Nutrition phenotypes in inflammatory bowel disease: emerging concepts and future directions to guide clinical...

Nutrition occupies a central and dynamic role across the inflammatory bowel disease (IBD) care continuum, from disease risk reduction and prevention, through induction and maintenance of remission, to the mitigation of disease-related and unrelated complications and the preservation of quality of life - yet translating this evidence into individualized clinical practice remains a persistent challenge. To address this gap, we conducted a narrative review of the current literature and propose the concept of the nutrition phenotype: a structured framework that integrates disease-specific characteristics, nutritional status, body composition, dietary patterns, and lifestyle factors to define clinically distinct patient profiles. Applying this framework to six phenotypes: malnutrition, overnutrition, dietary therapeutics, functional symptoms, high enteric loss, and complication prevention, we synthesize the evidence supporting targeted nutritional interventions for each and present an integrated clinical algorithm plus a proposed hierarchy for managing patients with overlapping phenotypes to guide prioritization and decision-making. This phenotype-driven approach provides a practical, personalized structure for nutrition care in inflammatory bowel disease, with the aim of improving implementation feasibility and patient outcomes across real-world clinical settings.