Nutrition in inflammatory bowel disease
A review
DOI:
https://doi.org/10.29193/RMU.37.3.8Keywords:
INFLAMMATORY BOWEL DISEASES, NUTRITIONAL STATUS, DIET THERAPYAbstract
There is vast epidemiological evidence based on cohort studies of large populations of humans, that diet exerts a strong influence on the development and outcome of inflammatory bowel disease. Besides, most evidence-based medical therapies for this condition aim to suppress the immune response and entail significant side effects. Current evidence has proved that several diet factors probably protect against outbreaks, as in the case of fibre, zinc and vitamin D in both forms of inflammatory bowel disease and a high proportion of polyunsaturated fatty acids (PUFAs) n -3 / n -6 in the ICU diet. Other foods also impact the outbreak risk, such as those containing myristic acid, red meats and sugar. This review will explore diet interactions and the immune system within the context of Crohn's disease and ulcerative colitis, focusing on the role of diet in the pathogenesis, in particular in terms of its interaction with the patient's immune system. Simultaneously, the role of medical nutrition will be analysed as a therapeutic intervention.
References
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8) Ryan E, McNicholas D, Creavin B, Kelly ME, Walsh T, Beddy D. Sarcopenia, and inflammatory bowel disease: a systematic review. Inflamm Bowel Dis 2019; 25:67-73. doi: 10.1093/ibd/izy212.
9) Pedersen M, Cromwell J, Nau P. Sarcopenia is a predictor of surgical morbidity in inflammatory bowel disease. Inflamm Bowel Dis 2017; 23(10):1867-72. doi: 10.1097/MIB.0000000000001166.
10) Shenkin A. Micronutrients in health and disease. Postgrad Med J 2006; 82:559-67. doi: 10.1136/pgmj.2006.047670.
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12) Tian T, Wang Z, Zhang J. Pathomechanisms of oxidative stress in inflammatory bowel disease and potential antioxidant therapies. Oxid Med Cell Longev 2017; 2017:4535194. doi: 10.1155/2017/4535194.
13) Franzosa EA, Sirota-Madi A, Avila-Pacheco J, Fornelos N, Haiser HJ, Reinker S, et al. Gut microbiome structure and metabolic activity in inflammatory bowel disease. Nat Microbiol 2019; 4(2):293-305. doi: 10.1038/s41564-018-0306-4.
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15) Klement E, Cohen RV, Boxman J, Joseph A, Reif S. Breastfeeding and risk of inflammatory bowel disease: a systematic review with meta-analysis. Am J Clin Nutr 2004; 80(5):1342-52. doi: 10.1093/ajcn/80.5.1342.
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21) Gatti S, Galeazzi T, Franceschini E, Annibali R, Albano V, Verma AK, et al. Effects of the exclusive enteral nutrition on the microbiota profile of patients with Crohn’s Disease: a systematic review. Nutrients 2017; 9:832. doi: 10.3390/nu9080832.
22) Fernández-Banares F, Cabré E, Esteve-Comas M, Gassull MA. How effective is enteral nutrition in inducing clinical remission in active Crohn’s disease? A meta-analysis of the randomized clinical trials. JPEN J Parenter Enteral Nutr 1995; 19:356-64.
23) Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn‘s disease. Cochrane Database Syst Rev 2007; (1):CD000542.
24) Guagnozzi D, González-Castillo S, Olveira A, Lucendo AJ. Nutritional treatment in inflammatory bowel disease. An update. Rev Esp Enferm Dig 2012; 104:479-88. doi: 10.4321/S1130-01082012000900006.
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26) Tsertsvadze A, Gurung T, Court R, Clarke A, Sutcliffe P. Clinical effectiveness and cost-effectiveness of elemental nutrition for the maintenance of remission in Crohn’s disease: a systematic review and meta-analysis. Health Technol Assess 2015; 19(26):1-138. doi: 10.3310/hta19260.
27) Wall C, Gearry R, Day A. Treatment of active Crohn’s disease with exclusive and partial enteral nutrition: a pilot study in adults. Inflamm Intest Dis 2018; 2:219-27. doi: 10.1159/000489630.
28) Li Y, Zuo L, Zhu W, Gong J, Zhang W, Gu L, et al. Role of exclusive enteral nutrition in the preoperative optimization of patients with Crohn’s disease following immunosuppressive therapy. Medicine (Baltimore) 2015; 94(5):e478.
