Inflammatory bowel disease and immunonutrition: novel therapeutic approaches through modulation of diet and the gut microbiome

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract, thought to at least in part reflect an aberrant immune response to gut bacteria. IBD is increasing in incidence, particularly in populations that have recently immigrated to western countries. This suggests that environmental factors are involved in its pathogenesis. We hypothesize that the increase in IBD rates might reflect the consumption of an unhealthy Western diet, containing excess calories and lacking in key nutritional factors, such as fibre and vitamin D. Several recent studies have determined that dietary factors can dramatically influence the activation of immune cells and the mediators they release through a process called immunonutrition. Moreover, dietary changes can profoundly affect the balance of beneficial versus pathogenic bacteria in the gut. This microbial imbalance can alter levels of microbiota-derived metabolites that in turn can influence innate and adaptive intestinal immune responses. If the diet-gut microbiome disease axis does indeed underpin much of the 'western' influence on the onset and progression of IBD, then tremendous opportunity exists for therapeutic changes in lifestyle, to modulate the gut microbiome and to correct immune imbalances in individuals with IBD. This review highlights four such therapeutic strategies - probiotics, prebiotics, vitamin D and caloric restriction - that have the potential to improve and add to current IBD treatment regimens.

What is Needed for Evidence‐Based Dietary Recommendations for Migraine: A Call to Action for Nutrition and Microbiome Research

“…98 Other contents of the colon which can be metabolized are protein residues and bile acid, which were found to be metabolized to inflammatory and carcinogenic metabolites by intestinal microbiota. 117 Thus, the level of consumption of fermentable fibers and other select nutrients influence the composition of gut bacteria. 6 Both dietary vitamin D deficiency and vitamin D receptor defects can disrupt the gut microbiota community and intestinal homeostasis.…”

“…98 Other contents of the colon which can be metabolized are protein residues and bile acid, which were found to be metabolized to inflammatory and carcinogenic metabolites by intestinal microbiota. 116 Also, adequate vitamin D consumption (above 600 IU per day for most adults) has also been deemed essential for maintaining intestinal homeostasis and microbiota diversity, 117,118 though prior studies provide little support for Vitamin D3 supplementation as an effective prophylactic for migraine attack frequency. 6 Both dietary vitamin D deficiency and vitamin D receptor defects can disrupt the gut microbiota community and intestinal homeostasis.…”

“…6 Both dietary vitamin D deficiency and vitamin D receptor defects can disrupt the gut microbiota community and intestinal homeostasis. 117 Thus, the level of consumption of fermentable fibers and other select nutrients influence the composition of gut bacteria.…”

Typical indigenous bacteria in the cecum of ddY mice fed a casein–beef tallow diet or whole‐egg diet

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Establishing the new playbook for interactions among microbiota, bacterial metabolites, adaptive immunity, autoimmune disease and metabolic syndrome

“…A testable prediction of these models is that clinical autoimmune and inflammatory disease phenotypes are products of aberrant immune regulation due to dysbiosis. Exciting evidence is rapidly accumulating that they are amenable to therapeutics such as probiotics, dietary modulation or the use of dietary supplements that mimic the metabolic outputs of a beneficial microbiome . Immunology offered the last great quantum jump to medical practice through the massive and diverse impact of monoclonal antibodies.…”