Abstract

Inflammatory bowel disease is a chronic and recurring inflammatory condition of the gastrointestinal tract encompassing ulcerative colitis and Crohn's disease. Although the pathogenesis of inflammatory bowel disease remains to be fully elucidated, environmental factors such as diet are believed to play a pivotal role in the onset and management of inflammatory bowel disease. Diet is thought to play an essential role in intestinal inflammation due to its regulatory effects on the microbiota, gut immune system, and epithelial barrier function. Although the evidence remains insufficient to draw firm conclusions on the role of specific dietary components in gastrointestinal diseases, studies have suggested that a Western diet with high intakes of total fats, omega-6 fatty acids, and meat have been associated with intestinal inflammation and relapse of inflammatory bowel disease. In contrast to a Western diet, plant-based diets often result in a reduced intake of total fats and meats and an increased intake of plant fibers which may contribute to reduced intestinal inflammation. This review critically examines the influence of plant-based dietary components on the clinical disease course of inflammatory bowel disease. Furthermore, this review discusses the benefits and possible limitations of plant-derived dietary components in the treatment of inflammatory bowel disease while addressing the principal type of disease and the anatomic site of inflammation within the gastrointestinal tract. Finally, this review points out important directions for future research on the role of diet in inflammatory bowel disease. A better understanding of the role of diet and intestinal inflammation may pave the way for novel dietary interventions and specific foods- or food supplements, which can support the treatment of inflammatory bowel disease.

Highlights

  • Crohn’s disease (CD) and ulcerative colitis (UC) are chronic relapsing inflammatory bowel diseases (IBD) [1, 2]

  • The central question is whether it is possible to support and maintain clinical remission of IBD by adopting a plant-based eating pattern? Plant-based foods are major sources of non-digestible carbohydrates (NDCs) and phytochemicals that are believed to interact with intestinal microbiota and exert direct influence on the gut immune system through several mechanisms related to the increased production of immunoregulatory postbiotics and downregulation of proinflammatory responses

  • More research is needed to determine whether these dietary components reduce disease activity in IBD patients

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Summary

INTRODUCTION

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic relapsing inflammatory bowel diseases (IBD) [1, 2]. The nutrient content and composition of plant foods vary greatly, the consumption of plant-based diets often result in a reduced intake of saturated fatty acids (SFAs) and animal-derived dietary protein and a concomitant higher intake of non-digestible carbohydrates (NDCs) and phytochemicals due to intakes of fruits and vegetables Together, this may reduce intestinal inflammation and disease activity through enhanced production of immunoregulatory postbiotics, down-regulation of pro-inflammatory cytokines, and increased microbial diversity [11,12,13]. While sulfur-containing AAs represent a powerful part of the cell antioxidant system, increased protein fermentation within the large intestine may have a detrimental impact on the gut barrier function, gut immune system, and intestinal inflammation through the production of several metabolites These metabolites include hydrogen sulfide (H2S), aromatic compounds (e.g., phenols, P-cresol), polyamines including ammonia, and nitric oxide (NO), and studies have found a higher fecal concentration of several of these metabolites (e.g., ammonia and total sulfide) in IBD patients compared to healthy individuals [34]. The inclusion of a variety of NDCs with varying physicochemical properties in the diet may be important to downregulate the rate of microbial fermentation of dietary proteins

Summary
Findings
CONCLUSION AND FUTURE RESEARCH
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