29) Yamamoto T, Nakahigashi M, Umegae S, Matsumoto K. Prospective clinical trial: enteral nutrition during maintenance infliximab in Crohn’s disease. J Gastroenterol 2010; 45:24-9.
30) Hirakawa H, Fukuda Y, Tanida N, Hosomi M, Shimoyama T. Home elemental enteral hyperalimentation (HEEH) for the maintenance of remission in patients with Crohn’s disease. Gastroenterol Jpn 1993; 28:379-84.
31) Koga H, Iida M, Aoyagi K, Matsui T, Fujishima M. [Long-term efficacy of low residue diet for the maintenance of remission in patients with Crohn’s disease] Nihon Shokakibyo Gakkai Zasshi 1993; 90(11):2882-8.
32) Takagi S, Utsunomiya K, Kuriyama S, Yokoyama H, Takahashi S, Iwabuchi M, et al. Effectiveness of an ‘half elemental diet’ as maintenance therapy for Crohn’s disease: a randomized-controlled trial. Aliment Pharmacol Ther 2006; 24:1333-40.
33) Hanai H, Iida T, Takeuchi K, Arai H, Arai O, Abe J, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn’s disease. Dig Liver Dis 2012; 44:649-54.
34) Yamamoto T, Nakahigashi M, Saniabadi AR, Iwata T, Maruyama Y, Umegae S, et al. Impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal cytokines during remission in patients with Crohn’s disease: a prospective study. Inflamm Bowel Dis 2007; 13(12):1493-01. doi: 10.1002/ibd.20238.
35) Johnson T, Macdonald S, Hill SM, Thomas A, Murphy MS. Treatment of active Crohn’s disease in children using partial enteral nutrition with liquid formula: a randomized controlled trial. Gut 2005; 55:356-61. doi: 10.1136/gut.2004.062554.
36) Levine A, Wine E, Assa A, Sigall Boneh R, Shaoul R, Kori M, et al. Crohn’s disease exclusion diet plus partial enteral nutrition induces sustained remission in a randomised controlled trial. Gastroenteroly 2019; 157:440-50.e8. doi: 10.1053/j.gastro.2019.04.021.
37) Svolos V, Hansen R, Nichols B, Quince C, Ijaz UZ, Papadopoulou RT, et al. Treatment of active Crohn’s disease with an ordinary food-based diet that replicates exclusive enteral nutrition. Gastroenterology 2019; 156:1354-67. doi: 10.1053/j.gastro.2018.12.002.
38) Kim SE. Importance of nutritional therapy in the management of intestinal diseases: beyond energy and nutrient supply. Intest Res 2019;17(4):443-54. doi: 10.5217/ir.2019.00075.
39) Albenberg LG, Lewis JD, Wu GD. Food, and the gut microbiota in inflammatory bowel diseases: a critical connection. Curr Opin Gastroenterol 2012; 28:314-20.
40) Müller JM, Keller HW, Erasmi H, Pichlmaier H. Total parenteral nutrition as the sole therapy in Crohn’s disease: a prospective study. Br J Surg 1983; 70(1):40-3.
41) Greenberg GR, Fleming CR, Jeejeebhoy KN, Rosenberg IH, Sales D, Tremaine WJ. Controlled trial of bowel rest and nutritional support in the management of Crohn’s disease. Gut 1988; 29:1309-15.
42) Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr 2016; 35(2):247-307. doi: 10.1016/j.clnu.2016.01.020.
43) Richman E, Rhodes JM. Review article: evidence-based dietary advice for patients with inflammatory bowel disease. Aliment Pharmacol Ther 2013; 38:1156-71.
44) Rolfe VE, Fortun PJ, Hawkey CJ, Bath-Hextall F. Probiotics for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev 2006; (4):CD004826. doi: 10.1002/14651858.CD004826.pub2.
45) Butterworth AD, Thomas AG, Akobeng AK. Probiotics for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2008; (3):CD006634. doi: 10.1002/14651858.CD006634.pub2.
46) Magro F, Gionchetti P, Eliakim R, Ardizzone S, Armuzzi A, Barreiro-de Acosta M, et al. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohns Colitis 2017; 11(6):649-70.
