title: Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease.
abstract: BACKGROUND
  There are insufficient data to make firm dietary recommendations for patients with inflammatory bowel disease (IBD). Yet patients frequently report that specific food items influence their symptoms. In this study, we describe patients' perceptions about the benefits and harms of selected foods and patients' dietary patterns.
  
  
  METHODS
  CCFA Partners is an ongoing internet-based cohort study of patients with IBD. We used a semi-quantitative food frequency questionnaire to measure dietary consumption patterns and open-ended questions to elicit responses from patients about food items they believe ameliorate or exacerbate IBD. We categorized patients into four mutually exclusive disease categories: CD without an ostomy or pouch (CD), UC without an ostomy or pouch (UC), CD with an ostomy (CD-ostomy), and UC with a pouch (UC-pouch).
  
  
  RESULTS
  Yogurt, rice, and bananas were more frequently reported to improve symptoms whereas non-leafy vegetables, spicy foods, fruit, nuts, leafy vegetables, fried foods, milk, red meat, soda, popcorn, dairy, alcohol, high-fiber foods, corn, fatty foods, seeds, coffee, and beans were more frequently reported to worsen symptoms. Compared to CD patients, CD-ostomy patients reported significantly greater consumption of cheese (odds ratio [OR] 1.56, 95 % CI 1.03-2.36), sweetened beverages (OR 2.14, 95 % CI 1.02-1.03), milk (OR 1.84, 95 % CI 1.35-2.52), pizza (OR 1.57, 95 % CI 1.12-2.20), and processed meats (OR 1.40; 95 % CI 1.04-1.89).
  
  
  CONCLUSIONS
  Patients identified foods that they believe worsen symptoms and restricted their diet. Patients with ostomies ate a more liberal diet. Prospective studies are needed to determine whether diet influences disease course.
authors.affiliation: Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Cohen
authors.forename: Dale
authors.initials: D
authors.lastname: Lee
authors.forename: Millie D
authors.initials: MD
authors.lastname: Long
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kappelman
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Martin
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
authors.forename: James D
authors.initials: JD
authors.lastname: Lewis
mesh_terms: D000328:Adult; D039021:Colonic Pouches; D004032:Diet / Q000009:adverse effects*; D004766:Enterostomy; D005260:Female; D005502:Food / Q000706:statistics & numerical data; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057566:Self Report