There was an association between sulfur microbial diet score and ulcerative colitis severity: the result of a cross-sectional study

Background

Considering the pivotal role of diet and microbiome in modulating the disease's severity and progression in patients with ulcerative colitis (UC), we performed a cross-sectional study to elucidate the link between the Sulfur microbial diet (SMD) score and the clinical course of UC.

Methods

158 patients with UC were enrolled. An expert gastroenterologist reported the disease severity using the Mayo score. An expert nutritionist recorded the amount and frequency of intake of 168 food items by the valid Food Frequency Questionnaire (FFQ). The method introduced by Nguyen et al. was used to calculate SMD score. The association between disease severity and adapted SMD score was analyzed by the logistic regression adjusting for dietary factors, demographic values, and lifestyle factors.

Results

The mean age of participants was 42.52 ± 12.61 years old and there were no significant differences in baseline information of patients in different adapted SMD score tertiles except for protein intake. There were significant differences in dietary intake of all components across the tertile of the adapted SMD score except for processed meat (p = 0.97). In the fully adjusted model, the odds of severe disease were 4.29 times higher in the patients in the third tertile of the adapted SMD score compared with the first tertile (OR: 4.29, 95 %CI: 1.42, 12.91).

Conclusions

The higher score of adapted SMD was associated with higher severity of UC. However, due to the limitations of this study, more longitudinal and clinical trials considering the different confounders should be undertaken to improve this conclusion.