Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Diets for inflammatory bowel disease: What do we know so far?

Abstract

In recent years, the role of diet in the pathogenesis of inflammatory bowel disease (IBD) has gained great interest within the scientific community. Eating habits from industrialised countries (the so-called western diet or WD) have been associated with a higher incidence of IBD in observational studies, although the dietary factors responsible for the development of the disease are still to be elucidated. Some components of the diet with proinflammatory potential may cause changes in immunity and intestinal microbiota, leading to the inflammatory reaction that causes IBD-related lesions. The quality of available evidence is low, due to methodological issues, such as the lack of intervention studies, small sample size and heterogeneity of studies. For this reason, scientific societies have offered their recommendations using clinical practice guidelines and consensus documents, in order to establish a common criterion in the nutritional treatment of patients with IBD. The objective of this review was to summarise the data published regarding diet in IBD and review the recommendations given by scientific societies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Intestinal barrier.

Similar content being viewed by others

References

  1. Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet Lond Engl. 2018;390:2769–78. 23 de

    Article  Google Scholar 

  2. Ng SC, Bernstein CN, Vatn MH, Lakatos PL, Loftus EV, Tysk C, et al. Geographical variability and environmental risk factors in inflammatory bowel disease. Gut. 2013;62:630–49.

    Article  PubMed  Google Scholar 

  3. Damas OM, Estes D, Avalos D, Quintero MA, Morillo D, Caraballo F, et al. Hispanics coming to the US adopt US cultural behaviors and eat less healthy: implications for development of inflammatory bowel disease. Dig Dis Sci. 2018;63:3058–66.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sigall Boneh R, Levine A, Lomer M, Wierdsma N, Alan P, Fiorino G, et al. Research gaps in diet and nutrition in inflammatory bowel disease. A topical review by ECCO. J Crohns Colitis. 2017;11:S28-9.

  5. Ananthakrishnan AN, Khalili H, Song M, Higuchi LM, Richter JM, Nimptsch K, et al. High school diet and risk of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis. 2015;21:2311–9.

    PubMed  Google Scholar 

  6. Ananthakrishnan AN, Khalili H, Konijeti GG, Higuchi LM, de Silva P, Korzenik JR, et al. A prospective study of long-term intake of dietary fiber and risk of Crohn’s disease and ulcerative colitis. Gastroenterology. 2013;145:970–7.

    Article  CAS  PubMed  Google Scholar 

  7. Ananthakrishnan AN, Khalili H, Konijeti GG, Higuchi LM, de Silva P, Fuchs CS, et al. Long-term intake of dietary fat and risk of ulcerative colitis and Crohn’s disease. Gut 2014;63:776–84.

    Article  CAS  PubMed  Google Scholar 

  8. Li F, Liu X, Wang W, Zhang D. Consumption of vegetables and fruit and the risk of inflammatory bowel disease: a meta-analysis. Eur J Gastroenterol Hepatol. 2015;27:623–30.

    Article  PubMed  Google Scholar 

  9. IBD in EPIC Study Investigators, Tjonneland A, Overvad K, Bergmann MM, Nagel G, Linseisen J, et al. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study. Gut. 2009;58:1606–11.

    Article  CAS  Google Scholar 

  10. Chan SS. Docosahexanoeic acid and eicosapentaenoic acid in the aetiology of crohn’s disease-data from a European prospective cohort study (EPIC). Gastroenterology 2012;142:S791.

    Google Scholar 

  11. Racine A, Carbonnel F, Chan SSM, Hart AR, Bueno-de-Mesquita HB, Oldenburg B, et al. Dietary patterns and risk of inflammatory bowel disease in Europe: results from the EPIC Study. Inflamm Bowel Dis. 2016;22:345–54.

    Article  PubMed  Google Scholar 

  12. Vasseur P, Dugelay E, Benamouzig R, Savoye G, Lan A, Srour B, et al. Dietary patterns, ultra-processed food, and the risk of inflammatory bowel diseases in the NutriNet-Santé Cohort. Inflamm Bowel Dis. 2021;27:65–73.

    Article  PubMed  Google Scholar 

  13. Bischoff SC. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr. 2020;39:632–53.

    Article  PubMed  Google Scholar 

  14. Birchenough G, Schroeder BO, Bäckhed F, Hansson GC. Dietary destabilisation of the balance between the microbiota and the colonic mucus barrier. Gut Microbes. 2019;10:246–50.

