Abstract
Patients frequently wonder whether their dietary pattern influences the course of inflammatory bowel disease (IBD). Many patients even avoid certain foods that aggravate their symptoms. Although interest in nutritional interventions is rising among physicians, the current application of nutritional interventions in the IBD population is limited due to the lack of scientific evidence from clinical trials. Several studies, however, have identified associations between diet, gut microbiota, intestinal epithelial integrity, and mucosal immune responses. In patients consuming predominantly a Western diet high in n-6 poly-unsaturated fatty acids (PUFAs), sugars, and meat, and low in fruits and vegetables, an impaired gut epithelial barrier and disturbances in the intestinal microbiota have been observed, resulting in a chronic mucosal inflammation. An anti-inflammatory diet may restore this disbalance. In this review, we discuss the effects of diet on the composition of the microbiota, the gut epithelial barrier function, and the mucosal immune system.
Highlights
Inflammatory bowel diseases (IBDs), consisting of Crohn’s disease (CD) and ulcerative colitis (UC), are chronic immune-mediated disorders that can have a large impact on the wellbeing and quality of life of patients worldwide [1,2]
“Africanization” of the diet led to a 2.5-fold increase of butyrate in the colon as a result of fermentation of fibers by changes in microbiota, whereas in Africans consuming a Western diet, the amounts of butyrate were reduced by 50%
We found that 70% of patients were able to alter their dietary habits toward a more Mediterranean pattern
Summary
Inflammatory bowel diseases (IBDs), consisting of Crohn’s disease (CD) and ulcerative colitis (UC), are chronic immune-mediated disorders that can have a large impact on the wellbeing and quality of life of patients worldwide [1,2]. Data from studies in oncology show that eating or avoiding certain foods can increase or decrease the risk for developing colorectal cancer and other digestive cancers, and that this is probably related to the pro-inflammatory aspects of certain foods. This would suggest that nutrition may affect both the pathogenesis and the disease course of IBD. Intake of a diet with a high fat content or a low ratio of pro-inflammatory n-6 to anti-inflammatory n-3 fats was associated with a higher level of disease activity [9,10,11] This suggests that a Western diet is an environmental risk factor for developing IBD. Only a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPS) has been shown to reduce complaints in a substantial part of the IBD population [15]
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