Restriction of dairy products; a reality in inflammatory bowel disease patients.

INTRODUCTION: Calcium deficiency is considered a risk factor for the development of osteoporosis in inflammatory bowel disease (IBD) patients. Various dietary restrictions, including milk products are reported by these patients. OBJECTIVE: To evaluate dairy product and dietary calcium intake by IBD patients. METHODS: This cross-sectional study enrolled 65 outpatients with IBD recruited from one reference center for IBD. A semi-structured questionnaire (to collect demographic, socioeconomic and clinical data) and a quantitative food frequency questionnaire were administered. With regard to clinical data, we evaluated the anthropometric nutritional status, the disease classification, the disease activity index and the presence of gastrointestinal symptoms. Self-reported modifications in the use of dairy products were evaluated. RESULTS: The IBD patients' ages ranged from 20-75 years and 67.0% were diagnosed with ulcerative colitis. The majority (64.7%) reported restricting dairy products. The frequency of gastrointestinal symptoms was higher among the Crohn's disease patients who restricted dairy products than among those with no restrictions (100% vs 42.9%; p = 0.013); this result was not observed among the UC (ulcerative colitis) patients. Disease activity was also more frequent in the IBD patients who restricted dairy products than in those with no restrictions (23.8% vs 4.5%; p = 0.031), and among the UC patients, extensive disease was more common in the patients who restricted dairy products than in those with no restrictions (42.9% vs 20.0%; p = 0.03). CONCLUSION: Restricting dairy products is common among IBD patients, possibly due to disease activity, the presence of gastrointestinal symptoms and the extension of the disease.

Introducción: Se considera que la deficiencia de calcio es un factor de riesgo para el desarrollo de osteoporosis en pacientes con enfermedad inflamatoria intestinal (EII). En estos pacientes se han notificado diversas restricciones dietéticas. Objetivo: Evaluar la ingesta de productos lácteos y calcio de la dieta en pacientes con EII. Métodos: En este estudio cruzado se reclutaron 65 pacientes ambulatorios con EII procedentes de un centro de referencia para EII. Se administraron un cuestionario semi-estructurado (que recogía datos demográficos, socio- económicos y clínicos) y un cuestionario de frecuencia de consumo de alimento. Con respecto a los datos clínicos, evaluamos el estado nutricional antropométrico, la clasificación de la enfermedad, el índice de actividad de la enfermedad y la presencia de síntomas gastrointestinales. Se evaluaron las modificaciones auto-notificadas en el uso de los productos lácteos. Resultados: Las edades de los pacientes con EII variaban entre los 20 y 75 años y el 67,0% fueron diagnosticados de colitis ulcerosa. La mayoría (64,7 %) notificaban una restricción de los productos lácteos. La frecuencia de síntomas gastrointestinales fue mayor en los pacientes con enfermedad de Crohn que restringían los productos lácteos que en aquellos que no lo hacían (100% frente a 42,9%; p = 0,013); este resultado no se observó en los pacientes con colitis ulcerosa CU. La actividad de la enfermedad también fue más frecuente en los pacientes con EII que restringían los productos lácteos que en aquellos sin restricción (23,8% frente a 4,5%; p = 0,031) y, en los pacientes con CU, la enfermedad extensa fue más habitual en pacientes que restringían los productos lácteos que en aquellos que no lo hacían (42,9 % frente a 20,0%; p = 0,03). Conclusión: La restricción de productos lácteos es habitual en pacientes con EII, posiblemente debido a la actividad de la enfermedad, la presencia de síntomas gastrointestinales y la extensión de la enfermedad.

Lack of effect of nucleotide-supplemented infant formula on the management of acute diarrhea in infants.

Nucleotides have been identified as conditionally essential nutrients. As prevention studies, conducted with nucleotide-supplemented formula, have shown statistically significant decrease in the risk of diarrhea, we tested the hypothesis that the consumption of nucleotide-supplemented formula during an acute diarrhea episode is associated with therapeutic effects in the treatment of infants with acute diarrhea and dehydration. A randomized, double-blind, controlled clinical trial was conducted in which patients were randomly assigned to 1 of 2 treatment groups. The "test" group consumed a nucleotide-supplemented infant formula and the "control" group consumed a nonsupplemented formula. Infants were accommodated in a metabolic unit where body weight, and all intakes and outputs were recorded at 24-hour intervals during hospitalization. Laboratory parameters including blood gases and electrolytes were monitored during hospitalization. Eighty-one male infants ranging in age from older than 1 month and younger than 1 year, with acute non-cholera diarrhea and dehydration were studied. Primary outcomes were stool output and duration of diarrhea and did not differ significantly between the groups, with a stool output of 304.2 (SD 254.0) vs 350.3 (SD 269.1) g/kg and a duration of diarrhea of 83.3 (SD 44.5) vs 88.8 (SD 46.6) for the test and control groups, respectively. Anemia was highly prevalent and breast-feeding practice was not frequent in both groups. The average energy intake and weight gain were similar in the 2 groups. This study demonstrated that nucleotide supplementation of infant formula during episodes of acute diarrhea has no therapeutic advantage compared to conventional infant formula.