A Review of Dietary Therapy for IBD and a Vision for the Future

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract. The rising incidence of IBD has been associated with urbanization and shifts toward a Westernized diet. The intestinal microbiome has been a focus of disease pathogenesis and also therapeutic intervention. Dietary therapy for IBD has been well-studied with exclusive enteral nutrition, a formula-based diet with the exclusion of foods. In addition, interest in food-based exclusion diets has been increasing, with patients and families leading the charge. Challenges with dietary therapy for IBD include the lack of understanding of a detailed mechanistic pathway to explain the impact of diet on IBD pathogenesis and the difficult nature of designing and implementing dietary clinical trials. Epidemiological studies have demonstrated associations and intervention studies have demonstrated efficacy, but specific dietary targets remain as hypotheses at present. Current IBD therapy focuses on suppression of the immune system, yet the incomplete efficacy of present drugs suggests that other therapies must be developed and employed. Dietary interventions, with known ability to modulate the intestinal microbiome, are a unique opportunity to improve outcomes in IBD. Dietary intervention trials are challenging, and capturing both broad dietary patterns as well as exposure to individual food compounds is important. With increasing patient interest and preliminary research in dietary therapy indicating efficacy, it is imperative to further advance the science of utilizing diet in IBD, as well as to support patients by proactively addressing diet within their care plan.

Analysis of the Nutrients and Food Products Intake of Polish Males with Ulcerative Colitis in Remission

“…Similarly, in the present study, the respondents excluded some food products from their diets, and when these products were analyzed within the food product groups, they were not found to differ from the foods excluded by the control group. Such exclusion of specific food products may be interpreted as a proper approach, as patients may have individual tolerance to some food products, and so personalized recommendations should be followed [47]. However, if the patients do not cover their nutritional requirements, avoiding food products is not a proper solution as it may lead to not properly balanced diet following, which is not in accordance with the general nutritional recommendations [5].…”

Inflammatory Bowel Diseases: Host-Microbial-Environmental Interactions in Dysbiosis

“…The role of diet in the development of IBD has been extensively studied [ 45 , 46 , 47 , 48 ]. The general perception is that a Western-style diet, which contains high levels of animal products and readily digestible carbohydrates but low amounts of vegetable or fruit, predisposes susceptible individuals to IBD [ 49 , 50 , 51 ].…”

Nutritional approach as therapeutic manipulation in inflammatory bowel disease

“…Most of the trials with adult CD patients showed that corticosteroid was more beneficial than EEN [18]. There results are based on the fact that EEN is more adherent in pediatric CD and is significantly effective in the early course of the disease [32,33]. Poor adherence could be the main barrier in achieving successful EEN therapy.…”