Fiber Intake in Inflammatory Bowel Disease: Impact of Disease Activity and Predictors of High Fiber Intake.

Goals: To assess if patients were meeting dietary fiber recommendations and compare intake between those with active versus inactive IBD, and between Crohn's (CD) and ulcerative colitis (UC).

Background: Fiber is an important component of the diet to maintain a healthy gut, including in patients with inflammatory bowel disease (IBD).

Study: A prospective, multicenter, cross-sectional study of eating habits was performed in 2 academic gastroenterology practices. Patients completed a food frequency questionnaire to assess fiber intake. Objective evidence of disease activity was assessed through fecal calprotectin, endoscopy or cross-sectional imaging. High fiber diets were those with ≥30 g/day for men or ≥25 g/day for women. Multivariate logistic regression analysis was performed to assess predictors of high fiber intake.

Results: Of 117 patients (71 CD, 43 UC, 3 IBDU), only 26% of patients were consuming high fiber diets. Average dietary fiber intake was lower for patients with active disease versus inactive disease (19 g vs. 24 g, P=0.0048) but on subgroup analysis this remained significant in UC (13 g vs. 22 g, P=0.0044) but not CD (21 g vs. 24 g, P=0.38). Increased education on nutrition was the most important predictor of eating a high fiber diet.

Conclusions: While most IBD patients are not eating high fiber diets, dietary fiber intake is likely similar to the average American diet. Fiber consumption is lower for IBD patients with active disease, particularly for patients with UC. Given education is the best predictor for consuming a high fiber diet, increased education efforts on the benefits of fiber should improve dietary fiber intake.