title: Food avoidance in patients with inflammatory bowel disease: What, when and who?
abstract: Patients with inflammatory bowel diseases avoid a variety of foods. However, it remains unclear how this behavior varies across patients. This cross-sectional study investigated how the food avoidance pattern in inflammatory bowel disease varies according to disease's activity, disease's subtype, Crohn's location, and prior history of bowel resection, strictures, and fistulae.
  
  
  
  Outpatients with Crohn's disease (n = 173) and ulcerative colitis (n = 72) reported which food they avoid when they perceive they are in remission or in active disease using a list of 82 food items classified in 10 categories. Medical charts were reviewed for patients' characteristics. Linear regression analyses were used to compare food exclusion rates between patients' subgroups and food categories.
  
  
  
  During remission, food exclusion rates varied from 1 to 39%. Most avoided foods were those with capsaicin, meat alternatives, and raw vegetables. Overall, food exclusion rates were 38% higher in Crohn's disease than ulcerative colitis (P < 0.001), and 50% higher in stricturing than non-stricturing Crohn's disease (P < 0.001). During active disease, food exclusion rates were 69% higher than in remission (P < 0.001). Similar differences between subgroups were again observed during active disease though less noticeable than in remission. No association was found with other disease characteristics. Avoided foods were very similar across patients except for alcoholic beverages and foods rich in dietary fibers/residue, which were avoided more specifically during active disease and in Crohn's disease, respectively.
  
  
  
  Food avoidance is common among patients with inflammatory bowel diseases, and most particularly in those with stricturing Crohn's disease. Specificities in avoidance pattern suggest that the clinical response to dietary restrictions may differ according to the disease's characteristics.
authors.affiliation: Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada. Electronic address: fanny.bergeron@umontreal.ca.
authors.forename: Fanny
authors.initials: F
authors.lastname: Bergeron
authors.affiliation: Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Service de gastroentérologie, Hôpital St-Luc, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada; Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada. Electronic address: mickael.bouin@umontreal.ca.
authors.forename: Mickael
authors.initials: M
authors.lastname: Bouin
authors.affiliation: Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Service de gastroentérologie, Hôpital St-Luc, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada. Electronic address: louise_daoust@sympatico.ca.
authors.forename: Louise
authors.initials: L
authors.lastname: D'Aoust
authors.affiliation: Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Service de gastroentérologie, Hôpital St-Luc, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada. Electronic address: michel.lemoyne@umontreal.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Lemoyne
authors.affiliation: Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada. Electronic address: nancy.presse@umontreal.ca.
authors.forename: Nancy
authors.initials: N
authors.lastname: Presse
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages; D001362:Avoidance Learning / Q000502:physiology*; D002211:Capsaicin; D003093:Colitis, Ulcerative / Q000503:physiopathology*; D003424:Crohn Disease / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004032:Diet; D004043:Dietary Fiber; D005260:Female; D005518:Food Preferences / Q000502:physiology*; D006801:Humans; D008297:Male; D008460:Meat; D008875:Middle Aged; D044623:Nutrition Therapy; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D004043:Dietary Fiber; D002211:Capsaicin
keywords: Crohn's disease; Diet; Food avoidance; Inflammatory bowel disease; Ulcerative colitis