Food-driven inflammation in inflammatory bowel disease: Dietary instigators and emerging nutritional strategies

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is influenced not only by genetics and immunity but also profoundly by dietary factors. Emerging research identifies specific food components - such as ultra-processed foods, high-fat diets, and red meats - as potent exacerbators of intestinal inflammation through mechanisms involving dysbiosis, immune activation, and gut barrier disruption. Conversely, fiber-rich, fermented, and certain dairy products may confer protective effects by enhancing microbiota diversity and mucosal integrity. Patient-specific factors like lactose or gluten sensitivity further modulate dietary responses. Personalized nutrition strategies, including elimination diets and microbiome-informed interventions, are gaining traction as adjunct therapies. Novel approaches such as ketogenic diets and intermittent fasting are under investigation, with mixed outcomes. Despite growing evidence, clinical dietary guidelines remain fragmented. This review synthesizes mechanistic and clinical data on diet-induced modulation of inflammation in IBD, highlighting the need for personalized, evidence-based nutritional strategies to improve disease outcomes and patient quality of life.