Purpose Non-specific inflammatory bowel diseases (IBD) include Crohn's disease and ulcerative colitis. More and more often attention is paid to the possibility of dietary support for inflammatory bowel diseases. Methods The following review article considers the role of dietary components in the treatment of IBD as: pteridines, probiotics, bovine immunoglobulin, vitamin D, omega-3, flavonoids, polyphenols, curcumin and phosphatidylcholine. The article also discusses plant raw materials of arjuna, soy protein and nettles, trying to summarize their effect on quenching the inflammatory process within the intestines. This review focuses on the possibilities of dietary components and supplementation use to improve the pharmacotherapy response as well as the general clinical patients’ condition. Results The mechanism of action of supportive therapy is based on reduction in oxidative stress, maintaining the adequate balance between Th1 and Th2 lymphocytes by affecting cytokines, increasing riboflavin supply for macrophages, increasing expression of vitamin D receptor, regulation by decreasing the expression of NF-κB in liver cells and ability to inhibit the COX2 entrance and inactivate prostaglandins that are involved in the inflammatory process and 12-lipoxygenase pathway inhibition. Conclusion Considering clinical researches, it seems that the use of the above-mentioned ingredients in the diet of patients suffering IBD may positively influence the treatment process and maintenance of remission.

Wstęp: Pacjenci z przewlekłymi chorobami jelit często cierpią na niedobory składników pokarmowych.Celem pracy było wskazanie różnic w sposobie żywienia, podaży składników odżywczych i pokarmowych oraz wykazanie konieczności suplementacji w grupie nastolatków.Materiały i metody: Grupę badaną stanowiło 26 osób: 8 z wrzodziejącym zapaleniem jelita grubego (WZJG), 8 z chorobą Leśniowskiego–Crohna (CD) oraz 10 z celiakią. Były to grupy o równym udziale obu płci. Wiek pacjentów wynosił odpowiednio 15,57 ±2,50, 15,75 ±1,75 oraz 14,8 ±1,99 lat.Sposób żywienia oceniono na podstawie wywiadu o spożyciu z ostatnich 24 godz., wprowadzonego do programu dietetycznego Dieta 5d rekomendowanego przez Instytut Żywności i Żywienia. Uzyskane wyniki porównano z aktualnymi normami żywienia. W ocenie różnic stanu odżywienia wykorzystano pomiar masy ciała i wzrostu oraz morfologię krwi. Dane poddano analizie statystycznej przy użyciu programu Statistica 12, wykorzystując test T dla prób niezależnych względem grup.Wyniki: Spożycie energii we wszystkich analizowanych grupach jest niewystarczające. Grupa pacjentów chorujących na celiakię spożywała najmniej kalorii. Najwięcej różnic statystycznie istotnych wykazano pomiędzy celiakią a WZJG. Odnosiły się one do niższego spożycia białka ogółem oraz wszystkich aminokwasów z wyjątkiem lizyny. W tej samej grupie wykazano istotnie niższe spożycie witamin E, C, pirydoksyny, tiaminy i kwasu foliowego, a także prawie wszystkich składników mineralnych. Dodatkowo stwierdzono niższe spożycie niezbędnych nienasyconych kwasów tłuszczowych oraz skrobi i błonnika pokarmowego u pacjentów z celiakią względem CD i WZJG. Najmniej różnic istotnie statystycznych występowało między chorymi na CD i WZJG. Spożycie wapnia we wszystkich badanych grupach było niewystarczające, aby pokryć dzienne zapotrzebowanie. Analiza statystyczna wyników morfologii krwi wykazała istotną różnicę w ilości monocytów u pacjentów z chorobą Crohna i wrzodziejącym zapaleniem jelita grubego. Pomiędzy chorymi na CD i celiakię różnica istotnie statystyczna dotyczyła RDW-CV, natomiast pomiędzy pacjentami z WZJG a celiakią różnica dotyczyła wartości erytrocytów, hematokrytu i MCV.Wnioski: Na podstawie oceny sposobu żywienia i morfologii należy stwierdzić, że wszystkie badane grupy narażone są na niedożywienie. Kaloryczność diety chorych na celiakię można zwiększyć przez dodanie skrobi ze źródeł bezglutenowych. We wszystkich grupach należy włączyć suplementację wapniem i witaminą D na takim samym poziomie. Dodatkowo ze względu na brak pełnego pokrycia zapotrzebowania wraz z dietą należy rozważyć suplementację potasu, magnezu i folianów szczególnie w grupie celiakii i CD. W celiakii suplementacja powinna dotyczyć także witaminy E, cynku, żelaza oraz jodu. Podaż błonnika w celiakii może być niewystarczająca. Obniżenie ilości erytrocytów ihematokrytu może sugerować występowanie WZJG. Niższe wartości płytek krwi, a w szczególności RDW-CV (%), może zwiększać prawdopodobieństwo występowania celiakii, natomiast wzrost monocytów może być charakterystyczny dla CD.

