Nutrition and the pancreas

The pancreas is a compound organ specialized in digestion and absorption of nutrients and in glucose homeostasis. Indeed, the exocrine component produces digestive enzymes and bicarbonates involved in the duodenal and jejunal digestion, whereas endocrine cells, mainly located in the islets of Langerhans, produce glucose-regulating hormones. These two different pancreatic functions are strictly and directly regulated by mechanisms that are still not completely understood. Not only pancreatic secretions but also the interaction between exocrine and endocrine pancreatic function have relevance on nutritional status, and there is increasing evidence that nutritional status impacts the prognosis of both inflammatory and pancreatic neoplastic diseases of the pancreas. Signs of malnutrition need to be investigated and identified in patients with pancreatic diseases to optimize the medical management and, potentially, to improve the clinical outcome. Considering the central role of the pancreas in the nutrition state, in this review, we aimed to report the current knowledge on pancreatic exocrine and endocrine functions and their relationship with diet, and the modifications and the impact on prognosis of the inflammatory and neoplastic diseases of the pancreas.