Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, California, USA.
Colitis and Crohn's Disease Center, University of California San Francisco, San Francisco, California, USA.
Nutr Clin Pract. 2024 Jun;39(3):530-545. doi: 10.1002/ncp.11146. Epub 2024 Mar 20.
Diet is an environmental exposure implicated in the development of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Dietary therapy is also a tool for management of these conditions. Nutrition therapy for IBD has been shown to reduce intestinal inflammation, promote healing, and alleviate symptoms, as well as improve patients' nutrition status. Although the mechanisms of action of most nutrition therapies for IBD are not well understood, the diets are theorized to eliminate triggers for gut dysbiosis and mucosal immune dysfunction associated with the typical Western diet. Exclusive enteral nutrition and the Crohn's disease exclusion diet are increasingly being used as the primary treatment modality for the induction of remission and/or maintenance therapy in children, and in some adults, with CD. Several other diets, such as the Mediterranean diet, anti-inflammatory diet for IBD, and diets excluding gluten, FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), lactose, or other compounds, may be helpful in symptom management in both CD and UC, though evidence for biochemical efficacy is limited. In this review, we discuss the role of diet components in IBD pathogenesis and examine diets currently used in the management of children and adults with IBD. We also address practical, psychosocial, and cultural considerations for dietary therapy across diverse populations.
饮食是一种环境暴露因素,与炎症性肠病(IBD)的发展有关,包括克罗恩病(CD)和溃疡性结肠炎(UC)。饮食疗法也是这些疾病的治疗手段之一。IBD 的营养治疗已被证明可以减轻肠道炎症、促进愈合、缓解症状,并改善患者的营养状况。尽管大多数 IBD 营养治疗的作用机制尚不清楚,但这些饮食被认为可以消除与典型西方饮食相关的肠道菌群失调和黏膜免疫功能障碍的触发因素。在儿童中,完全肠内营养和 CD 排除饮食越来越多地被用作诱导缓解和/或维持治疗的主要治疗方式,在一些成人中也有应用。其他一些饮食,如地中海饮食、IBD 抗炎饮食以及排除麸质、FODMAP(可发酵寡糖、双糖、单糖和多元醇)、乳糖或其他化合物的饮食,可能有助于 CD 和 UC 的症状管理,但生化疗效的证据有限。在这篇综述中,我们讨论了饮食成分在 IBD 发病机制中的作用,并研究了目前用于治疗儿童和成人 IBD 的饮食。我们还讨论了在不同人群中进行饮食治疗的实际、心理社会和文化考虑因素。
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