Nutritional Status and Dietary Patterns of Patients with Crohn’s Disease in Clinical Remission: Insights from a Sri Lankan Cohort

Background Malnutrition is common in Crohn’s Disease (CD) and diet plays a vital role in its clinical course and pathogenesis. Diet is a contributing factor for aggravation of symptoms. Though the assessment of nutritional status and dietary patterns are crucial in the management of CD, literature in this regard is limited in Asia. Methods This descriptive cross-sectional study was carried out at a gastroenterology unit in a tertiary care centre in Sri Lanka over one-year duration. 150 patients diagnosed with Crohn's disease and in remission were included in the study. The data were gathered using an interviewer-administered questionnaire and physical examination of anthropometric measures. Results The mean age (SD) was 33 (8.4) years with the M:F ratio of 2:1. Forty-six percent of the population (n = 69) had a normal BMI range according to standard WHO criteria for Asian populations, while 36% were underweight and 18% overweight. The mean (± SD) intake of energy and protein was 1477.5 ± 241.1 kcal per day (male – 1562.6 ± 205.9; female – 1326.1 ± 228.9, P < 0.001) and 44.8 ± 9.4 g per day (male – 45.9 ± 8.0; female – 43.0 ± 11.5, P = 0.3), respectively. The mean (SD) albumin level was 21.6 g/l (17.6), suggestive of chronic malnutrition of the cohort; however, the mean of other micronutrients is within the normal range. The majority of (98%) patients believed that certain foods made symptoms worse, and the common dietary triggers were red meat and carbonated drinks. Red meat (86%), Samaposha (82%) and peanuts (70%) were identified as the most avoided food items in a local context. Self-experience of food triggers was the most influential source to prevent relapses (n = 135, 90%), followed by medical advice (76%), social media and internet (50%). None of the sociodemographic factors and disease characteristics were significantly associated with the dietary pattern and food avoidance (p > 0.05). Malnutrition was associated with early onset disease and younger age < 40 years (p < 0.05). Conclusion Malnutrition is prevalent among Sri Lankan Crohn’s disease patients, with a significant proportion being underweight and having low energy and protein intake. Despite normal micronutrient levels, the low mean albumin suggests chronic malnutrition. Patients are relying primarily on personal experience to guide food avoidance. Malnutrition was significantly associated with early onset of disease and younger age. These findings highlight the need for targeted nutritional assessment and dietary guidance in CD management.