Nutrients, Vol. 18, Pages 785: A Randomised Controlled Trial Comparing the Effects of Personalised Diet and Physical Activity Intervention Versus Usual Care on Cardiometabolic Risk Factors in Adults with Inactive Inflammatory Bowel Disease

Nutrients, Vol. 18, Pages 785: A Randomised Controlled Trial Comparing the Effects of Personalised Diet and Physical Activity Intervention Versus Usual Care on Cardiometabolic Risk Factors in Adults with Inactive Inflammatory Bowel Disease

Nutrients doi: 10.3390/nu18050785

Authors:
Jia Min Yap
Catherine L. Wall
Kim Meredith-Jones
Ella Iosua
Hamish Osborne
Michael Schultz

Background: Adults with inflammatory bowel disease (IBD) have a high prevalence of modifiable cardiometabolic risk factors. This study investigates the impact of a personalised diet and physical activity intervention versus usual care on the risk factors. Methods: A 6-month randomised controlled trial was conducted at three hospitals in New Zealand (NZ) from 2023 to 2024. Adults with IBD in remission, a body mass index >25 kg/m2, and a low fibre intake <25 g/day were recruited. Participants were randomised to receive either generic healthy eating and physical activity education or personalised heart-healthy eating education based on the NZ Heart Foundation and a self-led physical activity program. The primary outcome was change in body fat, and secondary outcomes included disease activity, biomarkers, quality of life, physical activity, and dietary intake. Between-group differences were analysed using multivariable regression. Results: Sixty-four participants were randomised, and 51 (80%) completed the intervention. The median age was 47 years (LQ,UQ: 37, 55), 59% participants were female, 61% had Crohn’s disease, and 85% had faecal calprotectin <150 µg/g. Common cardiometabolic risks were high waist circumference (88%) and abnormal lipid profile (56%). There were no significant differences in primary or secondary outcomes except for dietary intakes: increased fruit (0.5 serves/day; 95% CI: 0.1, 1.0) and dietary fibre (3.1 g/1000 kcal/day; 95% CI: 1.1, 5.1); reduced discretionary food and drink (−1.7 serves/day; 95% CI: −3.0,−0.3), and sodium (−911 mg/day; 95% CI: −1783,−40). Conclusions: Personalised dietitian advice led to meaningful dietary changes without exacerbating disease activity. More intensive activity modalities can be recommended to support body composition improvements.

​Background: Adults with inflammatory bowel disease (IBD) have a high prevalence of modifiable cardiometabolic risk factors. This study investigates the impact of a personalised diet and physical activity intervention versus usual care on the risk factors. Methods: A 6-month randomised controlled trial was conducted at three hospitals in New Zealand (NZ) from 2023 to 2024. Adults with IBD in remission, a body mass index >25 kg/m2, and a low fibre intake <25 g/day were recruited. Participants were randomised to receive either generic healthy eating and physical activity education or personalised heart-healthy eating education based on the NZ Heart Foundation and a self-led physical activity program. The primary outcome was change in body fat, and secondary outcomes included disease activity, biomarkers, quality of life, physical activity, and dietary intake. Between-group differences were analysed using multivariable regression. Results: Sixty-four participants were randomised, and 51 (80%) completed the intervention. The median age was 47 years (LQ,UQ: 37, 55), 59% participants were female, 61% had Crohn’s disease, and 85% had faecal calprotectin <150 µg/g. Common cardiometabolic risks were high waist circumference (88%) and abnormal lipid profile (56%). There were no significant differences in primary or secondary outcomes except for dietary intakes: increased fruit (0.5 serves/day; 95% CI: 0.1, 1.0) and dietary fibre (3.1 g/1000 kcal/day; 95% CI: 1.1, 5.1); reduced discretionary food and drink (−1.7 serves/day; 95% CI: −3.0,−0.3), and sodium (−911 mg/day; 95% CI: −1783,−40). Conclusions: Personalised dietitian advice led to meaningful dietary changes without exacerbating disease activity. More intensive activity modalities can be recommended to support body composition improvements. Read More

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