Evaluation of My Nutrition Index in an IBD Patient Population

Abstract

Background: Measuring overall dietary nutritional value necessary for wellness is complex for healthy individuals, and even more so for patients suffering from complex diseases such as Crohn’s Disease. Clinical dieticians are challenged to provide beneficial dietary advice balanced against using incremental changes in patients’ selected diets to increase long-term adherence to dietary improvements. The My Nutrition Index (MNI) is a validated, personalized nutritional scale based on personal characteristics and dietary needs. In this study, we evaluated and adapted the MNI for use in an inflammatory bowel disease (IBD) patient population and validated it against the recommended diets suggested by a certified dietician. Methods: This is a cross-sectional study with patients’ pre-consultation diets based on 24-hour recall of dietary intake and post dietary consultation diets as recommended by a certified dietician. Participants were Crohn’s disease patients seen in the IBD subspecialty medical home at an academic IBD center, selected to represent the range of patients for whom a nutritional index would be most impactful. The primary outcome variable was the MNI for pre and post-consultation diets. Four focused subscales are also available: Vitamin Index, Mineral Index, Electrolyte Index, Macro Nutrient Index. In addition, consideration of Energy Ratio (observed calories relative to target calories) is important for IBD patients. The MNI and its subscales were calculated for each patient’s diet pre and post-consultation with the certified dietician and presented graphically. Results: The MNI and its subscales correctly marked the improved nutrient values of the recommended diets. Conclusions: The MNI tool, while not a substitute for dietitian advice, can inform both patients and their nutrition providers with numeric feedback around the nutritional value of their diet and reinforce small, customized, incremental changes to reach their goals.