Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2021; 27(34): 5775-5792
Published online Sep 14, 2021. doi: 10.3748/wjg.v27.i34.5775
Dietary intake in patients with chronic pancreatitis: A systematic review and meta-analysis
Qurat Ul Ain, Yasir Bashir, Linda Kelleher, David M Bourne, Suzanne M Egan, Jean McMahon, Laura Keaskin, Oonagh M Griffin, Kevin C Conlon, Sinead N Duggan
Qurat Ul Ain, Yasir Bashir, Suzanne M Egan, Laura Keaskin, Oonagh M Griffin, Kevin C Conlon, Sinead N Duggan, Professorial Surgical Unit, Department of Surgery, Trinity College Dublin, Dublin 24 D24 NR0A, Ireland
Linda Kelleher, Department of Nutrition and Dietetics, Tallaght University Hospital, Dublin 24 D24 NR0A, Ireland
David M Bourne, Department of Newcastle Nutrition, Freeman Hospital, Newcastle Upon Tyne NE77DN, United Kingdom
Jean McMahon, Library and Information Services Tallaght, Tallaght University Hospital, Dublin 24 D24 NR0A, Ireland
Oonagh M Griffin, Department of Nutrition and Dietetics, St. Vincent’s University Hospital, Dublin 4 D04 T6F4, Ireland
Author contributions: Ul Ain Q, Egan SM, McMahon J, Conlon KC and Duggan SN contributed to design of study; Ul Ain Q and Bashir Y contributed to acquisition of data, independent reviewer; Ul Ain Q, Bashir Y, and Duggan SN contributed to analysis and interpretation of data; Ul Ain Q and Duggan SN drafted and finally approved the article; Bashir Y, Kelleher L, Bourne DM, Egan SM, McMahon J, Griffin OM and Conlon KC critically revised and finally approved the article; Kelleher L, Bourne DM, Egan SM, McMahon J, Keaskin L, Griffin OM and Conlon KC contributed to interpretation of data; Duggan SN conceived the study, and is the overall guarantor of the study.
Supported by The Meath Foundation of Tallaght University Hospital, No. 117/2020.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 checklist and the manuscript was prepared and revised according to the PRISMA 2009 checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sinead N Duggan, RD, PhD, Senior Research Fellow, Professorial Surgical Unit, Department of Surgery, Trinity College Dublin, Dublin 24 D24 NR0A, Ireland. duggansi@tcd.ie
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: May 1, 2021
Revised: May 26, 2021
Accepted: August 18, 2021
Article in press: August 18, 2021
Published online: September 14, 2021
ARTICLE HIGHLIGHTS
Research background

Patients with chronic pancreatitis (CP) are a high risk of developing malnutrition due to progressive exocrine insufficiency, malabsorption, and adverse gastro-intestinal symptoms. Poor dietary intake and excess alcohol consumption may exacerbate malnutrition.

Research motivation

Although CP is a digestive disease, little is known regarding the dietary intake of patients with this condition, and no systematic reviews or meta-analyses have been undertaken to date.

Research objectives

The purpose of this systematic review and meta-analysis was to compare the macronutrient and micronutrient intake of patients with CP to that of healthy subjects, and to determine if there was a difference in dietary intake according to aetiology.

Research methods

With the guidance of a medical librarian, we conducted a search of multiple databases including Ovid Medline, EMBASE and Cochrane Review.

Research results

Twenty-three studies were retrieved in the search and included in the systematic review (representing 1577 patients with CP), of which 12 were eligible for meta-analysis (representing 1048 patients with CP and 1965 healthy controls). There was no statistical difference in the energy (calorie) intakes of patients with CP and controls. However, when analysing studies reporting non-alcohol calorie consumption, patients with CP consumed significantly fewer calories than health control subjects. Those with CP consumed more protein than healthy controls, but there was no difference in the consumption of carbohydrate and fat. Heterogeneity was considerably high for all outcome measures. A broad variety of methods was used in the various studies to estimate dietary intake, and most had been published more than ten years prior to this review.

Research conclusions

This was the first meta-analysis to evaluate the dietary intake of patients with CP. Although the calorie intake of patients with CP did not differ from that of healthy controls, studies that analysed the contribution of alcohol to energy intake showed that those with CP consumed fewer non-alcohol calories than controls. This may contribute to the poor nutritional status of patients with CP.

Research perspectives

The considerable heterogeneity made it difficult to make general conclusions, and the broad range of dietary assessment methods used means that under-or over-estimation of intake may have occurred. There were few data for micronutrient intake, a considerable research gap considering the common occurrence of biochemical deficiency in this patient group. There were few recently-published studies. Future studies should aim to characterise the dietary macronutrient and micronutrient intakes of patients with CP with robust methodology and study design.