CIUCIUC Nina1, PASCU Antonia Mariana2*, POP Anca Lucia3, NASUI Bogdana Adriana3
1 Assistant Professor, University of Medicine and Pharmacy, Cluj-Napoca, Department of Community Health
2 Resident Physical Medicine and Rehabilitation, Rehabilitation Hospital Cluj-Napoca
3 Lecturer, University of Medicine and Pharmacy, Cluj-Napoca, Department of Community Health
4 ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956, Bucharest (ROMANIA)
Corresponding autor: E-mails: nciuciuc@gmail.com
Abstract
Objectives. The premise of this study was that food has an important role in the appearance and evolution of digestive diseases and the analysis of food consumption and frequency of digestive diseases was followed. Methodology. A cross-sectional study was performed on a sample of 76 patients, aged between 21 and 87 years. The survey was conducted to determine the eating behaviour and other lifestyle risk factors. The analysis of data was performed using Microsoft Excel 2016 and SPSS version 20.0 (IBM program). The Kurskal – Wallis test was used to compare the data. The statistically significant results were those with p <0.05. Results. The study showed that some of the risk factors for the occurrence of digestive neoplasia and hepatic steatosis were red meat and processed meat (p= 0.02). The results revealed that the consumption of saturated and polyunsaturated fats n-6 was also a risk factor for gallstones (p= 0.03). The alcohol consumption is a risk factor for the occurrence of digestive neoplasms and hepatic steatosis (p =0.04). Conclusions. The study emphasized that the decreased consumption of red meat and animal fats and the reduction/total exclusion of alcohol are among the first nutritional recommendations. The increased consumption of plant foods and adopting a balanced lifestyle may reduce the risk of many digestive diseases.
Keywords: digestive pathology, unbalanced diet, risky eating habits, lifestyle.
Introduction
In Romania most deaths are caused by cardiovascular diseases, second most by oncological diseases and third most by digestive diseases. According to the data of the National Institute of Statistics of Romania, in Cluj County, in 2016 there were 389 deaths due to digestive diseases and 14,502 deaths in the whole country. At the national level, amongst the high frequency digestive diseases are inflammatory diseases (gastritis, duodenitis, inflammatory bowel disease and appendicitis), peptic ulcer, diseases of the gallbladder and bile duct [1]. Less is known about the correlations between the diet and steatosis, liver neoplasia and other inflammatory digestive disease in our study area. The objective of our study is to evaluate the correlations between food and the appearance and evolution of digestive diseases and to analyse the food consumption vs. frequency of digestive diseases.
Section
A sample of 76 hospitalized patients at the Cluj Napoca County Emergency Clinical Hospital, Department of Internal Medicine II has been studied. The patients voluntarily participated and were asked for informed consent. Inclusion criteria: patients previously diagnosed with digestive pathologies, with no other endogenous factors that would influence the appearance and evolution of the digestive pathology. The sample consisted of 64% men and 36% women, aged between 21 and 87 years, from urban and rural areas.
We conducted a cross-sectional study. To investigate the risk factors among the studied sample we used a valid and semi quantitative food-frequency questionnaire. The questionnaire included eating frequency questions, questions related to food preferences, preparation and personal exposure factors. Depending on their ingested food eating frequency, the answers of their survey received a score as follows: 1 point – daily, 2 points 2-3 times a week, 3 points 2-3 times a month 4 points rarely 5points never. In this survey, the lower the score was, the higher the consumption frequency was.
Microsoft Excel 2016 and SPSS version 20.0 (IBM program) were used in order to perform statistically analyse of the data. The Kruskal-Wallis test was used to collect the data. The results with p <0.05 were considered statistically significant.
Results
The results of this study emphasized that the patients with colonic pathology (10 patients), gastropathy (9 patients) and hepatic steatosis (9 patients), consumed milk daily, unlike the rest of the patients who had a lower consumption. (fig.1).
Fig. 1. Distribution of the sample by pathologies according to milk consumption
Chicken consumption was low in patients with gallstones (2 patients) in comparison to other patients with gastropathy (10 patients), colonic pathology (11 patients) and hepatic steatosis (9 patients) (fig. 2).
Fig. 2. Distribution of the sample by pathologies according to chicken consumption
The results of the study showed that the processed meat seemed to be preferred by patients with digestive neoplasms (5 patients 2-3 times / week) and hepatic steatosis (6 patients 2-3 times / week) in comparison to the patients with gastropathies, gallstones and colonic pathology (fig. 3).
Fig. 3. Distribution of the sample by pathologies according to the consumption of processed meat
The distribution of the sample according to pathology, regarding red meat consumption revealed that patients with gastropathy (11 patients) and colonic pathology (9 patients) consumed red meat 2-3 times a week, more often than those with other pathologies (fig.4).
Fig.4. Distribution of the sample by pathology according to red meat consumption
Regarding the consumption of animal fats, it seems that it was preferred by most patients with colonic pathology (11 patients 2-3 times / week), gastropathies (9 patients 2-3 times / week) and those with hepatic steatosis (8 patients daily consumption and 7 patients 2-3 times / week) (fig.5).