    Article  CAS  PubMed  Google Scholar 

  15. Le Leu RK, Young GP, Hu Y, Winter J, Conlon MA. Dietary red meat aggravates dextran sulfate sodium-induced colitis in mice whereas resistant starch attenuates inflammation. Dig Dis Sci. 2013;58:3475–82.

    Article  PubMed  CAS  Google Scholar 

  16. Ijssennagger N, Belzer C, Hooiveld GJ, Dekker J, van Mil SWC, Müller M, et al. Gut microbiota facilitates dietary heme-induced epithelial hyperproliferation by opening the mucus barrier in colon. Proc Natl Acad Sci USA. 2015;112:10038–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Partridge D, Lloyd KA, Rhodes JM, Walker AW, Johnstone AM, Campbell BJ. Food additives: assessing the impact of exposure to permitted emulsifiers on bowel and metabolic health—introducing the FADiets study. Nutr Bull. 2019;44:329–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Rohr MW, Narasimhulu CA, Rudeski-Rohr TA, Parthasarathy S. Negative effects of a high-fat diet on intestinal permeability: a review. Adv Nutr. 2020;11:77–91.

    Article  PubMed  Google Scholar 

  19. de Silva PSA, Luben R, Shrestha SS, Khaw KT, Hart AR. Dietary arachidonic and oleic acid intake in ulcerative colitis etiology: a prospective cohort study using 7-day food diaries. Eur J Gastroenterol Hepatol. 2014;26:11–8.

    Article  PubMed  CAS  Google Scholar 

  20. McCormick NM, Logomarsino JV. The specific carbohydrate diet in the treatment of Crohn’s disease: a systematic review. J Gastroenterol Hepatol Res. 2017;6:2392–9.

    Article  CAS  Google Scholar 

  21. McGuckin MA, Lindén SK, Sutton P, Florin TH. Mucin dynamics and enteric pathogens. Nat Rev Microbiol. 2011;9:265–78.

    Article  CAS  PubMed  Google Scholar 

  22. Desai MS, Seekatz AM, Koropatkin NM, Kamada N, Hickey CA, Wolter M, et al. A dietary fiber-deprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility. Cell. 2016;167:1339–1353.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Pituch-Zdanowska A, Banaszkiewicz A, Albrecht P. The role of dietary fibre in inflammatory bowel disease. Prz Gastroenterol. 2015;10:135–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Celiberto LS, Graef FA, Healey GR, Bosman ES, Jacobson K, Sly LM, et al. Inflammatory bowel disease and immunonutrition: novel therapeutic approaches through modulation of diet and the gut microbiome. Immunology 2018;155:36–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Limdi JK, Aggarwal D, McLaughlin JT. Dietary practices and beliefs in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2016;22:164–70.

    Article  PubMed  Google Scholar 

  26. Guadagnoli L, Mutlu EA, Doerfler B, Ibrahim A, Brenner D, Taft TH. Food-related quality of life in patients with inflammatory bowel disease and irritable bowel syndrome. Qual Life Res. 2019;28:2195–205.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bergeron F, Bouin M, D’Aoust L, Lemoyne M, Presse N. Food avoidance in patients with inflammatory bowel disease: what, when and who? Clin Nutr. 2018;37:884–9.

    Article  PubMed  Google Scholar 

  28. Macedo C, Portela F, Ferreira AM, Lopes S, Mendes S, Ferreira M, et al. Dietary restrictions on inflammatory bowel disease. J Crohns Colitis. 2019;13:S342.

    Article  Google Scholar 

  29. Tomar SK, Kedia S, Upadhyay AD, Bopanna S, Yadav DP, Goyal S, et al. Impact of dietary beliefs and practices on patients with inflammatory bowel disease: an observational study from India. JGH Open. 2017;1:15–21.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Opstelten JL, de Vries JHM, Wools A, Siersema PD, Oldenburg B, Witteman BJM. Dietary intake of patients with inflammatory bowel disease: a comparison with individuals from a general population and associations with relapse. Clin Nutr Edinb Scotl. 2019;38:1892–8.

    Article  Google Scholar 

  31. Crooks B, Limdi JK, McLaughlin JT. Dietary practices and beliefs of patients with inactive ulcerative colitis: a prospective study from the United Kingdom. Proc Nutr Soc. 2020;79. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L630723143.

  32. Crooks B, Limdi JK, McLaughlin JT. Dietary practices and beliefs of patients with older-onset inflammatory bowel disease: a prospective study from the United Kingdom. Proc Nutr Soc. 2020;79:E21.

