Dietary Habits of Individuals With Primary Sclerosing Cholangitis-Poor Fat-Soluble Vitamin Intake and Dietary Quality

Background and aims: Individuals with primary sclerosing cholangitis (PSC) have expressed a need for more dietary information. The aim of this study was to evaluate the dietary intake of individuals with PSC and compare it with Nordic nutrition recommendations 2023 (NNR2023).

Methods: A cross-sectional assessment of dietary intake was performed using a food-frequency questionnaire among 120 individuals with PSC from five regions across Sweden. Macro- and micronutrient intake was compared to NNR2023. Dietary quality was evaluated using an index developed by the National Food Agency in Sweden.

Results: The median age was 47 years (IQR 18), and median body mass index (BMI) was 25.2 kg/m² (IQR 5.9). Eight percent had a BMI < 20, and 13% had a BMI > 30. The average fibre intake was 18 g (IQR 18). Median energy distribution included 36% from fat (15% saturated, 4.6% polyunsaturated), 17% from protein and 43% from carbohydrates, highlighting an imbalanced diet with low carbohydrate, fibre and polyunsaturated fat intake and high saturated fat consumption. More than half reported suboptimal intake of zinc, selenium and vitamins C, D and K and > 30% suboptimal intake of vitamins A, B6, E, niacin, folate, potassium, magnesium and iron. Forty percent had poor dietary quality. Longer PSC duration and previous colectomy were associated with a lower dietary quality.

Conclusions: Many individuals with PSC do not reach the recommended levels of various micronutrients, especially fat-soluble vitamins and report a poor dietary quality. The results highlight the need for a comprehensive approach to nutritional management in this population.

Trial registration: ClinicalTrials.gov identifier: NCT04133792.