Dietary beliefs of people with ulcerative colitis and their effect on relapse and nutrient intake

Background & Aims: Ulcerative colitis usually follows a relapsing and remitting course. Patients believe that dietary factors are important. We wished to determine the nature of and reasons for patients’ dietary beliefs and their effect on relapse and nutrient intake. Methods: In a 1-year prospective cohort study, patients’ nutrient intake and disease activity were measured with a validated food frequency questionnaire and disease activity index. Food beliefs, demographics and disease characteristics were recorded. The influence of beliefs on the risk of relapse and nutrient intake were examined using chi-squared and Mann–Whitney U-tests. Results: One hundred and eighty-three patients were studied and 52% relapsed. Sixty-eight per cent held dietary beliefs and reported modifying their intake accordingly. The most common reported behaviour was the avoidance of milk and dairy products. Food beliefs were more common amongst those who had received dietary advice. No reported behaviour reduced the risk of relapse, but patients who avoided dairy products had a significantly lower intake of calcium. Folate intake was below UK recommended levels in 13% of patients. Conclusions: Patients with ulcerative colitis believe that many foods are harmful or helpful to their disease activity. Commonly held beliefs do not modify the risk of relapse, but do adversely affect nutrient intake.