Department of Internal Medicine, University of Chicago, Chicago, IL, USA.
Department of Internal Medicine, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL, 60637, USA.
Curr Gastroenterol Rep. 2020 Mar 17;22(4):19. doi: 10.1007/s11894-020-0755-9.
This article provides an updated review on the role of diet in the risk of developing Crohn's disease (CD) and CD management, areas of ongoing study.
Higher intake of dietary fiber (fruit fiber) has been associated with a reduced risk for CD. The exclusive enteral nutrition (EEN) diet remains the most validated nutritional recommendation for inducing remission in CD. The specific carbohydrate diet (SCD) has demonstrated reductions in CD severity scores in conjunction with medical therapies, and larger trials on its efficacy are ongoing. Several new exclusion diets modeled after EEN and SCD have shown potential efficacy in smaller studies that warrant replication. There is a paucity of clear dietary recommendations for the reduction in risk of CD clinical relapse. There are various components of diet that likely impact risk for CD development and contribute to its disease course; however, studies are often limited in their size or ability to demonstrate mechanistic causation. Further studies including diets that aim to expand on the restrictive nature of EEN may lead to stronger evidence for a diet-based approach to CD management.
本文就饮食在克罗恩病(CD)发病风险及 CD 管理中的作用进行综述,包括目前正在研究的领域。
膳食纤维(水果纤维)摄入量较高与 CD 发病风险降低相关。在诱导 CD 缓解方面,肠内营养(EEN)饮食仍然是最有效的营养推荐。特定碳水化合物饮食(SCD)与药物治疗联合应用时可降低 CD 严重程度评分,目前正在进行更大规模的疗效试验。在较小的研究中,几种以 EEN 和 SCD 为模型的新排除饮食显示出有潜力,但需要进一步复制。对于降低 CD 临床复发风险,目前还没有明确的饮食推荐。饮食的各个方面都可能影响 CD 的发病风险,并影响其疾病进程;然而,这些研究在规模或证明因果关系方面往往存在局限性。进一步的研究包括旨在扩大 EEN 限制性质的饮食,可能会为基于饮食的 CD 管理方法提供更强有力的证据。