Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, 300 Pasteur Drive, M211, Stanford, CA 94305, USA.
University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Nutrients. 2021 Mar 10;13(3):890. doi: 10.3390/nu13030890.
Despite being a focal issue to patients, the effect of diet on adult inflammatory bowel disease (IBD) remains underexplored with limited guidance. While promising clinical trials are currently underway, there is a need for further evidence-based recommendations. As such, we summarize the current evidence on various diets used in the treatment of IBD and also explore the potential applications of dietary data from related immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis and psoriasis, to provide additional information to inform IBD providers. To date, there have been multiple diets investigated as adjunctive therapy in IBD, but many associated studies are small, non-randomized, and not controlled. Mediterranean, vegetarian/vegan, and reduced-calorie/fasting diets have been studied and have shown some positive results in other IMIDs, which may suggest potential applicability to those with IBD, but larger, well-designed clinical trials are needed for further guidance. Gluten-free and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)diets do not appear to have an impact on IBD disease activity, but low FODMAP may potentially be helpful for those with concurrent functional gastrointestinal symptoms. Specific carbohydrate diets have been mainly assessed in children but show some potential in small adult studies.
尽管饮食对成人炎症性肠病 (IBD) 的影响是患者关注的焦点问题，但目前对此研究仍不够充分，相关指导有限。虽然目前正在进行有前景的临床试验，但仍需要更多基于证据的建议。因此，我们总结了目前关于治疗 IBD 中使用的各种饮食的证据，并探讨了来自相关免疫介导的炎症性疾病（IMID）（如类风湿关节炎和银屑病）的饮食数据的潜在应用，为 IBD 提供者提供更多信息。迄今为止，已经有多种饮食被作为 IBD 的辅助治疗进行了研究，但许多相关研究规模较小、非随机且不受控制。地中海饮食、素食/纯素饮食和低热量/禁食饮食已在其他 IMID 中进行了研究，并显示出一些积极的结果，这可能表明它们对 IBD 患者具有潜在适用性，但需要更大规模、精心设计的临床试验来提供进一步的指导。无麸质和低可发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食似乎对 IBD 疾病活动没有影响，但低 FODMAP 可能对同时存在功能性胃肠道症状的患者有帮助。特定碳水化合物饮食主要在儿童中进行评估，但在一些小型成人研究中显示出了一定的潜力。
