title: Diet of patients after pouch surgery may affect pouch inflammation.
abstract: OBJECTIVE
  To investigate the diet of pouch patients compared to healthy controls, and to correlate pouch patients' diet with disease behavior.
  
  
  METHODS
  Pouch patients were recruited and prospectively followed-up at the Comprehensive Pouch Clinic at the Tel Aviv Sourasky Medical Center. Pouch behavior was determined based on clinical, endoscopic and histological criteria. Healthy age- and sex-matched volunteers were selected from the "MABAT" Israeli Nutrition and Public Health Governmental Study and served as the control group. All the participants completed a 106-item food frequency questionnaire categorized into food groups and nutritional values based on those used in the United States Department of Agriculture food pyramid and the Israeli food pyramid. Data on Dietary behavior, food avoidance, the use of nutritional supplements, physical activity, smoking habits, and body-mass index (BMI) were also obtained. Pouch patients who had familial adenomatous polyposis (n = 3), irritable pouch syndrome (n = 4), or patients whose pouch surgery took place less than one year previously (n = 5) were excluded from analysis.
  
  
  RESULTS
  The pouch patients (n = 80) consumed significantly more from the bakery products food group (1.2 ± 1.4 servings/d vs 0.6 ± 1.1 servings/d, P < 0.05) and as twice as many servings from the oils and fats (4.8 ± 3.4 servings/d vs 2.4 ± 2 servings/d, P < 0.05), and the nuts and seeds food group (0.3 ± 0.6 servings/d vs 0.1 ± 0.4 servings/d, P < 0.05) compared to the controls (n = 80). The pouch patients consumed significantly more total fat (97.6 ± 40.5 g/d vs 84.4 ± 39 g/d, P < 0.05) and fat components [monounsaturated fatty acids (38.4 ± 16.4 g/d vs 30 ± 14 g/d, P < 0.001), and saturated fatty acids (30 ± 15.5 g/d vs 28 ± 14.1 g/d, P < 0.00)] than the controls. In contrast, the pouch patients consumed significantly fewer carbohydrates (305.5 ± 141.4 g/d vs 369 ± 215.2 g/d, P = 0.03), sugars (124 ± 76.2 g/d vs 157.5 ± 90.4 g/d, P = 0.01), theobromine (77.8 ± 100 mg/d vs 236.6 ± 244.5 mg/d, P < 0.00), retinol (474.4 ± 337.1 μg/d vs 832.4 ± 609.6 μg/d, P < 0.001) and dietary fibers (26.2 ± 15.4 g/d vs 30.7 ± 14 g/d, P = 0.05) than the controls. Comparisons of the food consumption of the patients without (n = 23) and with pouchitis (n = 45) showed that the former consumed twice as many fruit servings as the latter (3.6 ± 4.1 servings/d vs 1.8 ± 1.7 servings/d, respectively, P < 0.05). In addition, the pouchitis patients consumed significantly fewer liposoluble antioxidants, such as cryptoxanthin (399 ± 485 μg/d vs 890.1 ± 1296.8 μg/d, P < 0.05) and lycopene (6533.1 ± 6065.7 μg/d vs 10725.7 ± 10065.9 μg/d, P < 0.05), and less vitamin A (893.3 ± 516 μg/d vs 1237.5 ± 728 μg/d, P < 0.05) and vitamin C (153.3 ± 130 mg/d vs 285.3 ± 326.3 mg/d, P < 0.05) than the patients without pouchitis. The mean BMI of the pouchitis patients was significantly lower than the BMI of the patients with a normal pouch: 22.6 ± 3.2 vs 27 ± 4.9 (P < 0.001).
  
  
  CONCLUSIONS
  Decreased consumption of antioxidants by patients with pouchitis may expose them to the effects of inflammatory and oxidative stress and contribute to the development of pouchitis.
authors.affiliation: Orit Ianco, Amos Ofer, Erwin Santo, Iris Dotan, Comprehensive Pouch Clinic, IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
authors.forename: Orit
authors.initials: O
authors.lastname: Ianco
authors.forename: Hagit
authors.initials: H
authors.lastname: Tulchinsky
authors.forename: Michal
authors.initials: M
authors.lastname: Lusthaus
authors.forename: Amos
authors.initials: A
authors.lastname: Ofer
authors.forename: Erwin
authors.initials: E
authors.lastname: Santo
authors.forename: Nachum
authors.initials: N
authors.lastname: Vaisman
authors.forename: Iris
authors.initials: I
authors.lastname: Dotan
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D004032:Diet / Q000009:adverse effects*; D059305:Diet, High-Fat / Q000009:adverse effects; D004040:Dietary Carbohydrates / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D007557:Israel; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D019449:Pouchitis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D000975:Antioxidants; D004040:Dietary Carbohydrates
keywords: Body mass index; Dietary reference intake; Food frequency questionnaire; Ileal-pouch anal anastomosis; Pouch surgery; Ulcerative colitis