What do people with inflammatory bowel disease want to know about diet? The dietary information needs of people with inflammatory bowel disease and perceptions of healthcare providers.

BACKGROUND: Inflammatory bowel disease (IBD) is an incurable illness of the gastrointestinal tract. Its relapsing-remitting nature negatively impacts physical health and quality of life. Food and eating are key concerns for people with this illness. To provide holistic person-centred care, healthcare providers (HCPs) need to meet patients' dietary information needs. However, there is a paucity of literature describing these in any meaningful detail. The present study aimed to explore the perceived dietary information needs of individuals with IBD, the perceptions of HCPs and enablers and barriers to communication. METHODS: Online and face-to-face semi-structured interviews with 13 HCPs and 29 people with IBD were conducted. The framework method aided thematic analysis of de-identified interview recordings. RESULTS: The cyclical nature of IBD contextualised the five themes. Both individuals with IBD and HCPs articulated similar ideas viewed from different perspectives: (1) living with IBD is exasperating and unique to the individual; (2) individuals with IBD desire dietary information; (3) diet manipulation is used to exert control on a disease with unpredictable nature; (4) people with IBD and HCPs have different views on the role of diet; and (5) doctors are perceived as gatekeepers to accessing dietetics care. CONCLUSIONS: A lack of dietary guidance at diagnosis negatively impacts the patient's journey with food and eating. The present study supports a paradigm shift towards holistic person-centred care for consistent access to dietetics services to meet the needs of people with IBD.

A scoping review of the dietary information needs of people with inflammatory bowel disease.

AIMS: This review aimed to explore and describe the dietary information needs of individuals with inflammatory bowel disease and sources of information. METHODS: A scoping review of English language articles and grey literature, using electronic databases with a predefined search strategy was undertaken. Data were synthesised based on the identified variables (e.g. dietary information needs and sources of dietary information) corresponding to the aims of this review. RESULTS: Forty-six studies were included, reporting data from 7557 people with inflammatory bowel disease, of which 58.6% had Crohn's disease and 60.1% were males. Dietary information was rated very important and appeared to be influenced by the disease course. The need to discuss it is heightened at important stages, namely diagnosis and relapse. Dietary information was described broadly and included advice about foods to avoid and dietary advice for symptoms management. No major differences were noted in the dietary information needs of people with Crohn's disease compared to ulcerative colitis. The main sources of dietary information were the gastroenterologist (36%-98%), the internet (9%-60%) and non-dietetic professionals (84.7%). CONCLUSION: This review highlights limited literature describing the dietary information needs of people with inflammatory bowel disease. Importantly, the limited access to specialised dietary advice for this cohort is concerning. Future studies are required to explore not only the nuances in the needs of those with active disease and in remission, but to further understand issues of access to specialised dietary advice to provide holistic person-centred care desired by this cohort.

Update on the Quality and Health Literacy Demand of Diet-Related Videos on YouTube for People With Polycystic Kidney Disease.

OBJECTIVE: To describe the quality and health literacy demand of publicly available diet-related videos on YouTube for people with polycystic kidney disease (PKD). DESIGN AND METHODS: This desk-based content analyzed involved a comprehensive search of YouTube using key words relating to the dietary management of people with PKD. The health literacy demand was evaluated using the Patient Education Material Assessment Tool (PEMAT) for audio-visual materials. A PEMAT score of >70% is indicative of videos that are understandable and actionable. RESULTS: A total of 15 videos were evaluated (median 1.28 minutes duration (range: 55 seconds-81 minutes). The majority were produced by reputable sources (such as a PKD-related charity (n = 12) or a nephrologist (n = 2). The quality of the videos was high with the majority (14/15) providing evidence-based advice. The understandability and actionability of the videos were considered low (median PEMAT score 67% (interquartile range: 51.4-81.7) and 66.83% (interquartile range: 50-67), respectively. CONCLUSION: There has been a small increase in the number of diet-related videos for people with PKD in the past 5 years. The majority provide evidence-based information, which is also a substantial improvement since the last analysis in 2015. Unfortunately, the health literacy demand of these resources remains suboptimal, and future work should be directed to improving the understandability and actionability of videos.

Systematic review with meta-analysis: dietary intake in adults with inflammatory bowel disease.

BACKGROUND: Poor dietary intake is associated with the development of malnutrition, micronutrient deficiencies, anaemia and osteoporosis in individuals with inflammatory bowel disease. While trials are underway to manipulate the diet of people with IBD, there has been no comprehensive systematic review of the dietary intake of adults with IBD. AIMS: To conduct a systematic evaluation and meta-analysis of the dietary intake of adults with IBD, including macronutrients, micronutrients and food group data. METHODS: CINAHL, Embase, Medline and Scopus were searched from 1 January 2000 to 25 September 2020 for cohort, case-control or cross-sectional studies that reported usual dietary intake in adults. Data were pooled and reported as weighted mean intake for: all adults with IBD; Crohn's disease; ulcerative colitis; active disease; remission; males; females. A random-effects meta-analysis model compared intake with healthy individuals. RESULTS: Forty studies were identified and 19 were included in the meta-analysis. All subgroups of adults with IBD consumed inadequate energy (mean intake in adults with IBD 1980 ± 130 kcal), fibre (14 ± 4 g), folate (246 ± 33 mg) and calcium (529 ± 114 mg) per day. Intake of breads and cereals, legumes, fruit, vegetables and dairy were inadequate. Compared to healthy individuals, adults with IBD consume significantly less dietary fibre (SMD -0.59; 95% CI: -0.73, -0.46). CONCLUSIONS: This review provides improved clarity about the dietary intake of adults with IBD. Future attention is required to improve diet quality and increase understanding of factors influencing dietary intake in IBD.

Review of the Sensory and Physico-Chemical Properties of Red and White Wheat: Which Makes the Best Whole Grain?

Establishing sensory and physico-chemical differences between products made from red and white wheat may guide the choice of wheat for use in whole grain and high fibre products. As sensory acceptance is key to consumption, this scoping review aimed to document sensory and physico-chemical research demonstrating quantitative differences in red and white wheat and the associated bran. The following databases were systematically searched following the PRISMA protocol: PubMed, Medline, Scopus, CINHAL and ScienceDirect (1990-2019). Of 16 studies, 13 were sensory studies with 529 participants (six of which included quantitative analysis) and three additional quantitative studies. Overall, 10 studies were in favour of white wheat (seven sensory studies, two focused on quantitative analysis and two with additional quantitative studies). Whole grain (wholemeal) bread, pita bread, crackers, noodles, tortillas, flour, intact grains and bran were examined. Aside from the seed coat colour, levels of bound versus free phenolic compounds and polyphenol oxidase activity appeared most responsible for the differences in red and white wheat. Ensuring the sample size for sensory studies are large enough to detect between-group preferences and linking to physico-chemical analysis are recommended. Attention to blinding techniques in sensory testing and use of food products realistically and consistently prepared with commercial potential are also suggested. This scoping review provides confidence in preference for white wheat for whole grain products, particularly for breads, tortillas and in the choice of white wheat for products suitable for the Asian market.