CENTER FOR INFLAMMATORY BOWEL DISEASES
Nutrition Clinic Recommends Evidence-Based Diet Strategies Personalized to Patient Needs
Nutrition has become an increasing focus in the management of inflammatory bowel disease. For some patients, altering the diet can help to reduce inflammation and improve symptoms. IBD patients are at risk for avoidant restrictive food intake disorder (ARFID), a form of overly selective eating that can lead to malnutrition. And importantly, the issue of nutrition is at the top of minds for patients with IBD. “A question from almost every IBD patient is, ‘What can I eat?” says Berkeley Limketkai, MD, PhD, director of clinical research for the Center for Inflammatory Bowel Diseases and a health sciences associate clinical professor of medicine in the Vatche and Tamar Manoukian Division of Digestive Diseases. The Center for Inflammatory Bowel Diseases’ newly established multidisciplinary IBD Nutrition Clinic incorporates the latest evidence in making dietary recommendations personalized to each patient’s needs. The clinic, directed by Dr. Limketkai and including a team of specially trained IBD registered dietitians, also assists with perioperative nutrition planning to optimize surgical outcomes. Dr. Limketkai points out that dietary recommendations for IBD patients are not one-size-fits-all. His team takes each patient’s clinical profile — including their nutritional status, current and previous diets, and any known tolerances or intolerances. “We consider the person’s medical, social, and cultural history,” Dr. Limketkai says. “For example, you can’t just say ‘follow a Mediterranean diet,’ because that means very different things to individuals from different backgrounds.” The recommended interventions include diets published in the research literature as well as those developed and studied at UCLA. To help identify optimal dietary strategies, the team utilizes a clinical decision-support tool based on dietary and outcomes data collected on previous patients —approximately 700 patients are currently in the database. “What we learn from each patient helps to inform the recommendations we make to future patients,” Dr. Limketkai explains. The research conducted by the clinic is important because of the need for a better understanding of the role of nutrition
in IBD, and which patients are most likely to benefit from which approaches. “This is a relatively immature field in the sense that we have only begun to develop robust research data in humans in the last several years,” Dr. Limketkai says. “We are now seeing an acceleration of those studies, and by developing that knowledge base we can continue improving the care we provide.” Diet and other environmental triggers are believed to play an important role in both the development of IBD and disease severity, along with factors such as genetic predisposition, the microbiome, and the sensitivity of the immune system, Dr. Limketkai says. “A complex interplay of factors are involved,” he explains. “As one of the components, nutrition is probably important for everybody, though more for some than for others. But what we do know is that nutrition is something patients have control over, which is why many are eager to try to alter their diet in an effort to reduce symptoms and inflammation — and there is evidence that in some patients, this can be effective. We want to support patients by offering them the best evidence-based practice for nutritional care of IBD.”
“Dr. Limketkai points out that dietary recommendations for IBD patients are not one-size-fits-all.”
Berkeley Limketkai, MD, PhD
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uclahealth.org/departments/medicine/gastro
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