    Article  Google Scholar 

  33. Cohen AB, Lee D, Long MD, Kappelman MD, Martin CF, Sandler RS, et al. Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease. Dig Dis Sci. 2013;58:1322–8.

    Article  CAS  PubMed  Google Scholar 

  34. Lim H-S, Kim S-K, Hong S-J. Food elimination diet and nutritional deficiency in patients with inflammatory bowel disease. Clin Nutr Res. 2018;7:48–55.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Walton M, Alaunyte I. Do patients living with ulcerative colitis adhere to healthy eating guidelines? A cross-sectional study. Br J Nutr. 2014;112:1628–35.

    Article  CAS  PubMed  Google Scholar 

  36. Casanova MJ, Chaparro M, Molina B, Merino O, Batanero R, Dueñas-Sadornil C, et al. Prevalence of malnutrition and nutritional characteristics of patients with inflammatory bowel disease. J Crohns Colitis. 2017;11:1430–9.

    Article  PubMed  Google Scholar 

  37. Nguyen GC, Munsell M, Harris ML. Nationwide prevalence and prognostic significance of clinically diagnosable protein-calorie malnutrition in hospitalized inflammatory bowel disease patients. Inflamm Bowel Dis. 2008;14:1105–11.

    Article  PubMed  Google Scholar 

  38. Levine A, Rhodes JM, Lindsay JO, Abreu MT, Kamm MA, Gibson PR, et al. Dietary guidance for patients with inflammatory bowel disease from the international organization for the study of inflammatory bowel disease. Clin Gastroenterol Hepatol. 2020;18:1381–92.

    Article  PubMed  Google Scholar 

  39. Sood A, Ahuja V, Kedia S, Midha V, Mahajan R, Mehta V, et al. Diet and inflammatory bowel disease: The Asian Working Group guidelines. Indian J Gastroenterol. 2019;38:220–46.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Colombel J-F, Shin A, Gibson PR. AGA clinical practice update on functional gastrointestinal symptoms in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2019;17:380–390.e1.

    Article  PubMed  Google Scholar 

  41. Roszkowska A, Pawlicka M, Mroczek A, Balabuszek K, Nieradko-Iwanicka B. Non-celiac gluten sensitivity: a review. Medicina (Kaunas). 2019;55:222.

    Article  Google Scholar 

  42. Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut 2017;66:1517–27.

    Article  CAS  PubMed  Google Scholar 

  43. Sugihara K, Morhardt TL, Kamada N. The role of dietary nutrients in inflammatory bowel disease. Front Immunol. 2018;9:3183.

    Article  CAS  PubMed  Google Scholar 

  44. Testa A, Imperatore N, Rispo A, Rea M, Tortora R, Nardone OM, et al. Beneficial effect of a low fodmaps diet in different gastrointestinal disorders. United Eur Gastroenterol J. 2017;5:A741.

    Google Scholar 

  45. Zhan Y, Zhan Y-A, Dai S-X. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clin Nutr Edinb Scotl. 2018;37:123–9.

    Article  Google Scholar 

  46. Bodini G, Zanella C, Crespi M, Lo Pumo S, Demarzo MG, Savarino E, et al. A randomized, 6-wk trial of a low FODMAP diet in patients with inflammatory bowel disease. Nutr Burbank. 2019;67-68:110542.

    Article  CAS  Google Scholar 

  47. Cox SR, Stagg AJ, Fromentin S, Ehrlich SD, McCarthy NE, Galleron N, et al. Low FODMAP diet improves functional-like gastrointestinal symptoms but reduces bifidobacteria and faecali bacterium Prausnitzii in quiescent inflammatory bowel disease: a randomised controlled trial and metagenomic analysis. Gastroenterology 2018;154:S–177.

    Article  Google Scholar 

  48. Pedersen N, Ankersen DV, Felding M, Wachmann H, Végh Z, Molzen L, et al. Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease. World J Gastroenterol. 2017;23:3356–66. 14 de mayo de

    Article  PubMed  PubMed Central  Google Scholar 

  49. Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Muir JG, Gibson PR. Consistent prebiotic effect on gut microbiota with altered FODMAP intake in patients with Crohn’s disease: a randomised, controlled cross-over trial of well-defined diets. Clin Transl Gastroenterol. 2016;7:e164.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Cox SR, Lindsay JO, Fromentin S, Stagg AJ, McCarthy NE, Galleron N, et al. Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial. Gastroenterology 2020;158:176–188. e7

    Article  CAS  PubMed  Google Scholar 

  51. Maagaard L, Ankersen DV, Végh Z, Burisch J, Jensen L, Pedersen N, et al. Follow-up of patients with functional bowel symptoms treated with a low FODMAP diet. World J Gastroenterol. 2016;22:4009–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Hwang C, Ross V, Mahadevan U. Popular exclusionary diets for inflammatory bowel disease: the search for a dietary culprit. Inflamm Bowel Dis. 2014;20:732–41.

