Szilagyi Andrew, Wyse Jonathan, Abdulezer Jennifer
Division of Gastroenterology, Department of Medicine, Jewish General Hospital, McGill University School of Medicine, 3755 Cote St Catherine Rd, Montreal, Quebec, H3 T 1E2, Canada.
ELNA Medical Center Decarie ELNA Medical Group, 6900 Decarie Blvd, Côte Saint-Luc, Canada.
Curr Gastroenterol Rep. 2025 Apr 30;27(1):29. doi: 10.1007/s11894-025-00980-w.
The pandemic of obesity preceded global spread of Inflammatory Bowel diseases by almost 2 decades. A pathogenic relationship has been described between obesity and inflammatory bowel diseases, but Crohn`s disease may be selectively impacted. The role of diet in pathogenesis has also gained significant support in the last few decades. This review explores dietary relationships to account for epidemiological observations. Quantifiable indices for diets have been described including a glycemic index, inflammatory indices and levels of food processing. Meta-analyses have been published which examine each for effects on obesity and co-morbidities as well as Crohn's disease and ulcerative colitis. This review suggests that ultra-processed foods provide the best link between obesity and Crohn's disease explaining epidemiological observations. However, the other 2 types of dietary indices likely contribute to ulcerative colitis as well as to co-morbidities related to both obesity and inflammatory bowel diseases. The term ultra-processed foods cover a large number of additives and extensive work is needed to define individual or combined harmful effects. Furthermore, the interactions among the 3 main indices need clarification in order to precisely apply therapeutic diets to both diseases (obesity and inflammatory bowel disease).
肥胖症的流行比炎症性肠病在全球范围内的传播早了近20年。肥胖与炎症性肠病之间已被描述存在致病关系，但克罗恩病可能受到选择性影响。在过去几十年中，饮食在发病机制中的作用也得到了大量支持。本综述探讨饮食关系以解释流行病学观察结果。已经描述了饮食的可量化指标，包括血糖指数、炎症指数和食品加工水平。已经发表了荟萃分析，研究了它们对肥胖症及其合并症以及克罗恩病和溃疡性结肠炎的影响。本综述表明，超加工食品为肥胖症和克罗恩病之间提供了最佳联系，解释了流行病学观察结果。然而，其他两种饮食指标可能也与溃疡性结肠炎以及与肥胖症和炎症性肠病相关的合并症有关。超加工食品这一术语涵盖大量添加剂，需要开展广泛工作来确定其个体或综合有害影响。此外，为了将治疗性饮食精确应用于这两种疾病（肥胖症和炎症性肠病），需要阐明这三个主要指标之间的相互作用。
