Adherence to Mediterranean diet in outpatients with inflammatory bowel diseases is low, and only weakly associated with clinical outcomes - a single-center observational study.

BACKGROUND: Dietary behavior is associated with the course of several somatic and mental disorders. In inflammatory bowel diseases (IBD), where mental health is frequently impaired, adherence to recommended Mediterranean diet (MD) and its clinical relevance remain unclear. OBJECTIVE: This study investigated MD adherence in IBD outpatients and its associations with disease activity and psychosocial outcomes. METHODS: 430 patients completed questionnaires assessing adherence to MD (MEDAS), depression and anxiety (HADS), fatigue (FACIT-F), and quality of life (SHS). Network analysis using Spearman correlations was performed to visualize associations among parameters. RESULTS: Adherence to MD was low (median MEDAS = 6), with the greatest deficits in fish (11.2%), fruits (15.3%), and pulses (18.1%). Adherence was higher in female than in male patients (6 vs 5, p=0.002). Depressive symptoms were present in 24.3%, anxiety in 40.6%, and severe fatigue in 33.6% of patients. Fatigue, depression and anxiety formed a dense cluster in the network analysis and strongly linked to quality of life, while MD was only weakly related to other parameters. CONCLUSION: Our data show low MD adherence and high levels of fatigue, symptoms of anxiety and depression that are strongly linked to quality of life and disease activity.