    Article  PubMed  Google Scholar 

  53. Manceñido Marcos N, Pajares Villarroya R, Salinas Moreno S, Arribas López MR, Comas Redondo C. The association between de novo inflammatory bowel disease and celiac disease. Rev Esp Enferm Dig. 2020;112:7–11.

    PubMed  Google Scholar 

  54. Bengi G, Civak M, Akarsu M, Soytürk M, Ellidokuz E, Topalak Ö, et al. Prevalance of celiac disease in patients with inflammatory bowel disease in Turkish population. Gastroenterol Res Pract. 2019;2019:6272098.

  55. Aziz I, Branchi F, Pearson K, Priest J, Sanders DS. A study evaluating the bidirectional relationship between inflammatory bowel disease and self-reported non-celiac gluten sensitivity. Inflamm Bowel Dis. 2015;21:847–53. abril de

    Article  PubMed  Google Scholar 

  56. Limketkai BN, Sepulveda R, Hing T, Shah ND, Choe M, Limsui D, et al. Prevalence and factors associated with gluten sensitivity in inflammatory bowel disease. Scand J Gastroenterol. 2018;53:147–51.

    Article  CAS  PubMed  Google Scholar 

  57. Herfarth HH, Martin CF, Sandler RS, Kappelman MD, Long MD. Prevalence of a gluten-free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases. Inflamm Bowel Dis. 2014;20:1194–7.

    Article  PubMed  Google Scholar 

  58. Gibson PR. Use of the low-FODMAP diet in inflammatory bowel disease. J Gastroenterol Hepatol. 2017;32(Suppl 1):40–2.

    Article  CAS  PubMed  Google Scholar 

  59. Kaplan HC, Opipari-Arrigan L, Schmid CH, Schuler CL, Saeed S, Braly KL, et al. Evaluating the Comparative effectiveness of two diets in pediatric inflammatory bowel disease: a study protocol for a series of N-of-1 trials. Healthcare (Basel) 2019;7.

  60. Burgis JC, Nguyen K, Park KT, Cox K. Response to strict and liberalized specific carbohydrate diet in pediatric Crohn’s disease. World J Gastroenterol. 2016;22:2111–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Cohen SA, Gold BD, Oliva S, Lewis J, Stallworth A, Koch B, et al. Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease. J Pediatr Gastroenterol Nutr. 2014;59:516–21.

    Article  CAS  PubMed  Google Scholar 

  62. Suskind DL, Wahbeh G, Cohen SA, Damman CJ, Klein J, Braly K, et al. Patients perceive clinical benefit with the specific carbohydrate diet for inflammatory bowel disease. Dig Dis Sci. 2016;61:3255–60.

    Article  CAS  PubMed  Google Scholar 

  63. Vincenzi M, Paolini B, Del Ciondolo I, Pasquini E, Ceccarelli L, Gennai K, et al. Effects on symptoms and on nutritional adequacy of a low fodmaps diet and specific carbohydrate diet on inflammatory bowel disease. Double blind and randomized study. Preliminary Result Gastroenterol. 2016;150:S425.

    Google Scholar 

  64. Jarmakiewicz-Czaja S, Piątek D, Filip R. The influence of nutrients on inflammatory bowel diseases. J Nutr Metab. 2020;2020:2894169.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  65. Szilagyi A, Galiatsatos P, Xue X. Systematic review and meta-analysis of lactose digestion, its impact on intolerance and nutritional effects of dairy food restriction in inflammatory bowel diseases. Nutr J. 2016;15:67. 13 de

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  66. Jowett SL, Seal CJ, Phillips E, Gregory W, Barton JR, Welfare MR. Dietary beliefs of people with ulcerative colitis and their effect on relapse and nutrient intake. Clin Nutr. 2004;23:161–70.

