Sex Differences Outweigh Dietary Factors in Food-Related Quality of Life in Patients with Inflammatory Bowel Disease

PMID: 40218872
Source: Nutrients
Publication date: 2025-04-12
Year: 2025

Abstract

BACKGROUND: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), consists of chronic gastrointestinal inflammation, with nutrition playing a significant role in its development. IBD patients often face dietary challenges affecting their quality of life (QoL), yet research on food-related QoL (FR-QoL) and sex-specific differences is limited. It was hypothesized that dietary patterns and choices impact food-related quality of life in IBD and that these effects vary by sex. The objective of this analysis was, therefore, to evaluate the impact of diet on food-related quality of life for men and women with IBD, respectively. METHODS: A monocentric, cross-sectional study at a tertiary referral center analyzed the food-related quality of life in 117 women and 116 men with IBD, with a particular focus on dietary choices and patterns. To achieve this, multiple assessment tools, including the German version of the IBD-specific Questionnaire for Food-Related Quality of Life (FR-QoL-29-German) and a validated Food Frequency Questionnaire (FFQ) for dietary behavior, were used. Clinical indices (Harvey-Bradshaw Index (HBI); Partial Mayo Score (PMS)) and biochemical markers (C-reactive protein; fecal calprotectin) were evaluated. RESULTS: The FR-QoL-29-German sum score differed significantly between the sexes (p = 0.034; g = -0.3), with men showing a higher mean score. Distinct dietary patterns showed little correlation with FR-QoL for both sexes, except for a significant inverse correlation between FR-QoL and sQ-HPF scores for men (p = 0.021; r = -0.214) but not for women (p = 0.897; r = -0.012). In a logistic regression analysis that was adjusted for confounding, the impact of IBD-specific and diet-related factors on FR-QoL was assessed, and disease entity was identified as a significant influencing factor for men but not for women. In women, older age and lower body weight were associated with higher FR-QoL. CONCLUSIONS: The findings of this study indicate that dietary choices and patterns do not exhibit uniform associations with IBD-related quality of life. In addition, sex differences have been identified as a substantial factor in IBD food-related quality of life.