Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study

Silja H Overgaard; Signe B Sørensen; Heidi L Munk; Anders B Nexøe; Henning Glerup; Rikke H Henriksen; Tanja Guldmann; Natalia Pedersen; Sanaz Saboori; Lone Hvid; Jens F Dahlerup; Christian L Hvas; Mohamad Jawhara; Karina W Andersen; Andreas K Pedersen; Ole H Nielsen; Fredrik Bergenheim; Jacob B Brodersen; Berit L Heitmann; Thorhallur I Halldorsson; Uffe Holmskov; Anette Bygum; Robin Christensen; Jens Kjeldsen; Torkell Ellingsen; Vibeke Andersen

doi:10.3389/fnut.2022.985732

Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study

Silja H Overgaard^*
, Signe B Sørensen
, Heidi L Munk
, Anders B Nexøe
, Henning Glerup
, Rikke H Henriksen
, Tanja Guldmann
, Natalia Pedersen
, Sanaz Saboori
, Lone Hvid
, Jens F Dahlerup
, Christian L Hvas
, Mohamad Jawhara
, Karina W Andersen
, Andreas K Pedersen
, Ole H Nielsen
, Fredrik Bergenheim
, Jacob B Brodersen
, Berit L Heitmann
, Thorhallur I Halldorsson

Uffe Holmskov, Anette Bygum, Robin Christensen, Jens Kjeldsen, Torkell Ellingsen, Vibeke Andersen

^*Corresponding author for this work

University Research Clinic for Innovative Patient Pathways
Næstved-Slagelse-Ringsted Hospitals
University of Copenhagen
Bispebjerg and Frederiksberg Hospitals
Aarhus University Hospital
University of Iceland

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

Background: Biologic disease-modifying drugs have revolutionised the treatment of a number of chronic inflammatory diseases (CID). However, up to 60% of the patients do not have a sufficient response to treatment and there is a need for optimization of treatment strategies.

Objective: To investigate if the treatment outcome of biological therapy is associated with the habitual dietary intake of fibre and red/processed meat in patients with a CID.

Methods: In this multicentre prospective cohort study, we consecutively enrolled 233 adult patients with a diagnosis of Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis (RA), Axial Spondyloarthritis, Psoriatic Arthritis and Psoriasis, for whom biologic therapy was planned, over a 3 year period. Patients with completed baseline food frequency questionnaires were stratified into a high fibre/low red and processed meat exposed group (HFLM) and an unexposed group (low fibre/high red and processed meat intake = LFHM). The primary outcome was the proportion of patients with a clinical response to biologic therapy after 14-16 weeks of treatment.

Results: Of the 193 patients included in our primary analysis, 114 (59%) had a clinical response to biologic therapy. In the HFLM group ( N = 64), 41 (64%) patients responded to treatment compared to 73 (56%) in the LFHM group ( N = 129), but the difference was not statistically significant (OR: 1.48, 0.72-3.05). For RA patients however, HFLM diet was associated with a more likely clinical response (82% vs. 35%; OR: 9.84, 1.35-71.56).

Conclusion: Habitual HFLM intake did not affect the clinical response to biological treatment across CIDs. HFLM diet in RA patients might be associated with better odds for responding to biological treatment, but this would need confirmation in a randomised trial.

Trial registration: (clinicaltrials.gov), identifier [NCT03173144].

Original language	English
Article number	985732
Journal	Frontiers in Nutrition
Volume	9
Number of pages	13
ISSN	2296-861X
DOIs	https://doi.org/10.3389/fnut.2022.985732
Publication status	Published - 13. Oct 2022

Bibliographical note

Copyright © 2022 Overgaard, Sørensen, Munk, Nexøe, Glerup, Henriksen, Guldmann, Pedersen, Saboori, Hvid, Dahlerup, Hvas, Jawhara, Andersen, Pedersen, Nielsen, Bergenheim, Brodersen, Heitmann, Halldorsson, Holmskov, Bygum, Christensen, Kjeldsen, Ellingsen and Andersen.