    Article  PubMed  Google Scholar 

  67. Opstelten JL, Leenders M, Dik VK, Chan SSM, van Schaik FDM, Khaw K-T, et al. Dairy products, dietary calcium, and risk of inflammatory bowel disease: results from a European prospective cohort investigation. Inflamm Bowel Dis. 2016;22:1403–11.

    Article  PubMed  Google Scholar 

  68. Brasil Lopes M, Rocha R, Castro Lyra A, Rosa Oliveira V, Gomes Coqueiro F, Silveira Almeida N, et al. Restriction of dairy products; a reality in inflammatory bowel disease patients. Nutr Hosp. 2014;29:575–81.

    PubMed  Google Scholar 

  69. Bernstein CN, Ament M, Artinian L, Ridgeway J, Shanahan F. Milk tolerance in adults with ulcerative colitis. Am J Gastroenterol. 1994;89:872–7.

    CAS  PubMed  Google Scholar 

  70. Ahishali E, Akkus EE, Dolapcioglu C, Sayiner M, Arslan T, Yilmaz R, et al. Assessment of lactose intolerance in ulcerative colitis patients on remission. J Crohns Colitis. 2015;9:S351.

    Article  Google Scholar 

  71. Menezes C, Rocha R, Coqueiro F, Lopes M, Nunes P, Sales L, et al. Lactose intolerance in inflammatory bowel disease patients. J Crohns Colitis. 2013;7:S91.

    Article  Google Scholar 

  72. Jasielska M, Grzybowska-Chlebowczyk U. Lactose malabsorption and lactose intolerance in children with inflammatory bowel diseases. Gastroenterol Res Pract. 2019;2019:1–6.

    Article  Google Scholar 

  73. Eadala P, Matthews SB, Waud JP, Green JT, Campbell AK. Association of lactose sensitivity with inflammatory bowel disease-demonstrated by analysis of genetic polymorphism, breath gases and symptoms. Aliment Pharm Ther. 2011;34:735–46.

    Article  CAS  Google Scholar 

  74. Vernia P, Loizos P, Di Giuseppantonio I, Amore B, Chiappini A, Cannizzaro S. Dietary calcium intake in patients with inflammatory bowel disease. J Crohns Colitis. 2014;8:312–7.

    Article  PubMed  Google Scholar 

  75. Lopes M, Rocha R, Oliveira V, Coqueiro F, Menezes C, Silveira N, et al. Dairy food consumption by patients with inflammatory bowel disease. Inflamm Bowel Dis. 2012;18:S36.

    Article  Google Scholar 

  76. Silvennoinen J, Lamberg-Allardt C, Kärkkäinen M, Niemelä S, Lehtola J. Dietary calcium intake and its relation to bone mineral density in patients with inflammatory bowel disease. J Intern Med. 1996;240:285–92. noviembre de

    Article  CAS  PubMed  Google Scholar 

  77. Larussa T, Suraci E, Marasco R, Imeneo M, Abenavoli L, Luzza F. Self-prescribed dietary restrictions are common in inflammatory bowel disease patients and are associated with low bone mineralization. Medicina (Kaunas). 2019;20:507.

    Article  Google Scholar 

  78. Nolan-Clark D, Tapsell LC, Hu R, Han DY, Ferguson LR. Effects of dairy products on Crohn’s disease symptoms are influenced by fat content and disease location but not lactose content or disease activity status in a New Zealand population. J Am Diet Assoc. 2011;111:1165–72.

    Article  PubMed  Google Scholar 

  79. Vagianos K, Sexton K, Bernstein M, Hu P, Zhao K, Bernstein CN, et al. Dietary lactose consumption is associated with both increased symptoms and intestinal inflammation in IBD. Gastroenterology 2016;150:S41–2.

    Article  Google Scholar 

  80. Lewis JD, Abreu MT. Diet as a trigger or therapy for inflammatory bowel diseases. Gastroenterology. 2017;152:398–414.e6.

    Article  CAS  PubMed  Google Scholar 

  81. Liu X, Wu Y, Li F, Zhang D. Dietary fiber intake reduces risk of inflammatory bowel disease: result from a meta-analysis. Nutr Res. 2015;35:753–8.

    Article  PubMed  CAS  Google Scholar 

  82. Andersen V, Chan S, Luben R, Khaw K-T, Olsen A, Tjonneland A, et al. Fibre intake and the development of inflammatory bowel disease: a European prospective multi-centre cohort study (EPIC-IBD). J Crohns Colitis. 2018;12:129–36.