Fig.5. Distribution of the sample by pathologies according to the consumption of animal fats
Alcohol consumption was avoided by patients with gastropathy (11 patients rarely consume), while the majority who consume daily are the patients with hepatic steatosis (6 patients) (fig. 6).
Fig.6. Distribution of the sample by pathologies according to alcohol consumption
Using the Kruskal Wallis test, it was concluded that these differences in medium values are statistically significant for processed meat (p = 0.03), for alcohol consumption (p = 0.04),
For the consumption of animal fats (p = 0.03) and for the consumption of chicken meat (p = 0.012).
Table nr.1 The score of the sample depending on the pathology
| Variable (Pathology) | Median score | Min | Max | P value (p<0,05) |
| Processed meat consumption | ||||
| Gastropathy | 3 | 2.25 | 4.75 | 0.02 |
| Gallstones | 3 | 2.75 | 3.5 | |
| Colonic pathology | 3 | 2 | 3.5 | |
| Hepatic steatosis | 2 | 2 | 3 | |
| Digestive cancers | 2 | 1 | 2 | |
| Alcohol consumption | ||||
| Gastropathy | 4 | 3 | 4 | 0.04 |
| Gallstones | 4 | 3.75 | 4.25 | |
| Colonic pathology | 4 | 2.5 | 5 | |
| Hepatic steatosis | 3 | 1 | 3.5 | |
| Digestive cancers | 2 | 1 | 3.75 | |
| Fats | ||||
| Gastropathy | 2 | 1.25 | 3 | 0.03 |
| Gallstones | 1 | 1 | 1.25 | |
| Colonic pathology | 4 | 2.5 | 5 | |
| Hepatic steatosis | 3 | 1 | 3.5 | |
| Digestive cancers | 2 | 1 | 3.75 | |
| Chicken meat | ||||
| Gastropathy | 2 | 1 | 2 | 0.01 |
| Gallstones | 2 | 1 | 3 | |
| Colonic pathology | 1 | 1 | 2 | |
| Hepatic steatosis | 2 | 2 | 3 | |
| Digestive cancers | 1 | 1 | 1 | |
Discussions
The present study aimed to identify the dietary risk factors involved in the occurrence and evolution of digestive diseases and to analyse the relation between the frequency of food consumption and different digestive diseases.
The results of the study confirm the results of other studies regarding colonic pathology, gastropathy and hepatic steatosis and milk consumption, with reverse association between milk consumption and the occurrence of colorectal and gastric cancer [2].
Regarding the consumption of processed meat, the values were statistically significant, the patients with digestive neoplasms and hepatic steatosis having a higher overall consumption than patients with gastropathy, gallstones and colonic pathology. These study results confirmined the results of other literature data [3, 4].
Regarding the consumption of red meat, our results revealed that patients with gastropathies and colonic pathology ingested 2-3 times a week, more often than those with other pathologies. These result are confirmed by other studies from literature that concluded that the red meat is classified as “possibly carcinogenic” and the processed meat is classified as carcinogenic to humans [5,6]. The mechanism of the consumption of these two types of meat would increase the risk of colorectal cancer has not yet been established, but remains to be determined, along with the role of carcinogens in uncooked or unprocessed meat.
Our findings showed that the majority of the patients with colonic pathology consumed animal fats 2-3 times a week. After evaluating the median score in the survey, we concluded that patients with gastropathy, neoplasms, colonic pathology and liver steatosis consume less of these fats than those with gallstones, overall. The relationship between the consumption of animal fats and certain vegetable fats (n-6 series) and gallstones has been shown in several studies [5, 7].
Regarding alcohol consumption the present study revealed that the majority of interviewed patients suffering from gastropathy had the lowest intake of alcohol, while the majority of those who consumed daily are suffering from hepatic steatosis [6]. According to the median scores calculated on different pathologies, our results concluded that patients with gastropathy, gallstones and colonic pathology generally consume less alcohol than those suffering from digestive neoplasms and hepatic steatosis. The same results were obtained in other published studies on the effects of chronic alcohol consumption. An important study was the one about the alcohol consumption and colorectal cancer. Alcohol can be a solvent, which makes it easier for carcinogenic molecules to enter mucous cells [8,9,10,11].
The study of dietary risk factors involved in the occurrence of digestive diseases is difficult to perform because the occurrence of digestive diseases is determined by a multitude of other factors. Due to the vast pathologies of the digestive system, we cannot say with certainty that any food caused a certain pathology, we can only say which foods were consumed more often by patients with a certain pathology.
The limits of the study are given by the survey method, this being a subjective method and the accuracy of the answers depends on the degree of training of the interviewed subject.
Conclusion
In our study, the patients with gallstones consumed more animal fat than most patients with gastropathy, digestive neoplasms, colonic pathology and hepatic steatosis. The majority of patients with digestive neoplasms and hepatic steatosis consumed more alcohol than the patients with gastropathy, gallstones and colonic pathology. The results of this study can be used to implement public health policies and education of the population regarding a healthier lifestyle in order to prevent gastric pathology.
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