P0218 Dietary Inflammatory Index and disease activity in patients with IBD: is there an association? A Preliminary Analysis
Authors: Soares C , Martins D , Sousa P , Cancela E , Martins S , Torres D , Ministro P 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) is increasing in incidence in recently industrialized and developing countries, and this increment is paralleled by Westernization of lifestyle.1 In fact, specific nutrients and additives instigate gut inflammation and increasing evidence demonstrates its impact on developing IBD and disease behavior.2,3 Dietary Inflammatory Index (DII) was developed to assess the inflammatory properties of a diet.4 The aim of this study is to assess the association between higher DII scores and disease activity in patients with ulcerative colitis (UC) and Crohn’s disease (CD).

Methods
A cross-sectional study was conducted from June to October 2024. Patients undergoing ambulatory treatment at a day care IBD unit were consecutively recruited. A self-applied semiquantitative food frequency questionnaire, validated for the adult Portuguese population, was applied and medical charts reviewed. Blood and feces were collected, and anthropometric parameters measured by a body composition analyzer (Tanita DC-430MA). DII score was calculated according to the Shivappa et al. method, using 30 parameteres.4 The primary outcome was to assess the association between DII scores and 4 disease activity levels defined by clinical and biological activity markers (table 1). Clinical activity was classified according to Mayo Partial score for UC and Harvey-Bradshaw index (HBI) for CD. Biological activity was evaluated through fecal calprotectin.

Results
A total of 100 IBD patients (37 UC, 61 CD and 2 non-classified) were included; mean age 43.47 ±16.03 years, 41% female. Mean disease duration was 9.72±7.62 years. Baseline characteristics are described at table 2. Mean DII score was 1.49±2.43. The calculated DII score was categorized into quartiles. Comparison of calprotectin, CRP and Mayo Partial score by DII quartile was performed using Kruskal-Wallis test, and HBS using one-way ANOVA. No statistically significant correlations were found. Chi-square test for the association between activity levels and DII quartiles showed no statistically significant differences (p 0.496 DC; p 0.492 UC).

Conclusion
An association between DII scores and disease activity was not observed. Further studies with larger and more homogeneous samples are needed in the future to clarify the utility of this score in clinical practice. Given the undeniable and growing importance of these tools, other scales should also be studied and validated in IBD population.

References
1.Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021 Jan;18(1):56-66.
2.Adolph TE, Zhang J. Diet fuelling inflammatory bowel diseases: preclinical and clinical concepts. Gut. 2022 Dec;71(12):2574-2586.
3.Adolph TE, Meyer M, Schwärzler J, Mayr L, Grabherr F, Tilg H. The metabolic nature of inflammatory bowel diseases. Nat Rev Gastroenterol Hepatol. 2022 Dec;19(12):753-767. 4 Sh Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014 Aug;17(8):1689-96.