    Article  PubMed  Google Scholar 

  83. Anderson JL, Hedin CR, Benjamin JL, Koutsoumpas A, Ng SC, Hart AL, et al. Dietary intake of inulin-type fructans in active and inactive Crohn’s disease and healthy controls: a case-control study. J Crohns Colitis. 2015;9:1024–31.

    Article  PubMed  Google Scholar 

  84. Brotherton CS, Martin CA, Long MD, Kappelman MD, Sandler RS. Avoidance of fiber is associated with greater risk of crohn’s disease flare in a 6-month period. Clin Gastroenterol Hepatol. 2016;14:1130–6.

    Article  PubMed  Google Scholar 

  85. Godny L, Maharshak N, Reshef L, Goren I, Yahav L, Fliss-Isakov N, et al. Fruit consumption is associated with alterations in microbial composition and lower rates of pouchitis. J Crohns Colitis. 2019;13:1265–72.

    Article  CAS  PubMed  Google Scholar 

  86. Wedlake L, Slack N, Andreyev HJN, Whelan K. Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis. 2014;20:576–86.

    Article  PubMed  Google Scholar 

  87. Brotherton CS, Taylor AG, Bourguignon C, Anderson JG. A high-fiber diet may improve bowel function and health-related quality of life in patients with Crohn disease. Gastroenterol Nurs. 2014;37:206–16.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Tasson L, Canova C, Vettorato MG, Savarino E, Zanotti R. Influence of diet on the course of inflammatory bowel disease. Dig Dis Sci. 2017;62:2087–94.

    Article  CAS  PubMed  Google Scholar 

  89. Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N. Engl J Med. 1985;312:283–9.

    Article  CAS  PubMed  Google Scholar 

  90. Whalen KA, McCullough ML, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and Mediterranean diet pattern scores are inversely associated with biomarkers of inflammation and oxidative balance in adults. J Nutr. 2016;146:1217–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Kyaw MH, Moshkovska T, Mayberry J. A prospective, randomized, controlled, exploratory study of comprehensive dietary advice in ulcerative colitis: impact on disease activity and quality of life. Eur J Gastroenterol Hepatol. 2014;26:910–7.

    Article  CAS  PubMed  Google Scholar 

  92. Levenstein S, Prantera C, Luzi C, D’Ubaldi A. Low residue or normal diet in Crohn’s disease: a prospective controlled study in Italian patients. Gut. 1985;26:989–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Koga H, Iida M, Aoyagi K, Matsui T, Fujishima M. [Long-term efficacy of low residue diet for the maintenance of remission in patients with Crohn’s disease]. Nihon Shokakibyo Gakkai Zasshi. 1993;90:2882–8.

    CAS  PubMed  Google Scholar 

  94. Chiba M, Abe T, Tsuda H, Sugawara T, Tsuda S, Tozawa H, et al. Lifestyle-related disease in Crohn’s disease: relapse prevention by a semi-vegetarian diet. World J Gastroenterol. 2010;16:2484–95.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Chiba M, Tsuji T, Komatsu M. How to optimize effects of infliximab in inflammatory bowel disease: incorporation of a plant-based diet. Gastroenterology. 2020;158:1512.

    Article  PubMed  Google Scholar 

  96. Chiba M, Ishii H, Komatsu M. Recommendation of plant-based diets for inflammatory bowel disease. Transl Pediatr. 2019;8:23–7.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Chiba M, Tsuji T, Nakane K, Komatsu M. High amount of dietary fiber not harmful but favorable for Crohn disease. Perm J. 2015;19:58–61.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Chiba M, Nakane K, Tsuji T, Tsuda S, Ishii H, Ohno H, et al. Relapse prevention by plant-based diet incorporated into induction therapy for ulcerative colitis: a single-group trial. Perm J. 2019;23:18–220.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N. Engl J Med. 2018;378:e34.

    Article  CAS  PubMed  Google Scholar 

  100. Cárdeno A, Magnusson MK, Strid H, Alarcón de La Lastra C, Sánchez-Hidalgo M, Ohman L. The unsaponifiable fraction of extra virgin olive oil promotes apoptosis and attenuates activation and homing properties of T cells from patients with inflammatory bowel disease. Food Chem. 2014;161:353–60.

    Article  PubMed  CAS  Google Scholar 

  101. Lo C-H, Khalili H, Song M, Lochhead P, Burke KE, Richter JM, et al. Healthy lifestyle is associated with reduced mortality in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2021;19:87–95.e4.

