食物摄入障碍（ARFID）和营养支持的使用。主成分分析和聚类分析将患者按饮食模式进行分类。结果纳入425名受试者（平均41岁，96%为女性）；46.4%的人超重/肥胖。患者食用高蛋白（77.2 g±37.8）、高脂肪（79.1 g±36.9）低热量、维生素B和D饮食；只有24.7%达到了纤维要求。存在四种饮食模式：(1)“低食物摄入”（n = 149），营养不足程度最高，ARFID评分最高（p < 0.001），最有可能使用营养支持（24%,p = 0.02）；(2)“素食/有健康意识”（n = 120），纤维摄入量最高（p < 0.001）；(3)“低残留”（n = 35），主要见于三级诊所（46%,p < 0.001）；(4)“精制/高度加工”，BMI最高（27.3 kg/m2, p < 0.001），存在消化不良（p = 0.007），最不可能进行饮食咨询（p = 0.02）。结论本研究首次测量了新生儿的营养摄入、充足性和饮食模式。限制或高度加工食品摄入的患者有更多的胃肠道症状。需要进一步的研究来确定如何在临床实践中最好地管理这些饮食模式，以优化摄入量并最大限度地减少人工营养支持的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.