Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study

Figures & data

Figure 1. Flow chart of the exclusion and inclusion criteria for IBD patients from the IBSEN III study and the Tromsø7 sample. IBSEN: Inflammatory Bowel Disease in South-Eastern Norway; CD: Crohn’s disease; UC: ulcerative colitis; FFQ: food frequency questionnaire; IBD: inflammatory bowel disease; IBS: irritable bowel syndrome.

Table 1. Clinical characteristics of IBD patients.

	CD (n = 82)	UC (n = 145)
CRP (mg/L)^a	5 (2–10)	4 (1.4–7)
Calprotectin (mg/kg)^a,b	343 (147–976)	323 (77–1801)
Montreal disease location CD, n (%)
L1 terminal ileum	46 (56.1)	–
L2 colon	13 (15.9)	–
L3 ileocolon	23 (28)	–
L4 upper GI modifier	0	–
Montreal disease behavior CD, n (%)
B1 non-structuring, non-penetrating	62 (75.6)	–
B2 structuring	17 (20.7)	–
B3 penetrating	2 (2.4)	–
B4 perianal disease modifier	1 (1.2)	–
Montreal disease location UC, n (%)
E1 ulcerative Proctitis		54 (37.5)
E2 left-sided UC		40 (27.8)
E3 extensive colitis		50 (34.7)
Montreal disease severity UC, n (%)
S0 clinical remission		10 (6.9)
S1 mild		53 (36.8)
S2 moderate		60 (41.7)
S3 severe		21 (14.6)

CD: Crohn’s disease; UC: ulcerative colitis; CRP: C-reactive protein

^aPresented as median (25–75 percentiles); ^b38% missing.

Table 2. Background characteristics of IBD patients and the Tromsø7 sample.

	Women			Men
	IBD (n = 113)	Tromsø7 (n = 4348)	p-value	IBD (n = 114)	Tromsø7 (n = 3903)	p Value
Age (years), mean (SD)^a	52 (8.4)	57 (10.6)	<0.001	53 (10.2)	58 (11)	<0.001
Height (cm), mean (SD)^a	168 (0.1)	165 (0.1)	<0.001	181 (0.1)	178 (0.1)	<0.001
BMI (kg/m²), mean (SD)^a	27 (5.9)	26.7 (4.7)	0.57	26.5 (3.6)	27.4 (3.7)	0.01
Higher education >12 years, n (%)	52 (46.8)	2349 (54.9)	0.09	59 (53.2)	2036 (52.5)	0.89
Tobacco use, n (%)
Current smoker	10 (9)	550 (12.8)	0.23	6 (5.4)	427 (10.9)	0.06
Former smoker	64 (57.7)	1905 (44.4)	0.006	65 (57.1)	1754 (44.9)	0.01
Current snuff tobacco user	4 (3.6)	124 (2.9)	0.68	29 (25.9)	411 (10.5)	<0.001

^aTested using independent samples t-test. Other p values were obtained using χ² test. Statistically significant p-values in bold.

IBD: Inflammatory bowel disease; SD: standard deviation

Table 3. Intake of macro- and micronutrients* in IBD patients compared to the Tromsø7 sample and Nordic nutrition Recommendations.

