Inflamm Bowel Dis. 2024 Feb 1;30(2):273-280. doi: 10.1093/ibd/izad139.

Kelli E DuBois ^1 2, Christine E Blake ², Caroline Rudisill ², Sayward E Harrison ³, Michael D Wirth ^4 5 6 7, James R Hébert ^4 5 6

Author information

¹Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

²Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

³Department of Psychology, University of South Carolina, Columbia, SC, USA.

⁴Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

⁵Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

⁶Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC, USA.

⁷College of Nursing, University of South Carolina, Columbia SC, USA.

Abstract

Background: Individuals with ulcerative colitis (UC) seek complementary treatment methods, including diet and physical activity, to manage the burden of living with UC. This study examined associations between diet-associated inflammation, physical activity (PA), and UC-related health outcomes.

Methods: Data were obtained from 2052 IBD Partners e-cohort participants with UC. To quantify the inflammatory potential of food intake, dietary data were converted into Dietary Inflammatory Index (DII) and energy adjusted (E-DII) scores. Physical activity data were collected using the Godin-Shephard Leisure Time Activity Index. Outcome variables included the Simple Clinical Colitis Activity Index, Short Inflammatory Bowel Disease Questionnaire, and psychosocial PROMIS domains.

Results: Higher E-DII scores, as indicator of increased dietary inflammatory potential, were associated with increased disease activity (β = 0.166; P < .001), anxiety (β = 0.342; P = .006), depression (β = 0.408; P = .004), fatigue (β = 0.386; P = .005), sleep disturbance (β = 0.339; P = .003), and decreased social satisfaction (β = -0.370; P = .004) and quality of life (β = -0.056; P < .001). Physical activity was inversely associated with disease activity (β = -0.108; P < .001), anxiety (β = -0.025; P = .001), depression (β = -0.025; P = .001), fatigue (β = -0.058; P < .001), and sleep disturbance (β = -0.019; P = .008), while positively associated with social satisfaction (β = 0.063; P < .001) and quality of life (β = 0.005; P < .001). Beneficial effects were generally greater for strenuous PA intensity.

Conclusions: An anti-inflammatory diet and increased PA are associated with decreased disease activity, anxiety symptoms, depression symptoms, and fatigue, and associated with improved quality of life, sleep, and social satisfaction for patients with UC. Such modalities may reduce the daily burden of illness and aid in managing systemic and localized inflammation associated with UC.