{'fraction_non_alphanumeric': 0.04550827423167849, 'fraction_numerical': 0.03486997635933806, 'mean_word_length': 4.514657980456026, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 1, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The complex relationship between diet, symptoms and intestinal inflammation in persons with IBD: The Manitoba Living with IBD study.

BACKGROUND
We aimed to examine whether an association exists between diet quality, based on the Prospective Urban and Rural Epidemiologic Study (PURE) Healthy Diet Score (HDS), and active IBD.


METHODS
Participants were drawn from the Manitoba Living with IBD Study cohort. The Harvard Food Frequency Questionnaire (FFQ) was used to calculate the HDS at two time points; baseline and 1-year follow-up. Using generalized estimating equations (GEE) logistic regression, we assessed the association between the HDS and: 1. the IBD Symptom Inventory (IBDSI), 2. intestinal inflammation, measured by fecal calprotectin (FCAL), and 3. self-reported IBD flares.


RESULTS
There were 294 completed FFQs among 153 people. Of these, 100% had completed data about an IBD flare, 98% had FCAL measurements and 96% had completed IBDSI scores. On a HDS scoring method of 0-8, the odds of FCAL>250 were lower for participants with a HDS of 4 versus 0-3 [adjusted OR 0.38, 95% CI, 0.19-0.77]. When applying a second HDS scoring method (8-40), the odds of having an IBD flare were 3.6 times greater for participants with a HDS between 21 and 24 compared to a HDS ≤20, [adjusted OR 3.63, 95% CI, 1.03-12.78].


CONCLUSIONS
We found that active inflammation was less likely among those with a moderate HDS score, while symptomatic IBD flares were more likely. People may choose to consume a moderate amount of healthy foods such as fruits and vegetables, even if known that those foods may cause a symptomatic flare. This article is protected by copyright. All rights reserved.