Dietary and Nutritional Risk Factors for Inflammatory Bowel Disease: A Case at Kenyatta National Hospital in Nairobi, Kenya

Abstract

The increasing incidence of Inflammatory Bowel Disease (IBD) is linked to changing diets, environmental exposures, limited diagnostic access, and treatment costs. Lacking clear guidance, many patients adopt restrictive diets that can harm their health. Nutritional interventions should therefore go beyond meeting energy and nutrient needs to support disease management. Growing evidence shows that certain foods influence inflammation, underscoring the importance of individualized, evidence-based dietary strategies for IBD care.To identify, understand and evaluate the Dietary and Nutritional Risk factors associated with Inflammatory Bowel Disease. This study used an analytical observational design with a hospital-based cross-sectional approach at Kenyatta National Hospital. Quantitative data were analyzed using SPSS version 26. Descriptive statistics were used to summarize socio-demographic, clinical, and dietary characteristics of participants. Group differences for categorical variables were assessed using χ² tests (with Fisher’s exact test where expected cell counts were <5). All tests were two-sided with α=0.05. Missing data were handled by pairwise exclusion for all inferential analyses; for descriptive summaries, available-case denominators are shown. Specifically, for the binary endpoints Core IBD Therapy and Adjunct Comorbidity Care, records with missing values in the outcome or any included covariate were excluded pairwise from the relevant analyses. Use of core IBD pharmacotherapy was higher in IBD than GD (100% vs 75.3%; p<0.001). IBD patients more frequently reported therapeutic supplements (62.5% vs 39.2%; p=0.016) and preventive supplements (40.0% vs 15.2%; p=0.003). Restrictive therapeutic diets were common (47.5% IBD vs 34.2% GD; p=0.159). Diarrhea was more frequent in IBD (75.0% vs 50.6%; p=0.011); vomiting did not differ. Rates of documented nutritional deficiency (~60%) and malnutrition (~40%) were similar across groups. Diet intake patterns showed high reliance on staples and plant based proteins, with selective avoidance of animal fats and some animal proteins. IBD patients reported greater dietary variety, consuming more fruits, vegetables, dairy, and healthy fats compared to those with gastroesophageal disorders, who tended to restrict foods to prevent reflux. This reflects IBD patients’ active dietary management to control symptoms and maintain nutrition. They also relied more on supplements and therapeutic diets, such as low-residue or lactose-free plans, to ease gastrointestinal discomfort. Despite occasional food aversions and reduced diversity, most maintained adequate caloric intake, with only severe cases requiring medical nutrition support—highlighting the importance of individualized dietary care in managing IBD.