Multidimensional Impact of Mediterranean Diet on IBD Patients

Abstract

Background & Aims Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to ameliorate both obesity and NAFLD, the aim of this study was to analyze the impact of Md on the nutritional state, liver steatosis, clinical disease activity, and quality of life (QoL) in IBD patients. Methods Patients with IBD, both Crohn’s disease (CD) and ulcerative colitis (UC), followed Md for 6 months. Their body mass index (BMI), body tissue composition, liver steatosis and function, serum lipid profile, clinical disease activity, and inflammatory biomarkers (C-reactive protein and fecal calprotectin) were collected at baseline (T0) and compared with those obtained after 6 months (T180) to evaluate the impact of Md. Results One hundred forty-two IBD patients, 84 UC and 58 CD, followed Md for 6 months. At T180, diet-adherent CD and UC improved BMI (UC −0.42, P = 0.002; CD −0.48, P = 0.032) and waist circumference (UC −1.25 cm, P = 0.037; CD −1.37 cm, P = 0.041). Additionally, the number of patients affected by liver steatosis of any grade was significantly reduced in both groups (UC T0 31 of 84 [36.9%] vs T180 18 of 84 [21.4%], P = 0.0016; CD T0 27 of 58 [46.6%] vs T180 18 of 58 [31.0%], P < 0.001) after dietary intervention. Finally, after 6 months of the diet, fewer UC and CD patients with stable therapy had active disease (UC T0 14 of 59 [23.7%] vs T180 4 of 59 [6.8%], P = 0.004; CD T0 9 of 51 [17.6%] vs T180 2 of 51 [3.0%], P = 0.011) and elevated inflammatory biomarkers. Mediterranean diet improved QoL in both UC and CD, but neither serum lipid profile nor liver function were modified by the diet. Conclusions A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.

Effectiveness of Mediterranean Diet’s Adherence in Children with Inflammatory Bowel Diseases

“…There is a large body of evidence proving that Mediterranean dietary patterns regulate inflammation in chronic disease [ 33 , 34 , 35 ] and in individuals with IBD; there is some evidence that adherence to MD is associated with lower risk of developing IBD [ 36 , 37 ] and decreased inflammation [ 38 , 39 ]. The results of our study stimulate further interest in the relationships between dietary patterns, nutrition adequacy, and disease pathogenesis in IBD.…”

Olfactory Function in Patients with Inflammatory Bowel Disease (IBD) Is Associated with Their Body Mass Index and Polymorphism in the Odor Binding-Protein (OBPIIa) Gene

“…The first group was represented by the Inflammatory Bowel disease (IBD) patients ( n = 100; 54 men, 46 women; age 51.2 ± 1.41 year), recruited for the study at the clinic of the Gastroenterology Unit of the University Hospital Company (AOU) Monserrato (CA), Italy and included Crohn’s disease (CD) ( n = 44) and ulcerative colitis (UC) patients ( n = 56); the second group included healthy control (HC) subjects ( n = 99; 59 men, 40 women; age 47.3 ± 1.42 year) recruited by means of a public announcement at the local University, so as to have two populations matched for age ( χ2 = 4.33, p = 0.12) and gender ( χ2 = 0.64, p = 0.43). IBD diagnosis was obtained by a combination of clinical examination, endoscopy and radiology, and by means of the Crohn’s Disease Activity Index (CDAI) and Partial Mayo Score (PMS), the disease activity was evaluated for CD and UC patients, respectively [ 62 ]. All tested patients with CD and UC were recovering from the disease and were treated with cortisone or mesalamine or 5-ASA agents or monoclonal antibodies against TNF-α.…”

The Microbiome as a Therapy in Pouchitis and Ulcerative Colitis

“…A prospective study aimed to identify the impact of Md on the nutritional state, liver steatosis, clinical disease. The study reported a significant reduction of malnutrition-related parameters and liver steatosis was observed in UC patients after short-term dietary intervention 48 . Specifically they noticed that after 6 months of a Mediterranean diet fewer patients with UC had active disease (14 of 59 [23.7%] at start of trial vs 4 of 59 [6.8%] at 6 months following diet, P = 0.004) and furthermore, this study highlighted that a meditteranean diet was associated with an increase in quality of life 48 .…”