    Article  PubMed  Google Scholar 

  102. Khalili H, Håkansson N, Chan SS, Chen Y, Lochhead P, Ludvigsson JF, et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies. Gut.2020;69:1697–44.

    Article  Google Scholar 

  103. Taylor L, Almutairdi A, Shommu N, Fedorak R, Ghosh S, Reimer RA, et al. Cross-sectional analysis of overall dietary intake and mediterranean dietary pattern in patients with Crohn’s disease. Nutrients. 2018;10:1761.

    Article  PubMed Central  CAS  Google Scholar 

  104. Papada E, Amerikanou C, Forbes A, Kaliora AC. Adherence to Mediterranean diet in Crohn’s disease. Eur J Nutr. 2020;59:1115–21.

    Article  PubMed  Google Scholar 

  105. Godny L, Reshef L, Pfeffer-Gik T, Goren I, Yanai H, Tulchinsky H, et al. Adherence to the Mediterranean diet is associated with decreased fecal calprotectin in patients with ulcerative colitis after pouch surgery. Eur J Nutr. 2020;59:3183–90.

    Article  CAS  PubMed  Google Scholar 

  106. Marlow G, Ellett S, Ferguson IR, Zhu S, Karunasinghe N, Jesuthasan AC, et al. Transcriptomics to study the effect of a Mediterranean-inspired diet on inflammation in Crohn’s disease patients. Hum Genomics. 2013;7:24.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  107. Morvaridi M, Jafarirad S, Seyedian SS, Alavinejad P, Cheraghian B. The effects of extra virgin olive oil and canola oil on inflammatory markers and gastrointestinal symptoms in patients with ulcerative colitis. Eur J Clin Nutr. 2020;74:891–9.

    Article  CAS  PubMed  Google Scholar 

  108. Jantchou P, Morois S, Clavel-Chapelon F, Boutron-Ruault M-C, Carbonnel F. Animal protein intake and risk of inflammatory bowel disease: the E3N prospective study. Am J Gastroenterol. 2010;105:2195–201.

    Article  CAS  PubMed  Google Scholar 

  109. Rashvand S, Somi MH, Rashidkhani B, Hekmatdoost A. Dietary protein intakes and risk of ulcerative colitis. Med J Islam Repub Iran. 2015;29:253.

    PubMed  PubMed Central  Google Scholar 

  110. Ge J, Han TJ, Liu J, Li JS, Zhang XH, Wang Y, et al. Meat intake and risk of inflammatory bowel disease: a meta-analysis. Turk J Gastroenterol J Turk Soc Gastroenterol. 2015;26:492–7.

    Article  Google Scholar 

  111. Albenberg L, Brensinger CM, Wu Q, Gilroy E, Kappelman MD, Sandler RS, et al. A diet low in red and processed meat does not reduce rate of Crohn’s disease flares. Gastroenterology. 2019;157:128–136. e5

    Article  PubMed  Google Scholar 

  112. Mills SC, Windsor AC, Knight SC. The potential interactions between polyunsaturated fatty acids and colonic inflammatory processes. Clin Exp Immunol. 2005;142:216–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. de Silva PS, Korzenik JR. Inflammatory bowel disease: a focus on the involvement of dietary fats. Int J Interferon Cytokine Mediat Res. 2014;6:19–25.

    Article  CAS  Google Scholar 

  114. Innis SM, Pinsk V, Jacobson K. Dietary lipids and intestinal inflammatory disease. J Pediatr. 2006;149(Suppl.):S89–96.

    Article  CAS  Google Scholar 

  115. Kuwabara A, Nakase H, Tsuji H, Shide K, Chiba T, Inagaki N, et al. Fat restriction is associated with impaired quality of life in patients with ulcerative colitis and Crohn’s disease. Ulcers. 2011. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L364545773.

  116. Leiper K, Woolner J, Mullan MM, Parker T, van der Vliet M, Fear S, et al. A randomised controlled trial of high versus low long chain triglyceride whole protein feed in active Crohn’s disease. Gut. 2001;49:790–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  117. Barnes EL, Nestor M, Onyewadume L, de Silva PS, Korzenik JR, DREAM Investigators. High dietary intake of specific fatty acids increases risk of flares in patients with ulcerative colitis in remission during treatment with aminosalicylates. Clin Gastroenterol Hepatol. 2017;15:1390–1396.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. John S, Luben R, Shrestha SS, Welch A, Khaw K-T, Hart AR. Dietary n-3 polyunsaturated fatty acids and the aetiology of ulcerative colitis: a UK prospective cohort study. Eur J Gastroenterol Hepatol. 2010;22:602–6.

