The overall quality of evidence of recommendations surrounding nutrition and diet in inflammatory bowel disease.

Autor: Weissman S; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Fung BM; Division of Gastroenterology and Hepatology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA., Bangolo A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA. Ayrtonbangolo@yahoo.com., Rashid A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Khan BF; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Tirumala AKG; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Nagpaul S; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Cornwell S; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Karamthoti P; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Murugan V; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Taranichi IS; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Kalinin M; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Wishart A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Khalaf I; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Kodali NA; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Aluri PSC; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Kejela Y; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Abdul R; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Jacob FM; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Manoharasetty A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Sethi A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Nadimpallli PM; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Ballestas NP; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Venkatraman A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Chirumamilla A; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Nagesh VK; Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA., Gangwani MK; Department of Medicine, Toledo University Medical Center, Toledo, OH, USA., Issokson K; Department of Medicine, Section of Digestive Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Aziz M; Division of Gastroenterology, Toledo University Medical Center, Toledo, OH, USA., Swaminath A; Division of Gastroenterology, Inflammatory Bowel Disease Program, Lenox Hill Hospital, New York, NY, USA., Feuerstein JD; Division of Gastroenterology, Hepatology, and Nutrition, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2023 Apr 15; Vol. 38 (1), pp. 98. Date of Electronic Publication: 2023 Apr 15.
DOI: 10.1007/s00384-023-04404-x
Abstrakt: Background and Aim: Recently, there has been an increased focus on the role nutrition and diet play in maintaining health in inflammatory bowel disease (IBD). We aimed to assess the overall quality, strength, and transparency of conflicts among guidelines on nutrition/diet in IBD.
Methods: A systematic search was performed on multiple databases from inception until January 1, 2021, to identify guidelines pertaining to nutrition or diet in IBD. All guidelines were reviewed for disclosure of conflicts of interest (COI) and funding, recommendation quality and strength, external document review, patient representation, and plans for update-as per Institute of Medicine (IOM) standards. In addition, recommendations and their quality were compared between guidelines/societies.​ RESULTS: Seventeen distinct societies and a total of 228 recommendations were included. Not all guidelines provided recommendations on key aspects of diet-such as the role of supplements or the appropriate micro/macro nutrition in IBD. Fifty-nine percent of guidelines reported on COI, 24% underwent external review, and 41% included patient representation. 18.4%, 25.9%, and 55.7% of recommendations were based on high-, moderate-, and low-quality evidence, respectively. 10.5%, 24.6%, and 64.9% of recommendations were strong, weak/conditional, and did not provide a strength, respectively. The proportion of high-quality evidence (p = 0.12) and strong recommendations (p = 0.83) did not significantly differ across societies.
Conclusions: Many guidelines do not provide recommendations on key aspects of diet/nutrition in IBD. As over 50% of recommendations are based on low-quality evidence, further studies on nutrition/diet in IBD are warranted to improve the overall quality of evidence.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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