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超加工食品可能是炎症性肠病患病率上升的罪魁祸首。

Ultra-processed foods as a possible culprit for the rising prevalence of inflammatory bowel diseases.

作者信息

Vissers Eva, Wellens Judith, Sabino João

机构信息

Department of Chronic Diseases, Metabolism and Aging, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium.

Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.

出版信息

Front Med (Lausanne). 2022 Nov 7;9:1058373. doi: 10.3389/fmed.2022.1058373. eCollection 2022.

Abstract

Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract, and the exact pathogenesis is still unclear. It is believed that IBD develops in response to a complex interaction between the microbiota, environmental factors, and the immune system, in genetically predisposed individuals. Identifying these environmental factors will offer more insight in the development of the disease, and reveal new therapeutic targets for IBD patients. One of the environmental factors that has gained more interest over the last years is our diet. The prevalence of IBD has increased significantly and this increase is thought to be associated with a 'Western diet', characterized by high intake of fats, added sugar, meat, and ultra-processed foods (UPFs). The UPFs now account for almost 50% of the energy intake in Westernized countries and are therefore an important characteristic of this Western diet. UPFs are characterized by higher amounts of salt, fat, sugar and the presence of different food additives. Epidemiological studies have found associations between UPF intake and a range of non-communicable diseases, including inflammatory bowel disease (IBD). Preclinical and clinical evidence suggest that non-nutritive ingredients and additives, present in UPFs, can negatively affect different components of the intestinal barrier, such as the microbiota, the mucus layer, the epithelium, and the immune cells in the lamina propria. Disruption of this barrier can cause the immune system to encounter an increased bacterial exposure, leading to an aberrant immune response. In this article, the available evidence on the possible role of UPFs and their components in the increasing incidence and prevalence of IBD is reviewed. These findings can be translated to the clinic and may be helpful to consider when giving dietary advice to IBD patients. A better understanding of the role of UPFs may lead to less restrictive diets for patients with IBD, hence increasing the dietary compliance and efficacy of exclusion diets.

摘要

炎症性肠病(IBD)是胃肠道的慢性炎症性疾病,其确切发病机制仍不清楚。据信,在具有遗传易感性的个体中,IBD是由微生物群、环境因素和免疫系统之间的复杂相互作用引起的。识别这些环境因素将有助于更深入地了解该疾病的发展,并为IBD患者揭示新的治疗靶点。在过去几年中,饮食是引起更多关注的环境因素之一。IBD的患病率显著增加,这种增加被认为与以高脂肪、添加糖、肉类和超加工食品(UPF)摄入量高为特征的“西方饮食”有关。UPF现在占西方国家能量摄入的近50%,因此是这种西方饮食的一个重要特征。UPF的特点是盐、脂肪、糖含量较高,并且存在不同的食品添加剂。流行病学研究发现,UPF摄入量与一系列非传染性疾病之间存在关联,包括炎症性肠病(IBD)。临床前和临床证据表明,UPF中存在的非营养成分和添加剂会对肠道屏障的不同组成部分产生负面影响,如微生物群、黏液层、上皮细胞和固有层中的免疫细胞。这种屏障的破坏会导致免疫系统接触到更多的细菌,从而引发异常的免疫反应。在本文中,我们综述了关于UPF及其成分在IBD发病率和患病率增加中可能作用的现有证据。这些发现可以转化到临床中,在为IBD患者提供饮食建议时可能会有所帮助。更好地理解UPF的作用可能会使IBD患者的饮食限制减少,从而提高饮食依从性和排除饮食的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/9676654/d17e04a2c2f4/fmed-09-1058373-g0001.jpg

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