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Dietary Exposures and Interventions in Inflammatory Bowel Disease: Current Evidence and Emerging Concepts ()

NTforIBD Comment: Newsletter March 2023

Summary Excerpt: Specific dietary interventions have been shown to reduce symptoms, improve inflammatory biomarkers, and quality of life metrics to varying degrees, but these studies are limited by study design, underpowering, heterogeneity, and confounding. While no definitive recommendations regarding specific dietary interventions as therapy in IBD can be made at this clinicians together with a dedicated nutritionist should discuss types of dietary interventions previously investigated, possible benefits and risks, and quality of evidence with patients who may be interested in incorporating dietary changes to their standard therapies.

Nutrients 2023, 15, 579. https://doi.org/10.3390/nu15030579
Gubatan, J. et al

Date Title Diets Authors Summary Excerpt Citation
Jan 2023 Dietary Exposures and Interventions in Inflammatory Bowel Disease: Current Evidence and Emerging Concepts Gubatan, J. et al Specific dietary interventions have been shown to reduce symptoms, improve inflammatory biomarkers, and quality of life metrics to varying degrees, but these studies are limited by study design, underpowering, heterogeneity, and confounding. While no definitive recommendations regarding specific dietary interventions as therapy in IBD can be made at this clinicians together with a dedicated nutritionist should discuss types of dietary interventions previously investigated, possible benefits and risks, and quality of evidence with patients who may be interested in incorporating dietary changes to their standard therapies. Nutrients 2023, 15, 579. https://doi.org/10.3390/nu15030579
May 2022 Food as Treatment of Inflammatory Bowel Diseases Maldonado-Contreras, A The latest research on diet as treatment in inflammatory bowel disease is summarized with evidence for mechanisms behind diet as treatment. Infect Immun. 2022 May 19;90(5):e0058321. doi: 10.1128/iai.00583-21
Mar 2021 Therapeutic Implications of Diet in Inflammatory Bowel Disease and Related Immune-Mediated Inflammatory Diseases SCD, MED, SVD, AIP, Other Diets - UC Jiang Y et al Authors summarize the current evidence on various diets used in the treatment of IBD and explore applications from related immune mediated inflammatory diseases (IMID) Nutrients. 2021;13(3):890. Published 2021 Mar 10. doi:10.3390/nu13030890
Mar 2021 Diet in Treatment of Inflammatory Bowel Diseases EEN, PEN, SCD, IBD-AID, AIP, CDED, SVD, CD-TREAT Sasson AN et al We review findings from studies of the effects of dietary patterns, single micronutrients, and food additives in inducing and maintaining remission in patients with IBD. We discuss future directions for research and propose a framework for studies of dietary interventions in the treatment of IBD. Clin Gastroenterol Hepatol . 2021 Mar;19(3):425-435.e3. doi: 10.1016/j.cgh.2019.11.054. Epub 2019 Dec 5.
Sep 2020 Systematic Review with Meta-analysis of Partial Enteral Nutrition for the Maintenance of Remission in Crohn's Disease PEN Yang H et al The rate of clinical relapse at 0.5 to 2 years was significantly lower in patients receiving PEN (420-1800 kcal/d) than in those not receiving nutrition therapy (RR: 0.67, 95% CI: 0.54-0.82, P < .01; number needed to treat = 5, P < .01). Patients receiving PEN exhibited a higher frequency of clinical remission maintenance at 0.5 to 1 year (67%) than did those not receiving nutrition therapy (48%; RR: 1.32, 95% CI: 1.07-1.64, P = .01). Nutr Res. 2020 Sep;81:7-18. doi: 10.1016/j.nutres.2020.06.006. Epub 2020 Jun 9.
Mar 2020 A Case-Based Approach to New Directions in Dietary Therapy of Crohn's Disease: Food for Thought CDED Levine A et al This case-based narrative review will discuss the Crohn's disease exclusion diet (CDED) as monotherapy, combination therapy with drugs, as a rescue therapy in refractory patients and for de-escalation from medical therapy. Nutrients . 2020 Mar 24;12(3):880. doi: 10.3390/nu12030880.
Dec 2019 Diet in Treatment of Inflammatory Bowel Diseases EEN, PEN, SCD, IBD-AID, AIP, CDED, CD-TREAT, SVD Sasson AN We review findings from studies of the effects of dietary patterns, single micronutrients, and food additives in inducing and maintaining remission in patients with IBD. We discuss future directions for research and propose a framework for studies of dietary interventions in the treatment of IBD. Clin Gastroenterol Hepatol . 2019 Dec 5;S1542-3565(19)31394-1.
Nov 2019 Dietary Management of Pediatric Inflammatory Bowel Disease EEN, SCD, IBD-AID, CDED Kaenkumchorn T and Kesavan A In particular, nutritional therapies for IBD have garnered significant interest due to their limited side effect profile, bowel-sparing nature, and naturalistic approach. This review will examine the role of diet in the pathogenesis and malnutrition in IBD, and will discuss dietary approaches to management of IBD, including exclusive enteral nutrition, specific carbohydrate diet, anti-inflammatory diet, and food supplements (specifically curcumin and long-chain n-3 polyunsaturated fatty acids). J Med Food. 2019 Nov;22(11):1092-1099. doi: 10.1089/jmf.2019.0063. Epub 2019 Jul 18.
Oct 2019 Importance of Nutritional Therapy in the Management of Intestinal Diseases: Beyond Energy and Nutrient Supply EEN Kim SE In this article, we review various dietary nutrients and their contribution to the pathogenesis and treatment of various intestinal diseases including inflammatory bowel disease, irritable bowel syndrome, colorectal cancer, and diverticulitis, among other such disorders. A better understanding of diet-host-gut microbiome interactions is essential to provide beneficial nutrients for gut health and to limit nutritional hazards to ensure successful nutritional management of gastrointestinal conditions in clinical practice. Intest Res , 17 (4), 443-454 Oct 2019
Oct 2019 Nutritional Approach as Therapeutic Manipulation in Inflammatory Bowel Disease EEN, PEN Yoon JY Nutritional interventions not only correct nutritional deficiencies but also improve symptoms and clinical courses of the disease. Hence, nutritional approaches need to be developed to significantly evaluate the effectiveness of dietary interventions used to treat IBD. Intest Res , 17 (4), 463-475 Oct 2019
May 2019 Towards a Food Pharmacy: Immunologic Modulation Through Diet EEN Molendijk I et al 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. Nutrients , 11 (6) 2019 May 31
Apr 2019 A Review of Dietary Therapy for IBD and a Vision for the Future EEN, SCD, IBD-AID, CDED, SVD, CD-TREAT Green N et al 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. Nutrients , 11 (5) 2019 Apr 26

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