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Prognostic factors in Chronic Inflammatory Diseases: A PhD study within clinical epidemiology
Overgaard, S. H., 13. Sept 2023, Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet. 192 p.
Research output: Thesis › Ph.D. thesis

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Overgaard, S. H., Sørensen, S. B., Munk, H. L., Nexøe, A. B., Glerup, H., Henriksen, R. H., Guldmann, T., Pedersen, N., Saboori, S., Hvid, L., Dahlerup, J. F., Hvas, C. L., Jawhara, M., Andersen, K. W., Pedersen, A. K., Nielsen, O. H., Bergenheim, F., Brodersen, J. B., Heitmann, B. L., ... Andersen, V. (2022). Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study. Frontiers in Nutrition, 9, Article 985732. https://doi.org/10.3389/fnut.2022.985732

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title = "Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study",

abstract = "Background: Biologic disease-modifying drugs have revolutionised the treatment of a number of chronic inflammatory diseases (CID). However, up to 60\% of the patients do not have a sufficient response to treatment and there is a need for optimization of treatment strategies.Objective: To investigate if the treatment outcome of biological therapy is associated with the habitual dietary intake of fibre and red/processed meat in patients with a CID.Methods: In this multicentre prospective cohort study, we consecutively enrolled 233 adult patients with a diagnosis of Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis (RA), Axial Spondyloarthritis, Psoriatic Arthritis and Psoriasis, for whom biologic therapy was planned, over a 3 year period. Patients with completed baseline food frequency questionnaires were stratified into a high fibre/low red and processed meat exposed group (HFLM) and an unexposed group (low fibre/high red and processed meat intake = LFHM). The primary outcome was the proportion of patients with a clinical response to biologic therapy after 14-16 weeks of treatment.Results: Of the 193 patients included in our primary analysis, 114 (59\%) had a clinical response to biologic therapy. In the HFLM group ( N = 64), 41 (64\%) patients responded to treatment compared to 73 (56\%) in the LFHM group ( N = 129), but the difference was not statistically significant (OR: 1.48, 0.72-3.05). For RA patients however, HFLM diet was associated with a more likely clinical response (82\% vs. 35\%; OR: 9.84, 1.35-71.56). Conclusion: Habitual HFLM intake did not affect the clinical response to biological treatment across CIDs. HFLM diet in RA patients might be associated with better odds for responding to biological treatment, but this would need confirmation in a randomised trial.Trial registration: (clinicaltrials.gov), identifier [NCT03173144].",

author = "Overgaard, \{Silja H\} and S{\o}rensen, \{Signe B\} and Munk, \{Heidi L\} and Nex{\o}e, \{Anders B\} and Henning Glerup and Henriksen, \{Rikke H\} and Tanja Guldmann and Natalia Pedersen and Sanaz Saboori and Lone Hvid and Dahlerup, \{Jens F\} and Hvas, \{Christian L\} and Mohamad Jawhara and Andersen, \{Karina W\} and Pedersen, \{Andreas K\} and Nielsen, \{Ole H\} and Fredrik Bergenheim and Brodersen, \{Jacob B\} and Heitmann, \{Berit L\} and Halldorsson, \{Thorhallur I\} and Uffe Holmskov and Anette Bygum and Robin Christensen and Jens Kjeldsen and Torkell Ellingsen and Vibeke Andersen",

note = "Copyright {\textcopyright} 2022 Overgaard, S{\o}rensen, Munk, Nex{\o}e, Glerup, Henriksen, Guldmann, Pedersen, Saboori, Hvid, Dahlerup, Hvas, Jawhara, Andersen, Pedersen, Nielsen, Bergenheim, Brodersen, Heitmann, Halldorsson, Holmskov, Bygum, Christensen, Kjeldsen, Ellingsen and Andersen.",

year = "2022",

month = oct,

day = "13",

doi = "10.3389/fnut.2022.985732",

language = "English",

volume = "9",

journal = "Frontiers in Nutrition",

issn = "2296-861X",

publisher = "Frontiers Media",

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Overgaard, SH, Sørensen, SB, Munk, HL, Nexøe, AB, Glerup, H, Henriksen, RH, Guldmann, T, Pedersen, N, Saboori, S, Hvid, L, Dahlerup, JF, Hvas, CL, Jawhara, M, Andersen, KW, Pedersen, AK, Nielsen, OH, Bergenheim, F, Brodersen, JB, Heitmann, BL, Halldorsson, TI, Holmskov, U, Bygum, A , Christensen, R , Kjeldsen, J , Ellingsen, T & Andersen, V 2022, 'Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study', Frontiers in Nutrition, vol. 9, 985732. https://doi.org/10.3389/fnut.2022.985732

Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study. / Overgaard, Silja H; Sørensen, Signe B; Munk, Heidi L et al.
In: Frontiers in Nutrition, Vol. 9, 985732, 13.10.2022.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy

T2 - A prospective cohort study

AU - Overgaard, Silja H

AU - Sørensen, Signe B

AU - Munk, Heidi L

AU - Nexøe, Anders B

AU - Glerup, Henning

AU - Henriksen, Rikke H

AU - Guldmann, Tanja

AU - Pedersen, Natalia

AU - Saboori, Sanaz

AU - Hvid, Lone

AU - Dahlerup, Jens F

AU - Hvas, Christian L

AU - Jawhara, Mohamad

AU - Andersen, Karina W

AU - Pedersen, Andreas K

AU - Nielsen, Ole H

AU - Bergenheim, Fredrik

AU - Brodersen, Jacob B

AU - Heitmann, Berit L

AU - Halldorsson, Thorhallur I

AU - Holmskov, Uffe

AU - Bygum, Anette

AU - Christensen, Robin

AU - Kjeldsen, Jens

AU - Ellingsen, Torkell

AU - Andersen, Vibeke

N1 - Copyright © 2022 Overgaard, Sørensen, Munk, Nexøe, Glerup, Henriksen, Guldmann, Pedersen, Saboori, Hvid, Dahlerup, Hvas, Jawhara, Andersen, Pedersen, Nielsen, Bergenheim, Brodersen, Heitmann, Halldorsson, Holmskov, Bygum, Christensen, Kjeldsen, Ellingsen and Andersen.

PY - 2022/10/13

Y1 - 2022/10/13

N2 - Background: Biologic disease-modifying drugs have revolutionised the treatment of a number of chronic inflammatory diseases (CID). However, up to 60% of the patients do not have a sufficient response to treatment and there is a need for optimization of treatment strategies.Objective: To investigate if the treatment outcome of biological therapy is associated with the habitual dietary intake of fibre and red/processed meat in patients with a CID.Methods: In this multicentre prospective cohort study, we consecutively enrolled 233 adult patients with a diagnosis of Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis (RA), Axial Spondyloarthritis, Psoriatic Arthritis and Psoriasis, for whom biologic therapy was planned, over a 3 year period. Patients with completed baseline food frequency questionnaires were stratified into a high fibre/low red and processed meat exposed group (HFLM) and an unexposed group (low fibre/high red and processed meat intake = LFHM). The primary outcome was the proportion of patients with a clinical response to biologic therapy after 14-16 weeks of treatment.Results: Of the 193 patients included in our primary analysis, 114 (59%) had a clinical response to biologic therapy. In the HFLM group ( N = 64), 41 (64%) patients responded to treatment compared to 73 (56%) in the LFHM group ( N = 129), but the difference was not statistically significant (OR: 1.48, 0.72-3.05). For RA patients however, HFLM diet was associated with a more likely clinical response (82% vs. 35%; OR: 9.84, 1.35-71.56). Conclusion: Habitual HFLM intake did not affect the clinical response to biological treatment across CIDs. HFLM diet in RA patients might be associated with better odds for responding to biological treatment, but this would need confirmation in a randomised trial.Trial registration: (clinicaltrials.gov), identifier [NCT03173144].

AB - Background: Biologic disease-modifying drugs have revolutionised the treatment of a number of chronic inflammatory diseases (CID). However, up to 60% of the patients do not have a sufficient response to treatment and there is a need for optimization of treatment strategies.Objective: To investigate if the treatment outcome of biological therapy is associated with the habitual dietary intake of fibre and red/processed meat in patients with a CID.Methods: In this multicentre prospective cohort study, we consecutively enrolled 233 adult patients with a diagnosis of Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis (RA), Axial Spondyloarthritis, Psoriatic Arthritis and Psoriasis, for whom biologic therapy was planned, over a 3 year period. Patients with completed baseline food frequency questionnaires were stratified into a high fibre/low red and processed meat exposed group (HFLM) and an unexposed group (low fibre/high red and processed meat intake = LFHM). The primary outcome was the proportion of patients with a clinical response to biologic therapy after 14-16 weeks of treatment.Results: Of the 193 patients included in our primary analysis, 114 (59%) had a clinical response to biologic therapy. In the HFLM group ( N = 64), 41 (64%) patients responded to treatment compared to 73 (56%) in the LFHM group ( N = 129), but the difference was not statistically significant (OR: 1.48, 0.72-3.05). For RA patients however, HFLM diet was associated with a more likely clinical response (82% vs. 35%; OR: 9.84, 1.35-71.56). Conclusion: Habitual HFLM intake did not affect the clinical response to biological treatment across CIDs. HFLM diet in RA patients might be associated with better odds for responding to biological treatment, but this would need confirmation in a randomised trial.Trial registration: (clinicaltrials.gov), identifier [NCT03173144].

U2 - 10.3389/fnut.2022.985732

DO - 10.3389/fnut.2022.985732

M3 - Journal article

C2 - 36313095

SN - 2296-861X

VL - 9

JO - Frontiers in Nutrition

JF - Frontiers in Nutrition

M1 - 985732

ER -

Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study

Abstract

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Prognostic factors in Chronic Inflammatory Diseases: A PhD study within clinical epidemiology

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