	Women			Men			Recommendations NNR2012
	IBD (n = 113)	Tromsø7 (n = 4348)	p Value	IBD (n = 114)	Tromsø7 (n = 3903)	p Value	Women/men
Energy, MJ	9.3 (7.9–10.9)	8.4 (7.2–9.7)	<0.001	11.3 (9.1–13.2)	10.4 (8.9–12.1)	0.009	–
Protein, E%^a	18.1 (3)	17.8 (2.5)	0.26	17 (2.8)	17.3 (2.4)	0.16	10–20
Fat, E%^a	36.1 (5.2)	34.7 (5.5)	0.005	37 (6.5)	34.1 (5.5)	<0.001	25–40
SFA, E%^a	13 (2.6)	12.6 (2.7)	0.09	13.4 (2.7)	12.4 (2.6)	<0.001	<10
MUFA, E%^a	13.5 (2.4)	12.9 (2.7)	0.03	13.9 (3.1)	12.5 (2.6)	<0.001	10–20
PUFA, E%^a	6.5 (1.6)	5.9 (1.5)	<0.001	6.6 (1.6)	6.1 (1.6)	0.003	5–10
Omega-3, E%	1.4 (1.1–1.8)	1.4 (1.1–1.8)	0.65	1.3 (1–1.7)	1.4 (1.1–1.8)	0.01	≥1
Omega-3, g	3.3 (2.8–4.4)	3.2 (2.4–4.2)	0.04	3.8 (3–5.2)	4 (3–5.3)	0.36	–
Omega-6, g	11.9 (9.6–15.3)	9.7 (7.6–12.1)	<0.001	14.6 (11.6–18.4)	12.1 (9.6–15.2)	<0.001	–
Omega-6/3 ratio	3.5 (2.9–4.3)	3.1 (2.4–3.9)	<0.001	3.7 (3.2–4.9)	3.1 (2.4–3.8)	<0.001	–
Carbohydrates, E%^a	41.8 (6.6)	42 (6.1)	0.73	42.2 (7.5)	42.5 (5.9)	0.64	45–60
Dietary fiber, g	28.6 (22.1–34.6)	26.8 (22–32)	0.05	27.5 (22.6–36.8)	27.6 (22.9–33.4)	0.42	25–35
Added sugar, E%	5.3 (3–8.3)	4.8 (3.2–6.7)	0.08	5.8 (3.5–9.2)	5 (3.3–7.2)	0.06	<10
Alcohol, E%	0.6 (0.1–1.7)	1.9 (0.6–4.3)	<0.001	1.1 (0.4–2.5)	2.7 (1–5.4)	<0.001	<5
Alcohol, g	1.8 (0.5–5.2)	5.4 (1.8–12.5)	<0.001	4.3 (1.5–9.4)	9.7 (3.7–19.6)	<0.001	<10
Vitamin A, µg	1201 (903–1755)	1240 (917–1665)	0.93	1350 (971–1781)	1328 (985–1767)	0.93	700/900
Vitamin D, µg	9.8 (6.5–21)	10.1 (6.4–17.8)	0.36	11 (8.2–21.3)	11.3 (7.9–18.8)	0.95	10
Vitamin E, mg	19.3 (13.9–29)	17.3 (12.8–25.4)	0.03	20.2 (15.7–30.2)	18.6 (13.8–26.8)	0.01	8/10
Thiamin, mg	1.9 (1.5–2.5)	1.8 (1.4–2.5)	0.07	1.9 (1.6–2.5)	1.9 (1.6–2.4)	0.69	1.1/1.4
Riboflavin, mg	2.4 (1.8–3.1)	2.4 (1.9–3.4)	0.34	2.6 (2–3.2)	2.8 (2.2–3.5)	0.005	1.3/1.7
Niacin, mg	27.2 (21.7–35.3)	23.2 (18.4–30.9)	<0.001	30.1 (22.8–37)	26.6 (21.7–32.9)	0.003	15/18
Vitamin B6, mg	2.2 (1.7–3.2)	1.8 (1.4–2.5)	<0.001	2 (1.7–2.7)	2 (1.6–2.4)	0.1	1.2/1.5
Folate, µg	366 (281–474)	322 (258–406)	0.002	335 (273–424)	333 (274–409)	0.55	300^b
Vitamin B12, µg	7.1 (5.5–8.8)	7.1 (5.7–8.9)	0.87	7.8 (6.2–10.2)	8.9 (7–11)	<0.001	2
Vitamin C, mg	168 (106–223)	147 (103–202)	0.05	122 (81.7–187)	122 (85–176)	0.86	75
Calcium, mg	928 (679–1170)	982 (761–1253)	0.02	960 (725–1234)	1166 (898–1484)	<0.001	800
Iron, mg	11.6 (9.5–14.7)	10.2 (8.5–12.8)	<0.001	12.6 (9.9–15.5)	11.4 (9.4–13.8)	0.005	15 (9^c) /9
Magnesium, mg	399 (344–472)	362 (307–439)	0.1	427 (350–527)	440 (371–520)	0.19	350
Zinc, mg	13.4 (10.4–17.4)	11.1 (9.6–13.3)	<0.001	15.6 (12.7–19.7)	13.7 (11.4–16.5)	<0.001	7/9
Selenium, µg	61 (49.5–79.5)	55 (44–72)	0.009	67.5 (53.7–88.2)	68 (55–84)	0.76	50/60
Phosphorus, g	1.7 (1.4–2.1)	1.7 (1.4–2)	0.17	1.9 (1.5–2.3)	2 (1.7–2.4)	0.05	0.6
Iodine, mg	214 (153–294)	254 (189–333)	<0.001	220 (151–308)	305 (232–398)	<0.001	150

