Diet Advice for Crohn’s Disease: FODMAP and Beyond

Abstract

Crohn’s disease (CD) is a chronic, progressive, and destructive granulomatous inflammatory bowel disorder that can involve any part of the gastrointestinal tract. It has been presumed that different types of diet might improve gastrointestinal symptoms in CD patients. The aim of this review was to clarify the efficiency and indications of a low-“fermentable oligo-, di-, mono-saccharides and polyols” (FODMAP) diet (LFD) in CD and to further analyze the available data on other types of diets. PubMed, Cochrane Library, EMBASE and WILEY databases were screened for relevant publications regarding the effect of FODMAP diets on CD. Our search identified 12 articles analyzing the effect of an LFD in CD, 5 articles analyzing the effect of a Mediterranean diet (MD), 2 articles analyzing the effect of a vegetarian diet (VD), and 2 articles analyzing the effect of a low-lactose diet (LLD). The majority of the studies included in this review show the significant efficiency of the LFD in CD patients. We found significant evidence demonstrating that the LFD has a favorable impact on gastrointestinal symptoms in CD patients. Notwithstanding the evidence, it remains to be established if an LFD is more efficient than other types of diets in the short term and especially in the long term.

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

“…Although not included in this review, more literature is available on the effect of dietary interventions in chronic disease in studies that did not evaluate microbiome composition changes. For RA, T2DM, IBD, and CVD, Mediterranean and other plant-based diets have been shown to reduce clinical outcomes [ 97 , 98 , 99 , 100 , 101 , 102 , 103 ]. For IBD, there are also numerous studies showing the benefits of low FODMAP dietary interventions [ 101 ].…”

“…For RA, T2DM, IBD, and CVD, Mediterranean and other plant-based diets have been shown to reduce clinical outcomes [ 97 , 98 , 99 , 100 , 101 , 102 , 103 ]. For IBD, there are also numerous studies showing the benefits of low FODMAP dietary interventions [ 101 ].…”

Nutritional and Botanical Approaches for Inflammatory Bowel Disease

“…Several specific diets have been assessed for their impact in people with IBD, including an elemental diet, 33,34 low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol (FODMAP) diet, 35 the autoimmune protocol (AIP) diet, 36 and a diet targeting elimination of foods with high immunoglobulin G 4 (IgG4) titers by enzyme-linked immunoassay (ELISA). 37 The elemental diet provides a complete complement of basic proteins (as free-form amino acids, without whole proteins or small peptides), fats (often as medium-chain triglycerides), and carbohydrates, along with essential micronutrients sufficient to meet Recommended Dietary Allowances (RDA) requirements.…”

“…These included reduction of GI symptomatology (such as bloating, abdominal pain, flatulence, and diarrhea), improved health-related QOL, improved abundance of butyrate-producing gut bacteria, and better stool frequency and consistency. 35 Fructose malabsorption appears to be more common in people with CD than in people without. In addition, lactose malabsorption has been shown to occur more often in people with UC than in healthy controls.…”

Medicine-Food Herbs against Alzheimer’s Disease: A Review of Their Traditional Functional Features, Substance Basis, Clinical Practices and Mechanisms of Action

“…In recent years, with the improvement of public health awareness, people have paid increasing attention to the prevention and treatment of chronic diseases through diet, such as a "low-, fermentable oligo-, and di-, monosaccharides and polyols" diet, Mediterranean diet, a low-lactose diet, and medicinal food herb diet [8][9][10][11]. The concept of medicine food homology (MFH) originally came from the (Huangdi's) Internal Classic in ancient China, which means that Chinese medicine and food are of the same origin, and, thus, they can be used as food and administered to patients as medication to regulate the human body's metabolic disturbances or imbalances [11,12].…”