Abstract
The incidence of inflammatory bowel diseases (IBD), including Crohn’s disease (CD), is increasing worldwide, especially in young children and adolescents. Although hospitalized patients are usually provided with enteral or parenteral support, continuing care typically requires a trial-and-error approach to suppressing symptoms and maintaining disease remission. Current nutritional advice does not differ from general population guidelines. International collaborative studies have revealed 163 distinct genetic loci affecting susceptibility to IBD, in some of which host–microbe interactions can be seen to play an important role. The nature of these loci enables a rationale for predicting nutritional requirements that may not be evident through standard therapeutic approaches. Certain recognized nutrients, such as vitamin D and long-chain omega-3 polyunsaturated fatty acids, may be required at higher than anticipated levels. Various phytochemicals, not usually considered in the same class as classic nutrients, could play an important role. Prebiotics and probiotics may also be beneficial. Genomic approaches enable proof of principle of nutrient optimization rather than waiting for disease symptoms to appear and/or progress. We suggest a paradigm shift in diagnostic tools and nutritional therapy for CD, involving a systems biology approach for implementation.
Highlights
Inflammatory bowel diseases (IBD) cover a spectrum of gastrointestinal disorders, including both Crohn’s disease (CD) and ulcerative colitis (UC), differentiated by their location and behavior
There is reason to suggest that this could have significant benefits in terms of delaying inflammatory bowel diseases (IBD) progression and reducing the possibility of colorectal cancer (CRC) formation. Such information would ideally be tailored according to individual patient genetics, and validated using systems biology approaches, as detailed
Identification of NOD2 or ATG16L1 gene variants indicate that ability to respond appropriately to colonic bacteria is compromised [33, 34], and prebiotics and/or probiotics may provide an important starting point [14, 35,36,37]. Especially those carrying a number of variant single-nucleotide polymorphisms (SNPs), it becomes important to protect against genomic instability since this will reflect a propensity for cancer development
Summary
Inflammatory bowel diseases (IBD) cover a spectrum of gastrointestinal disorders, including both Crohn’s disease (CD) and ulcerative colitis (UC), differentiated by their location and behavior. There is reason to suggest that this could have significant benefits in terms of delaying IBD progression and reducing the possibility of CRC formation Such information would ideally be tailored according to individual patient genetics, and validated using systems biology approaches, as detailed . These are not included in lists of essential nutrients, many of them play key roles in maintaining genomic stability and in modulating the composition of the gut microbiome [7, 20, 21] These could be key factors in helping to prevent the development of CRC in IBD. Studies showing the importance of genotype in the phenotypic characteristics of the diseases encourage the possibility of tailoring diets based on genetic and genomic information [23]
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