Author ORCID Identifier

0000-0002-2246-3618

Date of Award

Spring 5-2-2019

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Shanta Dube, PhD, MPH

Second Advisor

Emilie Viennois, PhD

Third Advisor

Raeda Anderson, PhD

Abstract

BACKGROUND: Ulcerative colitis and Crohn’s disease are the two most common forms of inflammatory bowel disease (IBD). It is a chronic inflammatory condition of the gastrointestinal tract. Consumption of diets that are high in fat, sugars, sodium, and protein, and foods that are energy dense, and/or deficient of micronutrients has been implicated as one of the environmental factors associated with IBD. Nutritional guidelines are provided to help individuals manage disease symptoms and prevent relapses. However, current food consumption behavior of US adults with IBD is unclear.

AIM: To examine food consumption behavior in US adults with IBD and the association of intake of different food items with the disease outcome, using nationally representative data.

METHODS: Data from 33,672 sample adults who took part in the 2015 National Health Interview Survey (NHIS) were used to examine the association between food consumption with ulcerative colitis/Crohn’s disease. The 2015 NHIS includes the Cancer Control Supplement with question items that measure consumption of specific types of foods (e.g. vegetables, fries, sugary juice drinks). IBD was defined as any adults who were ever told by medical/health professionals that they have ulcerative colitis/Crohn’s disease. Bivariate and multivariate logistic regression were used to identify the odds of having colitis in strata with differential food item consumption and in strata consuming at different monthly frequency (> Median or ≤ Median). The analyses were adjusted for age, gender, race, ethnicity, region of residence, poverty level, smoking status, alcohol user and consumption status, and body mass index.

RESULTS: Prevalence of colitis was higher in Women than Men (57.4% vs 42.59%) and greater proportion of colitic population was White (88%). Colitic population were more likely to be smokers, former alcohol user, and infrequent drinkers than the non-colitic population. People with IBD were more likely to eat Fries, drink less 100% Fruit Juice, and eat more Cheese and Cookies. Intake of Fries (OR=1.60, 95% CI [1.14-2.25]) and Sports/Energy Drinks (OR=1.46, 95% CI [1.07-1.97]) and drinking more Soda/Pop were significantly associated with IBD, while Popcorn (OR=0.73, 95% CI [0.548-0.971]) and Milk (OR=0.70, 95% CI [0.497-0.998]) lowered the odds adjusting for covariates. Increase in intake of Popcorn and Whole Grain Bread lowered the odds of IBD in people already consuming < median. The benefit of increase in Vegetable intake was more profound in people already consuming > median rate.

DISCUSSION: Eating pattern in US population with IBD was mostly unremarkable from the non-colitic population. Intake of foods that are typically labeled as junk food is positively associated with the chronic disease of the digestive tract. It is unclear whether the results reflect potential diet modification in IBD population. Understanding the role diet has on IBD risk and prevalence would benefit from identifying other factors (i.e. food desert) influencing the intake of foods positively associated with the disease.

Available for download on Friday, May 01, 2020

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