Food choices and beliefs in adults with inflammatory bowel disease in Sweden

Objectives Diet is a recognised risk factor for inflammatory bowel disease (IBD) and a management strategy. Concerns persist regarding the adverse effects of restrictive diets, including nutritional deficiencies and selective eating. The impact of IBD on patients’ beliefs and dietary choices remains poorly characterised, especially in different geographic contexts. Aim To investigate dietary practices and beliefs in patients with IBD in Sweden, including variations by disease phenotype. Methods A 42-item questionnaire on food choices and beliefs was distributed to all adult members of Sweden’s largest IBD-patient organization. Results Of the 2,193 individuals invited, 738 (34%) responded, (Crohn’s disease (CD) 361 (49%); Ulcerative colitis (UC) 377 (51%)). IBD impacted thoughts about food in 71% ( n = 521). A higher proportion of those with CD (254, 70%) than UC (231, 61%), reported changing their diet due to IBD ( p = 0.009). A higher proportion of patients with CD (187, 52%), compared with UC (164, 43%), avoid certain foods in the belief that this can prevent flare-ups ( p = 0.024). 42% ( n = 311) of patients had not received dietary advice from health care providers, which was more common in UC (209, 55%) than CD (102, 28%), ( p < 0.001). Conclusions Beliefs about food and diet appear to influence dietary choices in IBD, many of whom report modifying their diet. This appears to be more pronounced among people with CD than UC, although the latter are less likely to receive dietary advice, highlighting potential disparities in access to dietary guidance.