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Open Access Research

Dietary iron does not impact the quality of life of patients with quiescent ulcerative colitis: an observational study

Zoe Tolkien1, Dora IA Pereira1, Laura Prassmayer1, Emily Fitt1, Gerda Pot12, Simon M Greenfield3 and Jonathan J Powell1*

Author Affiliations

1 MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK

2 Diabetes & Nutritional Sciences Division, School of Medicine, King’s College London, London SE1 9NH, UK

3 Gastroenterology Department, QE2 Hospital, East and North Hertfordshire NHS Trust, Welwyn Garden, UK

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Nutrition Journal 2013, 12:152  doi:10.1186/1475-2891-12-152

Published: 23 November 2013

Abstract

Background

In animal models, excess luminal iron exacerbates colonic inflammation and cancer development. Moreover, in inflammatory bowel disease (IBD) patients with mild to moderate disease activity dietary fortificant iron intake is inversely related to quality of life. Here we sought to determine whether dietary iron intakes were also related to quality of life in IBD patients in remission.

Methods

Forty eight patients with ulcerative colitis (UC), 42 of which had quiescent disease during this observational study, and 53 healthy control subjects completed quality of life questionnaires and 7-day food diaries. For comparative analysis, 34/group were matched and the linear relationship between dietary iron intakes (total, haem, non-haem or fortificant) and EuroQol quality of life measures was investigated. For UC patients the linear relationship between dietary iron intakes and the scores from the disease specific inflammatory bowel disease questionnaire (IBDQ) was also considered.

Results

The intake of dietary iron, and its various sub-fractions, were not associated with quality of life (EuroQol) in patients with quiescent disease or in healthy control subjects. The picture was similar for the 42 quiescent UC patients when disease-specific IBDQ was used. However, the 6 patients who relapsed during the study again showed an inverse association between IBDQ and dietary iron intake (p = 0.03).

Conclusions

Our data suggest that dietary iron does not impact on quality of life in quiescent UC patients but support that, once the disease is triggered, luminal iron may be a permissive factor for exacerbation of disease activity resulting in lower quality of life.

Keywords:
Dietary iron; Quality of life; Ulcerative colitis; Patients