Diet and risk of inflammatory bowel disease

Medical Department, Viborg Regional Hospital, Viborg, Denmark.
Digestive and Liver Disease (Impact Factor: 2.96). 11/2011; 44(3):185-94. DOI: 10.1016/j.dld.2011.10.001
Source: PubMed


A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses.
To review current knowledge on dietary risk factors for inflammatory bowel disease.
The PubMed, Medline and Cochrane Library were searched for studies on diet and risk of inflammatory bowel disease.
Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case-control studies are encumbered with methodological problems. Prospective studies on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty acids may be protective. No effect was found of intake of dietary fibres, sugar, macronutrients, total energy, vitamin C, D, E, Carotene, or Retinol (vitamin A) on risk of ulcerative colitis. No prospective data was found on risk related to intake of fruits, vegetables or food microparticles (titanium dioxide and aluminium silicate).
A diet high in protein, particular animal protein, may be associated with increased risk of inflammatory bowel disease and relapses. N-6 polyunsaturated fatty acids may predispose to ulcerative colitis whilst n-3 polyunsaturated fatty acid may protect. These results should be confirmed in other countries and in younger subjects before dietary counselling is recommended in high risk subjects.

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    • "The reduced generation of arachidonic acid–derived mediators that accompanies fish oil consumption has led to the hypothesis that fish oil is anti-inflammatory and may be useful in preventing or treating inflammatory conditions [156]. As mentioned previously, arachidonic acid may promote intestinal inflammation by regulating the inflammatory response, leading to high levels of cytokines, eicosanoids, free radicals, PGE, thromboxanes, and leukotrienes [157]. Therefore, the reduction of arachidonic acid that occurs after dietary omega-3 PUFA consumption may be the main mechanism behind the anti-IBD effects of omega-3s. "
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    ABSTRACT: The purpose of this review is to provide an overview of the effects that natural products have on inflammatory bowel disease (IBD) and to provide insight into the relationship between these natural products and cytokines modulation. More than 100 studies from the past 10 years were reviewed herein on the therapeutic approaches for treating IBD. The natural products having anti-IBD actions included phytochemicals, antioxidants, microorganisms, dietary fibers, and lipids. The literature revealed that many of these natural products exert anti-IBD activity by altering cytokine production. Specifically, phytochemicals such as polyphenols or flavonoids are the most abundant, naturally occurring anti-IBD substances. The anti-IBD effects of lipids were primarily related to the n-3 polyunsaturated fatty acids. The anti-IBD effects of phytochemicals were associated with modulating the levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1, IL-6, inducible nitric oxide synthase, and myeloperoxide. The anti-IBD effects of dietary fiber were mainly mediated via peroxisome proliferator-activated receptor-γ, TNF-α, nitric oxide, and IL-2, whereas the anti-IBD effects of lactic acid bacteria were reported to influence interferon-γ, IL-6, IL-12, TNF-α, and nuclear factor-κ light-chain enhancer of activated B cells. These results suggest that the anti-IBD effects exhibited by natural products are mainly caused by their ability to modulate cytokine production. However, the exact mechanism of action of natural products for IBD therapy is still unclear. Thus, future research is needed to examine the effect of these natural products on IBD and to determine which factors are most strongly correlated with reducing IBD or controlling the symptoms of IBD.
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