Plant-Based Diet Recommended for Inflammatory Bowel Disease

Chiba, Mitsuro; Hosoba, Mihoko; Yamada, K

doi:10.1093/ibd/izac279

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…The content of PBD is consistent with the healthy reference diet. Considering the large number of patients suffering from inappropriate dietary guidance, we believe recommending PBD based on available evidence as the next best option is prudent, and it will greatly benefit IBD patients [ 102 , 103 ].…”

Section: Discussionmentioning

confidence: 99%

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Chiba

Morita²

2023

Metabolites

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There has been no study of the therapeutic effect of a plant-based diet (PBD) in inflammatory bowel disease (IBD) except for our studies in Japan. In this review, we describe the rationale for the requirement of PBD in IBD and the outcomes of our modality incorporating PBD together with a literature review. The biggest problem in current therapy for IBD is the lack of a widely appreciated ubiquitous environmental factor in IBD. Therefore, a radical strategy against IBD has not been established. Japanese data showed an increased incidence of IBD in association with dietary westernization. Current global consumption consists of an excess of unhealthy foods and a shortage of healthy foods recognized as pro-inflammatory. Patients with IBD are no exception. One of the recommended healthy reference diets is PBD recognized as anti-inflammatory. We assert that IBD occurs in susceptible individuals mainly as a result of our omnivorous (westernized) diet. Therefore, we developed and began to provide a PBD, a lacto-ovo-vegetarian diet, for IBD patients in 2003. Infliximab and PBD as first-line (IPF) therapy was administered for all patients with newly developed Crohn’s disease (CD) and for severe ulcerative colitis (UC). Our modality broke the barrier of primary nonresponders to biologics, with a remission rate of 96% in CD, and created a new relapse-free course in slightly over half of the patients (52%) with CD. Based on the rationale derived from available evidence and the clinical outcomes, PBD is highly recommended for IBD.

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Section: Discussionmentioning

confidence: 99%

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Chiba

Morita²

2023

Metabolites

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“…Inflammatory bowel disease (IBD), encompassing conditions like Crohn’s disease and ulcerative colitis, has evolved into a global health concern [ 1 ], characterized by persistent and recurrent inflammation of the gastrointestinal tract. Although the precise pathogenesis of IBD remains elusive, various studies have proposed a link between genetic and environmental factors and chronic intestinal inflammation.…”

Section: Introductionmentioning

confidence: 99%

Protective Mechanism of Eurotium amstelodami from Fuzhuan Brick Tea against Colitis and Gut-Derived Liver Injury Induced by Dextran Sulfate Sodium in C57BL/6 Mice

Wang,

Liu,

Wei

et al. 2024

Nutrients

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The study explored the potential protective impact of the probiotic fungus Eurotium amstelodami in Fuzhuan brick tea on ulcerative colitis, along with the underlying mechanism. A spore suspension of E. amstelodami was administered to C57BL/6 mice to alleviate DSS-induced colitis. The findings indicated that administering E. amstelodami evidently enhanced the ultrastructure of colonic epithelium, showing characteristics such as enhanced TJ length, reduced microvilli damage, and enlarged intercellular space. After HLL supplementation, the activation of the liver inflammation pathway, including TLR4/NF-kB and NLRP3 inflammasome caused by DSS, was significantly suppressed, and bile acid metabolism, linking liver and gut, was enhanced, manifested by restoration of bile acid receptor (FXR, TGR5) level. The dysbiosis of the gut microbes in colitis mice was also restored by HLL intervention, characterized by the enrichment of beneficial bacteria (Lactobacillus, Bifidobacterium, Akkermansia, and Faecalibaculum) and fungi (Aspergillus, Trichoderma, Wallemia, Eurotium, and Cladosporium), which was closely associated with lipid metabolism and amino acid metabolism, and was negatively correlated with inflammatory gene expression. Hence, the recovery of gut microbial community structure, implicated deeply in the inflammatory index and metabolites profile, might play a crucial role in the therapeutic mechanism of HLL on colitis.

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“…Chiba et al introduced that a plant-based diet was effective for patients with severe ulcerative colitis when infliximab was used. They also introduced that high clinical efficacy was obtained in patients with Crohn's disease who received plant-based diet [2]. In my recognition, plant-based diet like lacto-ovo-vegetarian food includes taking mainly vegetables, eggs, and dairy products without animal fat/ protein.…”

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confidence: 99%

Reply to “promising modality for severe ulcerative colitis: infliximab and plant-based diet as first-line (IPF) therapy”

Naganuma

2024

J Gastroenterol

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with clinical remission? With the exception of overeating and extreme fat intake, it is desirable to minimize dietary restrictions during patients with remission.We recently demonstrated in multicenter prospective cohort study that advanced therapy as well as corticosteroids was effective as the first-line treatment in hospitalized patients [3,4], although the influence of dietary restriction was not investigated in our study. While recent guidelines indicated that corticosteroid is the first-line treatment for hospitalized patients with severe disease, we would like to emphasize that use of advanced therapy may be acceptable for patients with acute severe UC. Although there are many advanced therapies, these treatments should be selected according to the clinical background and severity of disease [3,4]. The effects of dietary therapy on hospitalized patients should be investigated by accumulating a large number of cases.

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Plant-Based Diet Recommended for Inflammatory Bowel Disease

Cited by 6 publications

References 12 publications

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Protective Mechanism of Eurotium amstelodami from Fuzhuan Brick Tea against Colitis and Gut-Derived Liver Injury Induced by Dextran Sulfate Sodium in C57BL/6 Mice

Reply to “promising modality for severe ulcerative colitis: infliximab and plant-based diet as first-line (IPF) therapy”

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