The Effect of Diet on The Health and Disease Status of The Gut Metabolome and Its Influence on Ulcerative Colitis

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Ulcerative colitis (UC) is the most common type of Inflammatory Bowel Diseases (IBD), it is a remitting and relapsing disorder that causes chronic mucosal inflammation of the large intestine. Symptoms can vary in severity and compromise the patient quality of life. Over the past decades, UC disease prevalence increased, particularly in urban populations and as its aetiology is still unidentified this implies the need for more research in this area. Nonetheless, it is assumed that environmental triggers can affect genetically susceptible individuals by dysbiosis, leading to chronic gastrointestinal (GI) inflammation. Diet is considered a major modifiable environmental factor leading to UC; as it can alter the balance between the pro-inflammatory and anti-inflammatory intestinal bacteria, which is believed to be a defining event in UC development. The aim of this study was to Identify the impact of diet in general and dietary fibers and fats consumption in specific on the health and disease status of UC patients in order to create new therapeutic approaches to promote UC health and prevent inflammation. A Cross-sectional observational clinical study was conducted, a total of 42 participants attending the IBD clinic at St. Marks Hospital were chosen to broadly represent the general population with UC. Patients were asked to complete a seven days food diary while maintain their usual dietary habits, moreover, a metabolomic questionnaire was obtained from the participants. Data from the food diaries were coded into Dietplan 7 software and analysed afterward with the metabolomic questioner using Statistical Package for Social Science (SPSS) Program, to crossmatch the disease status (remission vs active disease) with nutrients intake. Disease status was assessed based on the patients symptoms at recruitment using Partial Mayo Score (PMS) and endoscopy findings. Results showed that the risk of UC inflammation was significantly increased among participants aged ≥40 years (P=0.03). Inflammation risk was increased among obese participants whereas in overweight participants it was reduced by 77%. Significant differences were observed between remission and active disease status groups regarding the mean intake of fat, participants with the highest mean intake of fat had higher risk of UC inflammation (P=0.04). while participants with the highest mean intake of omega-6 had reduced risk of UC inflammation (P=0.04). Regarding Fibre intake, results showed a positive association between high fibre and carbohydrates intake and the risk of UC inflammation, though not significantly. Participants bowel activity was found to be negatively affected by high carbohydrates and fat intake (P=0.03 and P=0.02 respectively). Moreover, statistically significant association was found between vitamin K and Biotin intake and UC inflammation risk, participants consuming lower amount of vitamin K were at higher risk of UC inflammation (P=0.01), while those consuming higher amounts of Biotin had a higher risk of UC inflammation (P=0.04). In conclusion, diet in particular fat and fibre intake plays a role in UC disease status as high fat, fibre and Biotin intake and low vitamin K intake has been found to increase the risk of UC inflammation. Moreover, high fat, fibre and carbohydrates intake negatively impacts bowel health.