Take-home messages from 20 years progress in dietary therapy of inflammatory bowel disease

Gkikas, K. , Svolos, V., Hansen, R., Russell, R. K. and Gerasimidis, K. (2024) Take-home messages from 20 years progress in dietary therapy of inflammatory bowel disease. Annals of Nutrition and Metabolism, 79(6), pp. 476-484. (doi: 10.1159/000535007) (PMID:37944498)

Abstract

Background: A significant body of literature has interrogated the critical role of diet in the development and management of inflammatory bowel disease (IBD). Summary: This review provides a summary and critical appraisal of the literature in this area, focussing on four distinct themes: nutritional epidemiology, animal and in vitro experiments, enteral nutrition, and food-based dietary therapies. Key Messages: Nutritional epidemiology and data from experiments in animals indicate that a western-type diet pattern is associated with increased risk of IBD onset. However, these findings have not been consistently replicated in the dietary management of IBD. Exclusive enteral nutrition (EEN) is the only dietary therapy with reproducible evidence of efficacy in the management of active Crohn’s disease (CD). Use of EEN may also be useful for improving perioperative outcomes in CD, and as an adjuvant therapy to biologic therapy. Several dietary therapies for CD and ulcerative colitis have been proposed in the literature, but replication in well-controlled studies is needed before their routine use enters the clinical setting. Precision nutritional therapy might be an attractive therapeutic paradigm in a heterogenous disease like IBD. However, no recommendations for personalised dietary therapy can currently be made, and it is imperative we unravel the complex interplay between diet and gut inflammation before we are able to do so. Undoubtedly, diet is of critical importance in the development and management of IBD. However, the exact mechanism by which diet causes gut inflammation is still elusive, and dietary guidance is difficult to formulate.

• Item Type: Articles
• Keywords: Diet, inflammatory bowel disease, exclusive enteral nutrition, dietary therapy.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hansen, Dr Richard and Gkikas, Dr Konstantinos and Gerasimidis, Professor Konstantinos and Svolos, Dr Vaios
• Authors: Gkikas, K., Svolos, V., Hansen, R., Russell, R. K., and Gerasimidis, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Annals of Nutrition and Metabolism
• Publisher: Karger Publishers
• ISSN: 0250-6807
• ISSN (Online): 1421-9697
• Published Online: 09 November 2023
• Copyright Holders: Copyright © 2023 The Author(s)
• First Published: First published in Annals of Nutrition and Metabolism 79(6):476-484
• Publisher Policy: Reproduced under a Creative Commons license