Dietary management of adults with IBD — the emerging role of dietary therapy

Fitzpatrick, Jessica A; Melton, Sarah L; Yao, Chu K; Gibson, Peter R; Halmos, Emma P

doi:10.1038/s41575-022-00619-5

Cited by 74 publications

(56 citation statements)

References 218 publications

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“…There is increasing interest in alterations to body composition in patients with active IBD, especially myopenia and sarcopenia, which are evident in high percentage of such patients 21. Using BMI, the proportion of patients who fitted criteria for malnutrition reduced by 50% in the current study although these findings may be confounded by concomitant medical therapies and reduction of disease burden.…”

Section: Discussionmentioning

confidence: 75%

“…Body composition assessment, however, was not performed to assess the impact that weight loss may have had on muscle mass. A caveat in this discussion is that BMI and change in weight are flawed measures that can under and overestimate body composition and its change during therapy 21. It would be appropriate to perform more accurate assessments of muscle mass during EEN, but this requires adjustment to protocols and resources.…”

Section: Discussionmentioning

confidence: 99%

“…When available, objective measures generally appeared to correlate well with HBI score. The use of body composition assessment especially of muscle mass via, for example, bioimpedance or dual-energy X-ray absorptiometry, and muscle function by hand-grip strength during treatment with EEN should also be considered in future studies, especially since BMI is a poor measure of changes in muscle mass 21…”

Section: Discussionmentioning

confidence: 99%

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Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Melton

Fitzpatrick

Taylor

et al. 2022

Frontline Gastroenterol

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ObjectiveTo evaluate clinical outcomes, patterns of use, tolerance and nutritional outcomes of exclusive enteral nutrition (EEN) in adults with Crohn’s disease and to compare initiation in the inpatient compared with ambulatory care setting.Design/methodAdults with Crohn’s disease who received EEN at a single centre over 2.5 years were identified and outcomes assessed via examination of patient records.ResultsEEN was initiated in 60 patients (23 as an outpatient) who had objective evidence of active disease. Of 49 in whom the goal was induction of remission, 28 completed EEN and 24 achieved clinical remission/response. Twenty-one withdrew prematurely, due to intolerance in 15 and disease factors in 6. Of 11 with a planned intervention, 6 fulfilled the goal of downstaging disease while two were intolerant. Completion of the prescribed therapy was associated with self-reported adherence to EEN and with improvements in disease activity scores and biochemical markers. Malnutrition halved (40% to 20%) and intentional weight loss (median 5.1 kg) was achieved in six obese patients. The major reason for intolerance was the inability to accept total avoidance of non-formula food. There were no differences in any outcomes according to the location of initiation of therapy.ConclusionPositive outcomes occur in 70% of adult patients with Crohn’s disease tolerating EEN and 81% in those who are able to completely adhere to EEN, without compromise of nutritional status. Similar success occurs when initiated as an inpatient or outpatient. Failure to tolerate EEN is the major hurdle to its use.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Melton

Fitzpatrick

Taylor

et al. 2022

Frontline Gastroenterol

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“…However, most of these diets have shown contradictory results regarding their effectiveness in CD treatment [ 148 ]. The impact of these diets on the pathogenesis and management of CD has already been thoroughly reviewed elsewhere [ 149 , 150 ]. Of special interest is the case of the CD exclusion diet (CDED, low in fat and animal protein with high content of carbohydrates and dietary fiber) [ 130 , 151 , 152 , 153 , 154 , 155 ], which is emerging as a potent alternative to EEN.…”

Section: Nutritional Strategies In CD Treatment and Managementmentioning

confidence: 99%

“…Notwithstanding, therapeutic diets should be thoroughly supervised by an experienced nutritionist, as any nutritional deficiency or imbalance may lead to negative outcomes such as malnutrition or growth delay in children [ 149 ].…”

Section: Nutritional Strategies In CD Treatment and Managementmentioning

confidence: 99%

Crohn’s Disease, Host–Microbiota Interactions, and Immunonutrition: Dietary Strategies Targeting Gut Microbiome as Novel Therapeutic Approaches

Núñez‐Sánchez

Melgar

O’Donoghue

et al. 2022

IJMS

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Crohn’s disease (CD) is a complex, disabling, idiopathic, progressive, and destructive disorder with an unknown etiology. The pathogenesis of CD is multifactorial and involves the interplay between host genetics, and environmental factors, resulting in an aberrant immune response leading to intestinal inflammation. Due to the high morbidity and long-term management of CD, the development of non-pharmacological approaches to mitigate the severity of CD has recently attracted great attention. The gut microbiota has been recognized as an important player in the development of CD, and general alterations in the gut microbiome have been established in these patients. Thus, the gut microbiome has emerged as a pre-eminent target for potential new treatments in CD. Epidemiological and interventional studies have demonstrated that diet could impact the gut microbiome in terms of composition and functionality. However, how specific dietary strategies could modulate the gut microbiota composition and how this would impact host–microbe interactions in CD are still unclear. In this review, we discuss the most recent knowledge on host–microbe interactions and their involvement in CD pathogenesis and severity, and we highlight the most up-to-date information on gut microbiota modulation through nutritional strategies, focusing on the role of the microbiota in gut inflammation and immunity.

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DNA Nanostructures Treat Inflammatory Bowel Disease through ROS Scavenging and Gut Microbiota Modulation

Ge,

Jia,

Wang

et al. 2024

Adv Funct Materials

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Inflammatory bowel disease (IBD) encompasses a collection of chronic inflammatory conditions impacting the gastrointestinal tract, with a discernible global rise in prevalence and severity. The overabundance of reactive oxygen species (ROS) in the intestinal environment leads disruption of local redox homeostasis, and perturbation of the gut microbiota, exacerbating IBD. Consequently, mitigating excess ROS and preserving gut microbiota homeostasis have emerged as effective approaches for IBD management. In this study, a triangular DNA origami nanostructure loaded with siRNA targeting tumor necrosis factor α (siTNF‐αtDON) is introduced for this purpose. This nanostructure demonstrates efficacy in eliminating ROS within cells closely associated with IBD, diminishing inflammation, and ameliorating disorders in gut microbiota, as evidenced in an IBD mouse model. Furthermore, this investigation demonstrates the effects of siTNF‐αtDON on related inflammatory signaling pathways, including NF‐κB, MAPK/ERK and Keap1/Nrf2. Collectively, this study offers insights into the potential utilization of DNA nanostructures as antioxidants and gut microbiota modulators, presenting promising avenues for the IBD treatment.

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Dietary management of adults with IBD — the emerging role of dietary therapy

Cited by 74 publications

References 218 publications

Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Crohn’s Disease, Host–Microbiota Interactions, and Immunonutrition: Dietary Strategies Targeting Gut Microbiome as Novel Therapeutic Approaches

DNA Nanostructures Treat Inflammatory Bowel Disease through ROS Scavenging and Gut Microbiota Modulation

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