47) Balestrieri P, Ribolsi M, Guarino MPL, Emerenziani S, Altomare A, Cicala M. Nutritional aspects in inflammatory bowel diseases. Nutrients 2020; 12(2):372. doi: 10.3390/nu12020372.
48) Kilby K, Mathias H, Boisvenue L, Heisler C, Jones JL. Micronutrient absorption and related outcomes in people with inflammatory bowel disease: a review. Nutrients 2019; 11(6):1388. doi: 10.3390/nu11061388.
49) Wark G, Samocha-Bonet D, Ghaly S, Danta M. The role of diet in the pathogenesis and management of inflammatory bowel disease: a review. Nutrients 2020; 13(1):135. doi: 10.3390/nu13010135.
50) Bischoff SC, Escher J, Hébuterne X, Klêk S, Krznaric Z, Schneider S, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr 2020; 39(3):632-53. doi: 10.1016/j.clnu.2019.11.002.
2) Sartor RB, Wu GD. Roles for intestinal bacteria, viruses, and fungi in pathogenesis of inflammatory bowel diseases and therapeutic approaches. Gastroenterology 2017; 152(2):327–39.e4. doi: 10.1053/j.gastro.2016.10.012.
3) Kaplan GG, Ng SC. Understanding and preventing the global increase of inflammatory bowel disease. Gastroenterology 2017; 152:313-21. doi: 10.1053/j.gastro.2016.10.020.
4) Magro F, Gionchetti P, Eliakim R, Ardizzone S, Armuzzi A, Barreiro-de Acosta M, et al. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. J Crohns Colitis 2017; 11(6):649-70. doi: 10.1093/ecco-jcc/jjx008.
5) Baumgart DC, Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet 2007; 369(9573):1641-57. doi: 10.1016/S0140-36(07)60751-X.
6) Celiberto LS, Graef FA, Healey GR, Bosman ES, Jacobson K, Sly LM, et al. Inflammatory bowel disease and immunonutrition: novel therapeutic approaches through modulation of diet and the gut microbiome. Immunology 2018; 155:36-52. doi: 10.1111/imm.12939.
7) Yamamoto T, Nakahigashi M, Saniabadi AR. Review article: diet and inflammatory bowel disease-epidemiology and treatment. Aliment Pharmacol Ther 2009; 30(2):99-112. doi: 10.1111/j.1365-2036.2009.04035.x.
8) Ryan E, McNicholas D, Creavin B, Kelly ME, Walsh T, Beddy D. Sarcopenia, and inflammatory bowel disease: a systematic review. Inflamm Bowel Dis 2019; 25:67-73. doi: 10.1093/ibd/izy212.
9) Pedersen M, Cromwell J, Nau P. Sarcopenia is a predictor of surgical morbidity in inflammatory bowel disease. Inflamm Bowel Dis 2017; 23(10):1867-72. doi: 10.1097/MIB.0000000000001166.
10) Shenkin A. Micronutrients in health and disease. Postgrad Med J 2006; 82:559-67. doi: 10.1136/pgmj.2006.047670.
11) Hosomi K, Kunisawa J. The specific roles of vitamins in the regulation of immunosurveillance and maintenance of immunologic homeostasis in the gut. Immune Netw 2017; 17(1):13-9. doi: 10.4110/in.2017.17.1.13.
12) Tian T, Wang Z, Zhang J. Pathomechanisms of oxidative stress in inflammatory bowel disease and potential antioxidant therapies. Oxid Med Cell Longev 2017; 2017:4535194. doi: 10.1155/2017/4535194.
13) Franzosa EA, Sirota-Madi A, Avila-Pacheco J, Fornelos N, Haiser HJ, Reinker S, et al. Gut microbiome structure and metabolic activity in inflammatory bowel disease. Nat Microbiol 2019; 4(2):293-305. doi: 10.1038/s41564-018-0306-4.
14) Levine A, Sigall Boneh R, Wine E. Evolving role of diet in the pathogenesis and treatment of inflammatory bowel diseases. Gut 2018; 67:1726-38. doi: 10.1136/gutjnl-2017-315866.
15) Klement E, Cohen RV, Boxman J, Joseph A, Reif S. Breastfeeding and risk of inflammatory bowel disease: a systematic review with meta-analysis. Am J Clin Nutr 2004; 80(5):1342-52. doi: 10.1093/ajcn/80.5.1342.