    Article  CAS  PubMed  Google Scholar 

  119. Olendzki BC, Silverstein TD, Persuitte GM, Ma Y, Baldwin KR, Cave D. An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report. Nutr J. 2014;13:5.

    Article  PubMed  PubMed Central  Google Scholar 

  120. Konijeti GG, Kim N, Lewis JD, Groven S, Chandrasekaran A, Grandhe S, et al. Efficacy of the autoimmune protocol diet for inflammatory bowel disease. Inflamm Bowel Dis. 2017;23:2054–60.

    Article  PubMed  Google Scholar 

  121. Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut Oct de. 2004;53:1459–64.

    Article  CAS  Google Scholar 

  122. Bentz S, Hausmann M, Piberger H, Kellermeier S, Paul S, Held L, et al. Clinical relevance of IgG antibodies against food antigens in Crohn’s disease: a double-blind cross-over diet intervention study. Digestion 2010;81:252–64.

    Article  CAS  PubMed  Google Scholar 

  123. Gunasekeera V, Mendall MA, Chan D, Kumar D. Treatment of Crohn’s disease with an IgG4-guided exclusion diet: a randomized controlled trial. Dig Dis Sci. 2016;61:1148–57.

    Article  CAS  PubMed  Google Scholar 

  124. Rajendran N, Kumar D. Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease: a pilot study. Colorectal Dis. 2011;13:1009–13.

    Article  CAS  PubMed  Google Scholar 

  125. Jian L, Anqi H, Gang L, Litian W, Yanyan X, Mengdi W, et al. Food exclusion based on IgG antibodies alleviates symptoms in ulcerative colitis: a prospective study. Inflamm Bowel Dis. 2018;24:1918–25.

    Article  PubMed  Google Scholar 

  126. Chabane H, Doyen V, Bienvenu F, Adel-Patient K, Vitte J, Mariotte D, et al. Anti-food IgG assays: methods and clinical relevance of results. Position of the biology task force of the French society of allergy. Rev Fr Allergol. 2018;58:334–57.

    Article  Google Scholar 

  127. Stapel SO, Asero R, Ballmer-Weber BK, Knol EF, Strobel S, Vieths S, et al. Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report. Allergy. 2008;63:793–6.

    Article  CAS  PubMed  Google Scholar 

  128. Powell JJ, Thoree V, Pele LC. Dietary microparticles and their impact on tolerance and immune responsiveness of the gastrointestinal tract. Br J Nutr. 2007;98(Suppl 1):S59–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  129. Powell JJ, Faria N, Thomas-McKay E, Pele LC. Origin and fate of dietary nanoparticles and microparticles in the gastrointestinal tract. J Autoimmun. 2010;34:J226–233.

    Article  CAS  PubMed  Google Scholar 

  130. Lomer MCE, Hutchinson C, Volkert S, Greenfield SM, Catterall A, Thompson RPH, et al. Dietary sources of inorganic microparticles and their intake in healthy subjects and patients with Crohn’s disease. Br J Nutr. 2004;92:947–55.

    Article  CAS  PubMed  Google Scholar 

  131. Lomer MC, Harvey RS, Evans SM, Thompson RP, Powell JJ. Efficacy and tolerability of a low microparticle diet in a double blind, randomized, pilot study in Crohn’s disease. Eur J Gastroenterol Hepatol. 2001;13:101–6.

    Article  CAS  PubMed  Google Scholar 

  132. Lomer MCE, Grainger SL, Ede R, Catterall AP, Greenfield SM, Cowan RE. et al. Lack of efficacy of a reduced microparticle diet in a multi-centred trial of patients with active Crohn’s disease. Eur J Gastroenterol Hepatol. 2005;17:377–84.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

The authors’ responsibilities were as follows: C.S-M., N.B-T., L.A., I.R., A.M. and M.L.C. contributed to the design and drafted the manuscript. C.C., M.M., M.C., and I.B.: supervised and revised the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Clara Serrano-Moreno.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Serrano-Moreno, C., Brox-Torrecilla, N., Arhip, L. et al. Diets for inflammatory bowel disease: What do we know so far?. Eur J Clin Nutr 76, 1222–1233 (2022). https://doi.org/10.1038/s41430-021-01051-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-021-01051-9

Search

Quick links