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Understanding Role of Nutrition in Inflammatory Bowel Disease: A Comprehensive Review With Incorporation of AGA
Galvin Dhaliwal1, Dushyant Singh Dahiya2, Ashvin Singh Dhaliwal3
1Division of Gastroenterology and Hepatology, University of Houston/HCA Houston Healthcare, Kingwood, Texas, USA.
Abstract:
This comprehensive review delves into the evolving landscape of nutrition's role in Inflammatory Bowel Disease (IBD), while incorporating transformative insights from the recently published American Gastroenterology Association (AGA) clinical practice update (CPU) on diet in IBD. Recent years have witnessed a paradigm shift, recognizing diet not only as an influencer in disease development but also as a disease-modifying factor and treatment avenue for IBD. The AGA CPU endorses a balanced Mediterranean-style diet, emphasizing the need for personalized recommendations tailored to individual patient characteristics, including disease course, surgical history, and pharmacotherapy. The implementation of complex nutritional strategies necessitates the involvement of both gastroenterologists and registered dietitians. Guidance for patients and caregivers is available through organizations such as Crohn's and Colitis Canada and Crohn's and Colitis Foundation. While animal models offer valuable insights, the review underscores their limitations in replicating the complexity of IBD biology observed in humans. It advocates for an exploration of nutrigenomics, utilizing molecular tools to analyze how diet-derived bioactive compounds influence gene expression for precision nutrition insights. Practical challenges in dietary intervention studies, including regional variations and complexities in food handling, require attention for enhanced comparability. Limited data exist on combined dietary and medical therapies, but promising outcomes suggest potential synergies. Precision treatments could develop through an understanding of the function of particular food metabolites in influencing inflammation. The objective of this review is to offer a summary of the present comprehension of diet, serving as both a potential factor contributing to and a therapeutic avenue for IBD. Clinical Trial Registration: This study is not a part of a clinical trial.
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