The role of dietary supplements in inflammatory bowel disease: a systematic review

Abstract

Inflammatory bowel diseases (IBD) are chronic immune disorders of unclear aetiology. Dietary deficiencies may be a potential pathogenic factor in their development. Patients often take food supplements without knowledge of any evidence base. We have therefore assessed the evidence for food supplementation in the management of IBD. A PubMed search was performed for the terms Inflammatory bowel disease; nutritional deficiencies; dietary supplements; curcumin; green tea; vitamin D/other vitamins; folic acid; iron; zinc; probiotics; andrographis paniculata; and boswellia serrate. PubMed was used to search for all relevant articles published between January 1975 and September 2015. Curcumin supplementation has been reported to be effective in reducing the symptoms and the inflammatory indices in IBD patients. Similar results have been observed for green tea; however, pertinent studies are limited. Vitamin D supplementation may help to increase bone mineral density in IBD patients and to reduce disease activity. IBD patients with ileal resections higher than 20 cm may develop vitamin B12 deficiency that requires parenteral supplementation. There is no current evidence to support fat-soluble vitamin supplementation in IBD patients. Zinc and iron should be supplemented in selected cases. Probiotics (VSL#3) may reduce disease activity in IBD patients with pouchitis. Complementary and alternative medicines are used by IBD patients and some studies have shown promising results. In summary, attention to dietary factors such as curcumin, green tea and vitamins, including vitamins D and B12, appears to be beneficial and, if necessary, supplementation may be appropriate.

Dietary Extra-Virgin Olive Oil Polyphenols Do Not Attenuate Colon Inflammation in Transgenic HLAB-27 Rats but Exert Hypocholesterolemic Effects through the Modulation of HMGCR and PPAR-α Gene Expression in the Liver

“…Current therapies for IBD include mesalazine, immunosuppressive drugs, corticosteroids, and anti TNF-α, which are not devoid of serious side effects; therefore, alternative and safer therapeutic strategies for IBD management are needed [25]. Several nutraceuticals and phytochemicals are under investigation for their effects on IBD; however, despite some of them showing positive effects [26], strong evidence of effective protection is lacking [27, 28]. …”

Differential intestinal anti‐inflammatory effects of Lactobacillus fermentum and Lactobacillus salivarius in DSS mouse colitis: impact on microRNAs expression and microbiota composition

“…However, although they have proven clinical efficacy, this may be limited, and some of them may also present important side effects, which restricts their chronic administration . For this reason, many IBD patients look for complementary therapies that could improve the efficacy and safety of their pharmacological treatments, like nutritional supplements including probiotics . So far, the mechanisms underlying the beneficial effects of probiotics in these intestinal conditions have not been fully identified, but they appear to be multifactorial, involving epithelial barrier function enhancement, host‐microbial homeostasis and modulation of the immune system .…”

Potential role of nutraceutical compounds in inflammatory bowel disease

“…Plant-derived natural compounds carry out their protective and therapeutic effect through different molecular pathways, including anti-inflammatory and immunoregulatory mechanisms, anti-oxidative properties, and modulation of intracellular signaling transduction pathways[14]. Curcumin and green tea supplementation have been reported to be effective in reducing both IBD symptomatology and inflammatory scores, but strong evidence is limited[15]. The aim of this minireview is to describe the more common nutraceutical compounds used in IBD and to comment on recent findings for their possible applications in humans.…”