Diet and disease activity in patients with Inflammatory Bowel Disease

In addition to a genetic susceptibility, the immune system and the intestinal
microbiota, diet is hypothesized to be an important factor in the onset and
progression of Inflammatory Bowel Diseases (IBD). Further insight in factors
affecting disease activity may contribute to targeted interventions improving
disease burden and healthcare costs for these patients. However, well-designed
studies exploring the role of diet in the development of exacerbations are
hardly available. Furthermore, a subgroup of patients suffers from
malnutrition, although the exact prevalence is unknown since simple
non-invasive screening tools have not been validated for IBD.

We aim to study the role of diet in IBD in 2 subprojects: A) to study the
prevalence of malnutrition in a consecutive cohort of IBD outpatients and to
validate a malnutrition screening tool for IBD; B) To study the association of
dietary patterns and intestinal microbiota composition with disease activit,
and possible mechanisme in a consecutive cohort of IBD patients of the IBD-SL
biobank cohort.

Part A is a cross-sectional cohort study (n=300) and part B is a prospective
cohort study with a follow up of one year (n=600).

The population based IBD-SL cohort is an excellent cohort to assess
malnutrition in IBD patients. Blood and fecal samples are taken for routine
clinical care. A part of the fecal sample will be stored in de IBD-SL biobank
cohort for microbiota analyses. One extra serum tube (10 ml) and plasma tube
(8,5 ml) will be collected and stored in the biobank. At baseline
questionnaires have to be completed (Food frequency questionnaire (FFQ), short
nutritional assessment questionnaire (SNAQ), malnutrition screening tool (MST))
which will take about 35 minutes. Furthermore anthropometric measurements and a
Bod Pod® are performed. These investigations take about 20-30 minutes.
No side effects are to be expected from these measurements. However entering
the Bod Pod® may be somewhat claustrophobic to certain subjects, because of the
relative small size of the test chamber. Subjects may experience small pressure
changes on the ears.
Patients are followed during one year. At every routine outpatient visit the
results of blood and fecal samples collected for routine clinical care are
gathered and stored in the IBD-SL biobank cohort. Standardized clinical
activity scores are already registered for routine care by the
gastroenterologist and will be extracted from the electronic patient files. No
side effects are expected from these measurements