Ulcerative Colitis Is Associated With Diet-related Inflammation and Physical Activity in the IBD Partners E-cohort

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 (& beta; = 0.166; P < .001), anxiety (& beta; = 0.342; P = .006), depression (& beta; = 0.408; P = .004), fatigue (& beta; = 0.386; P = .005), sleep disturbance (& beta; = 0.339; P = .003), and decreased social satisfaction (& beta; = -0.370; P = .004) and quality of life (& beta; = -0.056; P < .001). Physical activity was inversely associated with disease activity (& beta; = -0.108; P < .001), anxiety (& beta; = -0.025; P = .001), depression (& beta; = -0.025; P = .001), fatigue (& beta; = -0.058; P < .001), and sleep disturbance (& beta; = -0.019; P = .008), while positively associated with social satisfaction (& beta; = 0.063; P < .001) and quality of life (& beta; = 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. An anti-inflammatory diet and increased physical activity are associated with a lower burden of illness on daily living among patients and may aid in managing the systemic and localized inflammation associated with ulcerative colitis.