Should the Mediterranean diet be recommended for inflammatory bowel diseases patients? A narrative review

Abstract

Inflammatory bowel diseases (IBD) are chronic, progressive and relapsing inflammatory disorders of unknown etiology that may cause disability over time. Data from epidemiologic studies indicate that diet may play a role in the risk of developing and the course of IBD. It is known that the group of beneficial bacteria was reduced in the IBD and that the Mediterranean diet (MD)—which is defined as eating habits characterized by high consumption of plant foods, mainly cereals, vegetables, fruit as well as olive oil, and small portions of dairy products, sweets, sugar and meat products—affects gut microbiota, enriching beneficial bacteria, which support gut barrier function and reduce inflammation. Although several studies support different favorable effects of MD on IBD, adherence to MD by IBD patients is generally low, including patients from the Mediterranean Basin. Patients avoid many products which are elements of MD because there cause gastrointestinal symptoms. Patients should be encouraged to have a healthy and well-balanced diet according to individual tolerance of products. A good option seems to be good modified MD, changing hard-to-digest products to easy digest.

Anti‐inflammatory effects of bay laurel (Laurus nobilis L.) towards the gut microbiome in dextran sodium sulfate induced colitis animal models

“…This is in line with the previous study, whereby UC patients showed a high SRB level in contrast to the healthy (Khalil et al, 2014). The current study revealed that the population of SRB declined with bay leaf additions that is proposed and related to the rich bioactive compounds in bay leaves, which promotes antioxidant activities, therefore, beneficial to prevent inflammation (Ratajczak et al, 2023).…”

“…The Bifidobacteria numbers in all UC animal groups were lower than the healthy models in G1 that showed a higher number of Bifidobacteria additionally to animal models provided with bay leaves supplemented diet (G3, G4, and G5) that have promoted the growth of the Bifidobacteria group. A similar observation was found in the study of Ratajczak et al (2023). In, the bay leaves in MD have significantly stimulated the growth of probiotic strains, that is, Bifibacteria and Lactobacilli.…”

“…This can be explained by the enrichment of the beneficial bacteria; which supported the gut barrier function and eventually reduced gut inflammation. In contrast, for people who usually consume a Western diet that mainly contains pro-inflammatory potential food, it negatively affects the gut microbiota and leads to gastrointestinal disorders (Ratajczak et al, 2023;Rawi et al, 2020).…”

A Systematic Review of the Role of Diet in Ulcerative Colitis

“…The Mediterranean diet which reduced liver steatosis, clinical disease activity, and quality of life for IBD patients, including those with UC, was also found to be helpful [13]. It has also been discovered that the Mediterranean diet is beneficial for IBD patients by reducing liver steatosis, active IBD, body mass index (BMI), and waist circumference, as well as by enhancing their quality of life [13,34]. The 4-SURE diet was well tolerated, and clinical and endoscopic conditions improved in 46% and 36% of participants, respectively [7].…”

Novel Biomarkers for Inflammatory Bowel Disease and Colorectal Cancer: An Interplay between Metabolic Dysregulation and Excessive Inflammation

“…However, 50% of patients lose response to infliximab, and patients cannot be on prolonged use of steroids. Several other therapies include aminosalicylates, corticosteroids, and disease-modifying anti-rheumatic drugs (azathioprine, cyclosporine, methotrexate), to mention a few [ 81 , 82 , 83 ]. Those with long-standing colitis (UC > 10 years) are at increased risk for CRC requiring invasive colonoscopies every 1–2 years, as screening biomarkers have not been identified.…”