Deciphering the diet-inflammatory bowel disease relationship: knowledge gaps and future perspectives

Area of Science:

• Gastroenterology and Nutrition Science
• Immunology and Microbiome Research

Background:

• Diet is increasingly recognized as a critical factor in inflammatory bowel disease (IBD) development and progression.
• Traditional views of diet as a passive exposure are being replaced by an understanding of its dynamic role in IBD pathogenesis.

Purpose of the Study:

• To redefine the role of diet as a multidimensional modifier in inflammatory bowel disease (IBD).
• To highlight the complex interactions between diet, genetics, microbiota, and environmental factors in IBD.
• To identify research priorities for advancing dietary interventions in IBD care.

Main Methods:

• This review synthesizes current evidence on diet's impact on IBD.
• It examines diet's influence through nutrient composition, cooking methods, contaminants, and lifestyle factors.
• The review incorporates insights from genetics, microbiome research, and intestinal barrier function.

Main Results:

• Diet acts as a dynamic determinant of IBD pathogenesis, progression, and treatment response.
• Factors beyond nutrient composition, including age, sex, and cooking methods, collectively shape disease trajectories.
• Complex interactions between diet, host genetics, and the gut microbiome are central to IBD.

Conclusions:

• Reframing diet as a biological, behavioral, and environmental nexus is essential for IBD care.
• Dietary interventions require culturally tailored, patient-centered frameworks for real-world adherence and equity.
• Future research should focus on long-term trials, advanced dietary assessment tools, and integrated data for personalized IBD therapy.