16) IBD in EPIC Study Investigators; Tjonneland A, Overvad K, BergmannMM, Nagel G, Linseisen J, Hallmans G, et al. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study. Gut 2009; 58:1606-11. doi: 10.1136/gut.2008.169078.
17) Torki M, Gholamrezaei A, Mirbagher L, Danesh M, Kheiri S, Emami MH. VitaminD deficiency associated with disease activity in patients with inflammatory bowel diseases. Dig Dis Sci 2015; 60(10):3085-91.
18) Kim SE. Importance of nutritional therapy in the management of intestinal diseases: beyond energy and nutrient supply. Intest Res 2019; 17(4):443-54. doi: 10.5217/ir.2019.00075.
19) Lewis JD, Albenberg L, Lee D, Kratz M, Gottlieb K, Reinisch W. The importance and challenges of dietary intervention trials for inflammatory bowel disease. Inflamm Bowel Dis 2017; 23(2):181-91.
20) Sigall-Boneh R, Levine A, Lomer M, Wierdsma N, Allan P, Fiorino G, et al. Research gaps in diet and nutrition in inflammatory bowel disease: a topical review by D-ECCO Working Group [Dietitians of ECCO] J Crohns Colitis 2017; 11(12):1407-19. doi: 10.1093/ecco-jcc/jjx109.
21) Gatti S, Galeazzi T, Franceschini E, Annibali R, Albano V, Verma AK, et al. Effects of the exclusive enteral nutrition on the microbiota profile of patients with Crohn’s Disease: a systematic review. Nutrients 2017; 9:832. doi: 10.3390/nu9080832.
22) Fernández-Banares F, Cabré E, Esteve-Comas M, Gassull MA. How effective is enteral nutrition in inducing clinical remission in active Crohn’s disease? A meta-analysis of the randomized clinical trials. JPEN J Parenter Enteral Nutr 1995; 19:356-64.
23) Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn‘s disease. Cochrane Database Syst Rev 2007; (1):CD000542.
24) Guagnozzi D, González-Castillo S, Olveira A, Lucendo AJ. Nutritional treatment in inflammatory bowel disease. An update. Rev Esp Enferm Dig 2012; 104:479-88. doi: 10.4321/S1130-01082012000900006.
25) Narula N, Dhillon A, Zhang D, Sherlock ME, Tondeur M, Zachos M. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2018; 4(4):CD000542. doi: 10.1002/14651858.CD000542.pub3.
26) Tsertsvadze A, Gurung T, Court R, Clarke A, Sutcliffe P. Clinical effectiveness and cost-effectiveness of elemental nutrition for the maintenance of remission in Crohn’s disease: a systematic review and meta-analysis. Health Technol Assess 2015; 19(26):1-138. doi: 10.3310/hta19260.
27) Wall C, Gearry R, Day A. Treatment of active Crohn’s disease with exclusive and partial enteral nutrition: a pilot study in adults. Inflamm Intest Dis 2018; 2:219-27. doi: 10.1159/000489630.
28) Li Y, Zuo L, Zhu W, Gong J, Zhang W, Gu L, et al. Role of exclusive enteral nutrition in the preoperative optimization of patients with Crohn’s disease following immunosuppressive therapy. Medicine (Baltimore) 2015; 94(5):e478.
29) Yamamoto T, Nakahigashi M, Umegae S, Matsumoto K. Prospective clinical trial: enteral nutrition during maintenance infliximab in Crohn’s disease. J Gastroenterol 2010; 45:24-9.
30) Hirakawa H, Fukuda Y, Tanida N, Hosomi M, Shimoyama T. Home elemental enteral hyperalimentation (HEEH) for the maintenance of remission in patients with Crohn’s disease. Gastroenterol Jpn 1993; 28:379-84.
31) Koga H, Iida M, Aoyagi K, Matsui T, Fujishima M. [Long-term efficacy of low residue diet for the maintenance of remission in patients with Crohn’s disease] Nihon Shokakibyo Gakkai Zasshi 1993; 90(11):2882-8.
32) Takagi S, Utsunomiya K, Kuriyama S, Yokoyama H, Takahashi S, Iwabuchi M, et al. Effectiveness of an ‘half elemental diet’ as maintenance therapy for Crohn’s disease: a randomized-controlled trial. Aliment Pharmacol Ther 2006; 24:1333-40.