*Micronutrient intakes including dietary supplements. ^aPresented as mean with standard deviation (SD) and tested using independent sample t-test. Other data presented as median (25–75 percentiles). ^bRecommendation for women not in reproductive age; ^cRecommendation for postmenopausal women. Statistically significant p-values in bold.

IBD: inflammatory bowel disease; NNR2012: Nordic Nutrition Recommendations 2012; MJ: mega joule; E%: energy percent; SFA: saturated fatty acids; MUFA: monounsaturated fatty acids; PUFA: polyunsaturated fatty acids

Figure 2. Percentage of IBD patients (n = 227) and the Tromsø7 sample (n = 8251) with intakes not in line with recommendations. *Significant difference between IBD and Tromsø7. IBD: inflammatory bowel disease. E%: energy percent; SFA: saturated fatty acids; MUFA: monounsaturated fatty acids; PUFA: polyunsaturated fatty acids.

Table 4. Median daily intake of food groups (g/d) in IBD patients compared to the Tromsø7 sample.

	Women			Men
	IBD (n = 113)	Tromsø7 (n = 4348)	p Value	IBD (n = 114)	Tromsø7 (n = 3903)	p Value
Bread	138 (74.3–168)	120 (88–160)	0.55	174 (102–246)	166 (125–212)	0.19
Other grain products	74.4 (37.2–130)	46.9 (22–81.2)	<0.001	68.6 (35–124)	46 (21–90)	<0.001
Vegetables	296 (171–401)	222 (147–317)	<0.001	199 (112–284)	170 (105–252)	0.05
Fruit and berries	285 (153–447)	286 (182–423)	0.61	251 (142–448)	270 (162–422)	0.85
Milk and cream	176 (61.7–377)	316 (158–513)	<0.001	223 (67.7–414)	445 (226–704)	<0.001
Milk	57 (2–300)	200 (0–400)	<0.001	143 (2–302)	400 (200–600)	<0.001
Cheese	20 (10–32.5)	30.1 (17.1–48.4)	<0.001	16.8 (7.7–37.1)	26.6 (14.1–45.1)	<0.001
Beverages	2077 (1484–2784)	1842 (1435–2483)	0.08	2093 (1464–2731)	1875 (1426–2539)	0.3
Coffee	409 (48.7–881)	684 (400–900)	0.002	878 (174–902)	800 (449–1200)	0.15
Alcoholic beverages	36 (9–64.5)	66 (22–149)	<0.001	60.6 (32.3–166)	154 (57–306)	<0.001
Sugar sweetened	5 (0–36)	0 (0–14)	<0.001	27.5 (5–150)	0 (0–42)	<0.001
Artificial sweetened	57 (2–371)	0 (0–56)	<0.001	37 (5–357)	0 (0–70)	<0.001

IBD: inflammatory bowel disease

Figure 3. Percentage of IBD patients (n = 227) and the Tromsø7 sample (n = 8251) with suboptimal nutrition-related blood indices. *Significant difference between IBD and Tromsø7, anemia: 99% CI for IBD (0.08, 0.19) and Tromsø7 (0.03, 0.04), hypoalbuminemia: 99% CI for IBD (0.02, 0.11) and Tromsø7 (3.62 × 10ˉ⁶, 0.005). IBD: inflammatory bowel disease.

Data availability statement

The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. Data will be shared on reasonable request to the corresponding author.