Non-specific inflammatory bowel diseases (IBD) include Crohn’s disease (CD) and ulcerative colitis (UC). Both diseases are characterized by chronic inflammation of unclear etiology. The inflammatory bowel diseases incidence is continuously observed to rise. Colon inflammatory response is a physiological process which occurrence is indispensable as an organisms’ defense reaction. The inflammation may be caused by internal factors associated with body’s cells as well as external factors, such as infections and exposition for inflammatory agents. Until recently, IBD have been classified as autoimmune diseases, today they seem to be associated with gut barrier disorders or dysbiosis. Factors that predispose to inflammatory bowel diseases include: genetic factors, dysbiosis and so called western-type diet, natural components such as gluten and lactose. In addition, the development of the disease is favored by: cigarette smoking, phosphate, nanomolecules, sodium chloride, emulgents, carrageenan, carboxymethylcellulose, pollution, maltodextrin. IBD affects whole the body, causing serious medical consequences. Symptoms like anxiety and chronic stress, that occur commonly, can lead to depressive disorders. Quantitative and qualitative dietary deficiency caused by absorption disorders, may promote the occurrence of osteoporosis and osteopenia. In addition, dysbiosis coexisting with alterations in intestinal permeability can lead to the development of nonalcoholic fatty liver disease. IBD medical consequences include also systemic complications, associated with the extra gastrointestinal manifestations’ occurrence.

Background. Celiac disease is an autoimmune disease that affects about 1% of the European population and 0.3–1.3% of the world’s population. The only method of treatment is introduction of a gluten-free diet. Objective. The aim of the study was to assess the nutrition of adolescents with celiac disease and to assess their nutritional status. Materials and methods. The study group comprised 24 patients with diagnosed celiac disease. The diagnosis was based on biopsy, serological tests and, in some cases, genetic tests. Anthropometric measurements included height, which was respectively 161.9 ±12.43 cm in boys and 163.6 ±9.03 cm in girls, and body weight oscillating between 56.55 ±16.24 kg for boys and 52.62 ±10.92 kg for girls. To assess the way of nutrition used an individually prepared questionnaire including an interview from the last 24 h. The menus were analyzed using the Dieta 5d program. The statistical analysis of the data was made using Statistica 12 program. Results. Gluten-free diet contributes to the occurrence of caloric deficiencies up to 36%. It was found inadequate intake of dietary fiber, for girls 15.45 ±9.84 g and 14.41 ±4.73 g for boys. It has been observed too low intake of ingredients such as calcium (565.65 ±347.41 mg), magnesium (223.41 ±73.84 mg), vitamin D (1.34 ±1.28 μg) and E (5.05 ±2.32 mg) as well as potassium (2848.67 ±1132.07 mg), iron (7.62 ±2.05 mg), zinc (7.11 ±2.41 mg) and thiamine (0.87 ±0.38 mg). The ingredients such as riboflavin, niacin, pyridoxine, cobalamin, and vitamins C and A were consumed in the right amount. Conclusions. Incorrectly used gluten-free diet may contribute to the recurrence of the disease. Chronic inadequate intake of fiber can lead to constipation. A deficiency of many nutrients can result in impaired development of the young organism such as anemia, growth retardation or osteoporosis.

Introduction: Crohn’s disease (CD) is classified as an inflammatory bowel disease, with a recent increased incidence in developed countries. Treatment is based on pharmacotherapy and nutritional support. Patients in the exacerbation phase are particularly exposed to the development of malnutrition, which in the case of children may result in the inhibition of growth or delay in puberty. For these reasons, nutrition is very important in the treatment process. In the remission phase of the disease, the diet should be consistent with the recommendations for the population of healthy people in order to prevent the formation of vitamin and mineral deficiencies.The aim of the study was to determine the nutritional status of adolescent CD patients and to analyze their diet.Materials and methods: The study was conducted on 14 children with CD, 6 girls and 8 boys with an average age of 16.25 ±1.65 years. Their nutrition was analyzed based on information obtained from a nutritional history collected over 3 days. The collected information was entered into the Diet 5 software. The results of the menus were compared to current dietary norms. The nutritional status of the children was based on a body mass index (BMI) analysis with reference to OLA and OLAF percentiles. The additional results of morphology and the levels of sodium, potassium, total calcium and 25(OH)D from their blood were compared. All obtained results were analysed statistically using Statistica v12.0 software.Results: The nutritional status of both the boys and the girls was normal, however the energy consumption was low (2274.83 ±475.93 kcal and 1843.33 ±258.4 kcal). Protein consumption was high, at 86.44 ±29.57 g and 62.36 ±26.51 g. In both groups, the levels of saturated fatty acids were too high (30.38 ±14.45, 23.02 ±13.53 mg), and in the boys’ group cholesterol was too high (427.41 ±278.3 mg). Both sexes consumed insufficient amounts of fiber (17.32 ±7.63 g, 19.84 ±4.85 g) and omega-3 (1.8 ±0.99 g, 1.74 ±0.89 g). Iron, copper, iodine and zinc were consumed at the appropriate level. Both sexes consumed too little calcium (586.44 ±458.11 mg, 742.47 ±515.37 mg), potassium (2892.96 ±1223.79 mg, 2901.62 ±1028.56 mg) and magnesium (283.45 ±145.26 mg, 276.71 ±163.32 mg). Folate consumption was too low (256.44 ±81.02 μg, 231.07 ±81.03 μg), vitamin D (2.85 ±1.00 μg, 0.96 ±0.68 μg) and also vitamin E in the group of girls (7.02 mg ±1.46 mg). The blood parameters did not differ significantly between the sexes, and the concentration of 25(OH)D was within the lower limit of the norm (28.17 ±5.91 ng/dL, 22.60 ±3.38 ng/dL).Conclusions: Low energy intake may adversely affect the nutritional status of CD patients. A deficiency in the diet of n-3 acids may promote the development of inflammation. Insufficient intake of calcium and vitamin D can disrupt the development of the skeletal system. The insufficient intake of dietary fiber can lead to constipation. A too low vitamin D intake and low blood levels of its metabolite indicate the need for supplementation. Additional supplementation of potassium and magnesium should be taken into consideration in the nutrition of CD patients.