RT Journal Article
SR Electronic
T1 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP 247
OP 257
DO 10.1136/flgastro-2023-102417
VO 15
IS 3
A1 Halmos, Emma P
A1 Godny, Lihi
A1 Vanderstappen, Julie
A1 Sarbagili-Shabat, Chen
A1 Svolos, Vaios
YR 2024
UL http://fg.bmj.com/content/15/3/247.abstract
AB Diet is a modifiable risk factor for disease course and data over the past decade have emerged to indicate its role in Crohn’s disease (CD) and ulcerative colitis (UC). However, literature is riddled with misinterpretation of data, often leading to unexpected or conflicting results. The key understanding is that causative factors in disease development do not always proceed to an opportunity to change disease course, once established. Here, we discuss the data on dietary influences in three distinct disease states for CD and UC—predisease, active disease and quiescent disease. We appraise the literature for how our dietary recommendations should be shaped to prevent disease development and if or how that differs for CD and UC induction therapy and maintenance therapy. In UC, principles of healthy eating are likely to play a role in all states of disease. Conversely, data linking dietary factors to CD prevention and treatment are paradoxical with the highest quality evidence for CD treatment being exclusive enteral nutrition, a lactose, gluten and fibre-free diet comprising solely of ultraprocessed food—all dietary factors that are not associated or inversely associated with CD prevention. High-quality evidence from dietary trials is much awaited to expand our understanding and ultimately lead our dietary recommendations for targeted patient populations.