Effects of diet, dietary inflammatory index, modified antiinflammatory dietary intervention via diet management platform on short-term prognosis in patients with ulcerative colitis: A prospective study.

OBJECTIVES: Emerging evidence highlights the role of diet in modulating the disease course of ulcerative colitis (UC). This prospective study investigated the association between diet quality, dietary inflammatory index (DII), and short-term clinical outcomes in UC patients.

METHODS: A total of 108 UC patients in remission or with mild disease activity were recruited. Dietary intake over 6 wk was prospectively recorded using a digital health management platform to assess nutrient composition and calculate DII scores. Subsequently, a cluster-controlled intervention was implemented using a modified antiinflammatory diet tailored to UC-specific needs. Clinical outcomes and fecal microbiota were evaluated.

RESULTS: Findings revealed that the majority of patients had inadequate intake of staple foods (78.7%) and vegetables (69.4%). Higher DII scores were significantly associated with an increased risk of relapse or persistent disease activity (OR = 5.82, 95% CI: 1.75-19.39, P = 0.004) and reduced abundance of butyrate-producing gut bacteria. After 6 wk, the intervention group achieved a greater reduction in DII scores (median change -1.31, P = 0.019) and demonstrated improved nutritional intake. Compared with general dietary advice, the structured intervention significantly reduced the risk of short-term adverse outcomes (OR = 0.022, 95% CI: 0.001-0.629, P = 0.026).

CONCLUSIONS: This study underscores the significant role of diet quality and DII in predicting UC prognosis. A targeted, digitally delivered antiinflammatory diet improved nutrient intake, modulated gut microbiota, and reduced short-term relapse risk. These findings support the integration of structured dietary strategies into UC management and suggest the feasibility of digital platforms in guiding personalized nutrition therapy.