Diet, Food, and Nutritional Exposures and Inflammatory Bowel Disease or Progression of Disease: an Umbrella Review

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2024-04-08 DOI:10.1016/j.advnut.2024.100219

Camilla Christensen , Andrea Knudsen , Erik K Arnesen , Jan Gunnar Hatlebakk , Ida Sofie Sletten , Lars T Fadnes

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引用次数: 0

Abstract

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), contributes to substantial morbidity. Understanding the intricate interplay between dietary factors and the incidence and progression of IBD is essential for developing effective preventative and therapeutic strategies. This umbrella review comprehensively synthesizes evidence from systematic reviews and meta-analyses to evaluate these complex associations. Dietary factors associated with an increased incidence and/or progression of IBD include a high intake of red and processed meat, other processed foods, and refined sugars, together with a low intake of vegetables, fruits, and fiber. For most other food groups, the results are mixed or indicate no clear associations with IBD, CD, and UC. Some differences seem to exist between UC and CD and their risk factors, with increased intake of dietary fiber being inversely associated with CD incidence but not clearly associated with UC. Dietary fiber may contribute to maintaining the gut epithelial barrier and reduce inflammation, often through interactions with the gut microbiota. This seems to play an important role in inflammatory mechanisms in the gut and in IBD incidence and progression. Diets low in fermentable saccharides and polyols can alleviate symptom burden, but there are concerns regarding their impact on the gut microbiota and their nutritional adequacy. Mediterranean diets, vegetarian diets, and a diet low in grains, sugars, and lactose (specific carbohydrate diet) are also associated with lower incidence and/or progression of IBD. The associations of dietary patterns are mirrored by inflammatory biomarkers. IBD is typically treated pharmaceutically; however, many patients have a suboptimal response to medical treatments. The findings from this umbrella review could provide evidence for nutritional counseling and be a valuable addition to traditional treatment plans for IBD.

This systematic review was registered at PROSPERO as CRD440252.

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饮食、食物和营养暴露与炎症性肠病或疾病进展：综述

炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），造成了严重的发病率。要制定有效的预防和治疗策略，就必须了解饮食因素与 IBD 的发病和发展之间错综复杂的相互作用。本综述全面综合了来自系统综述和荟萃分析的证据，以评估这些复杂的关联。与 IBD 发病率增加和/或病情恶化相关的饮食因素包括红肉和加工肉类、其他加工食品以及精制糖的高摄入量，以及蔬菜、水果和纤维素的低摄入量。至于大多数其他食物类别，研究结果不一，或表明与 IBD、CD 和 UC 没有明确的关联。UC 和 CD 与其风险因素之间似乎存在一些差异，膳食纤维摄入量的增加与 CD 的发病率成反比，但与 UC 并无明显关联。膳食纤维可能有助于维持肠道上皮屏障和减少炎症，通常是通过与肠道微生物群的相互作用来实现的。这似乎在肠道炎症机制以及 IBD 发病率和进展中发挥着重要作用。可发酵糖和多元醇含量低的饮食可减轻症状负担，但其对肠道微生物群的影响及其营养是否充足令人担忧。地中海饮食、素食以及谷物、糖和乳糖含量低的饮食（特定碳水化合物饮食）也与 IBD 的发病率和/或进展率降低有关。炎症生物标志物也反映了饮食模式的相关性。IBD 通常采用药物治疗，但许多患者对药物治疗的反应并不理想。本综述的研究结果可为营养咨询提供证据，并成为 IBD 传统治疗方案的重要补充。本系统综述在 PROSPERO 注册为 CRD440252。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.