Socioeconomic characteristics of the sample.

Background/Aims
Chronic inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis are known for a combination of food intolerance, decreased oral intake, and malabsorption which all predispose patients to malnutrition and suboptimal dietary intake. The present study was conducted to 1) examine self-reported food intolerances and dietary supplement use 2) assess nutritional intake 3) assess the nutritional status and screen for malnutrition among patients with chronic inflammatory bowel disease (CIBD).
Methods
48 patients with CIBDs (28 Crohn’s disease, 15 ulcerative colitis and 7 with atypical forms of IBD) took part in this cross-sectional study. Participants completed a food frequency questionnaire targeting dietary intakes and food trends over time. A questionnaire about food intolerance was also used. The nutritional status of patients with CIBDs was evaluated by a detailed history (medical diagnosis and medications and supplements administered) and by using the subjective global assessment (SGA) tool. Anthropometric data including height, weight, and BMI with body composition assessment using automated scales and stadiometer, while Bio-impedancemetry was used to measure body fat and visceral fat. Statistical analysis was conducted using SPSS 27, employing mean values, standard deviations, absolute and relative frequencies and Pearson’s chi-square test, with significance set at p ≤ 0.05.
Results
Food intolerance was equally common in all the types of CIBD specifically for dairy products, spicy foods, and high-fiber food items (beans and raw vegetables). Individuals with CIBD were also complaining about meat and chicken products (68%), followed by alcohol and soda (64%) and fish and sea foods (59%). 17% of the patients were malnourished. A significant percentage of malnourished patients with CIBD had to follow a diet outside the flare, had a nutritional follow up, were currently taking corticosteroids and had a severe form of the disease compared to patients who were well nourished.
Conclusions
This study has contributed valuable insights into the understanding that some food items could be associated to periods of increased disease activity in CIBD patients and that awareness/intervention regarding nutrition must be provided by healthcare professionals (dietitians, physicians…) to decrease the need for second line therapy. In addition, this self-reported food intolerance paper gives an insight for patients on food items usually avoided by CIBD patients during flares.

背景与目的
慢性炎症性肠病（chronic inflammatory bowel diseases, IBD）包括克罗恩病（Crohn’s disease）与溃疡性结肠炎（ulcerative colitis），其临床特征为食物不耐受、经口摄入减少与吸收不良并存，上述因素均会使患者面临营养不良与膳食摄入不佳的风险。本研究旨在达成以下3项目标：1）评估患者自我报告的食物不耐受与膳食补充剂使用情况；2）评估其营养摄入状况；3）评估慢性炎症性肠病（chronic inflammatory bowel disease, CIBD）患者的营养状态并筛查营养不良。

研究方法
本项横断面研究共纳入48例CIBD患者（28例克罗恩病、15例溃疡性结肠炎、7例非典型IBD患者）。受试者完成了针对长期膳食摄入与饮食趋势的食物频率问卷，并填写了食物不耐受相关调查问卷。通过详细病史采集（涵盖确诊信息、用药及补充剂使用情况）与主观全面营养评估（subjective global assessment, SGA）工具，对CIBD患者的营养状态进行评估。人体测量学数据包括身高、体重与BMI，并采用自动体重秤与身高计开展身体成分分析；同时借助生物电阻抗分析法（Bio-impedancemetry）测量体脂与内脏脂肪含量。统计学分析采用SPSS 27软件，计算均值、标准差、绝对与相对频率，并使用Pearson卡方检验，检验水准设定为p≤0.05。

研究结果
各类CIBD患者中均普遍存在食物不耐受，其中乳制品、辛辣食物与高纤维食物（豆类及生蔬菜）的不耐受发生率较高。CIBD患者还报告对肉类及禽类制品不耐受（占比68%），其次为酒精与碳酸饮料（64%）以及鱼类与海鲜（59%）。17%的患者存在营养不良。与营养状况良好的患者相比，营养不良的CIBD患者中，更高比例的人群在疾病非活动期需遵循特殊饮食、接受营养随访、当前使用糖皮质激素且病情处于重度阶段。

研究结论
本研究为理解部分食物可能与CIBD患者的疾病活动度升高阶段相关提供了有价值的认知依据，同时提示医疗专业人员（营养师、医师等）应开展营养相关的健康宣教与干预措施，以减少二线治疗的使用需求。此外，这项基于自我报告的食物不耐受研究，可为CIBD患者在疾病发作期通常需规避的食物种类提供参考视角。