Review article: the association of diet with onset and relapse in patients with inflammatory bowel disease

Abstract

SUMMARY BackgroundThe role of diet in inflammatory bowel disease (IBD) is supported by migration studies and increasing incidences in line with Westernisation.

Deregulation of intestinal anti-microbial defense by the dietary additive, maltodextrin

“…How diverse environmental risk factors 4 contribute to IBD is not well understood; however, increasing evidence suggests that they may disrupt critical host-microbial dynamics in the gut. 5 IBD patients have alterations in both composition and organization of the commensal microbiome, as well as enhanced mucosal permeability (reviewed in 6 ). Overall, the bacterial diversity of the IBD microbiome is reduced, with notable decreases in Bacteroidetes and Firmicutes (especially in specific Clostridium species) and increases in Actinobacteria and Proteobacteria (including Escherichia coli).…”

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

“…A systematic review of the literature has revealed that high intake of saturated fats, total polyunsaturated fatty acids (PUFAs), omega-6 fatty acids and meat predisposes to the development of both CD and UC, whereas dietary fiber and fruit consumption decreases the risk of CD, and high vegetable intake reduces the risk of UC [111]. Another study has confirmed that low intake of fruits and/or vegetables were associated with an increased onset risk of IBD, and grain consumption may have a protective role in CD [112]. High intake of sugar was also identified as a risk factor of the development of IBD.…”

Association of Dietary Factors With Ulcerative Colitis in India

“…Incidence of inflammatory bowel disease (IBD) is increasing all over the world as it has been in India in the last two decades [1][2][3][4] . Etiology of IBD is multifactorial and includes a genetic predisposition which is acted upon by host and environmental factors like the microbiome, immune system, diet and nutritional status, smoking, superclean hygiene (hypersterile environment) and increased antibiotic intake in infancy.…”

“…Though epidemiologic studies from the West indicate environmental factors to be more important in ulcerative colitis (UC) than Crohn's disease, evidence for causation is weak due to conflicting results of studies. Other methodology associated confounders in relation to diet include retrospective nature of studies and fallacy in dietary history recall, uncertainty about the exact time of onset of UC depending on symptoms, change in diet after symptom onset (without being involved in etiology) [1] . This is compounded by extreme day to day variation in type, amount and frequency of food consumption in modern times (making estimate of average daily consumption extremely difficult if not entirely impossible), interplay of different dietary components together rather than a single item in disease causation and bias introduced by diet commonly consumed in a particular region.…”

“…Various dietary factors implicated in causation of UC in Western studies include increased intake of animal protein (especially processed red meat) and margarine which are rich in linoleic acid, sugar and sugar containing foods, total fat and polyunsaturated fatty acids, omega 6 fatty acid and decreased intake of fruits and vegetables [1,2] . The dietary practices in India are very different from the West.…”