33) Hanai H, Iida T, Takeuchi K, Arai H, Arai O, Abe J, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn’s disease. Dig Liver Dis 2012; 44:649-54.
34) Yamamoto T, Nakahigashi M, Saniabadi AR, Iwata T, Maruyama Y, Umegae S, et al. Impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal cytokines during remission in patients with Crohn’s disease: a prospective study. Inflamm Bowel Dis 2007; 13(12):1493-01. doi: 10.1002/ibd.20238.
35) Johnson T, Macdonald S, Hill SM, Thomas A, Murphy MS. Treatment of active Crohn’s disease in children using partial enteral nutrition with liquid formula: a randomized controlled trial. Gut 2005; 55:356-61. doi: 10.1136/gut.2004.062554.
36) Levine A, Wine E, Assa A, Sigall Boneh R, Shaoul R, Kori M, et al. Crohn’s disease exclusion diet plus partial enteral nutrition induces sustained remission in a randomised controlled trial. Gastroenteroly 2019; 157:440-50.e8. doi: 10.1053/j.gastro.2019.04.021.
37) Svolos V, Hansen R, Nichols B, Quince C, Ijaz UZ, Papadopoulou RT, et al. Treatment of active Crohn’s disease with an ordinary food-based diet that replicates exclusive enteral nutrition. Gastroenterology 2019; 156:1354-67. doi: 10.1053/j.gastro.2018.12.002.
38) Kim SE. Importance of nutritional therapy in the management of intestinal diseases: beyond energy and nutrient supply. Intest Res 2019;17(4):443-54. doi: 10.5217/ir.2019.00075.
39) Albenberg LG, Lewis JD, Wu GD. Food, and the gut microbiota in inflammatory bowel diseases: a critical connection. Curr Opin Gastroenterol 2012; 28:314-20.
40) Müller JM, Keller HW, Erasmi H, Pichlmaier H. Total parenteral nutrition as the sole therapy in Crohn’s disease: a prospective study. Br J Surg 1983; 70(1):40-3.
41) Greenberg GR, Fleming CR, Jeejeebhoy KN, Rosenberg IH, Sales D, Tremaine WJ. Controlled trial of bowel rest and nutritional support in the management of Crohn’s disease. Gut 1988; 29:1309-15.
42) Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr 2016; 35(2):247-307. doi: 10.1016/j.clnu.2016.01.020.
43) Richman E, Rhodes JM. Review article: evidence-based dietary advice for patients with inflammatory bowel disease. Aliment Pharmacol Ther 2013; 38:1156-71.
44) Rolfe VE, Fortun PJ, Hawkey CJ, Bath-Hextall F. Probiotics for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev 2006; (4):CD004826. doi: 10.1002/14651858.CD004826.pub2.
45) Butterworth AD, Thomas AG, Akobeng AK. Probiotics for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2008; (3):CD006634. doi: 10.1002/14651858.CD006634.pub2.
46) Magro F, Gionchetti P, Eliakim R, Ardizzone S, Armuzzi A, Barreiro-de Acosta M, et al. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohns Colitis 2017; 11(6):649-70.
47) Balestrieri P, Ribolsi M, Guarino MPL, Emerenziani S, Altomare A, Cicala M. Nutritional aspects in inflammatory bowel diseases. Nutrients 2020; 12(2):372. doi: 10.3390/nu12020372.
48) Kilby K, Mathias H, Boisvenue L, Heisler C, Jones JL. Micronutrient absorption and related outcomes in people with inflammatory bowel disease: a review. Nutrients 2019; 11(6):1388. doi: 10.3390/nu11061388.
49) Wark G, Samocha-Bonet D, Ghaly S, Danta M. The role of diet in the pathogenesis and management of inflammatory bowel disease: a review. Nutrients 2020; 13(1):135. doi: 10.3390/nu13010135.
50) Bischoff SC, Escher J, Hébuterne X, Klêk S, Krznaric Z, Schneider S, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr 2020; 39(3):632-53. doi: 10.1016/j.clnu.2019.11.002.
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2021-08-24
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Moreira E, Rodríguez X, López P, Silva L, Olano E. Nutrition in inflammatory bowel disease: A review. Rev. Méd. Urug. [Internet]. 2021 Aug. 24 [cited 2024 Nov. 21];37(3):e37309. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/743
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