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Review
. 2019 May 8;11(5):1033.
doi: 10.3390/nu11051033.

Implications of the Westernized Diet in the Onset and Progression of IBD

Fernando Rizzello  1 , Enzo Spisni  2 , Elisabetta Giovanardi  3 , Veronica Imbesi  4 , Marco Salice  5 , Patrizia Alvisi  6 , Maria Chiara Valerii  7   8 , Paolo Gionchetti  9
Affiliations
Review

Implications of the Westernized Diet in the Onset and Progression of IBD

Fernando Rizzello et al. Nutrients. .

Abstract

Inflammatory bowel diseases (IBD) are currently considered multifactorial pathologies in which various combined environmental factors act on a genetic background, giving rise to a chronic inflammation of the gastrointestinal tract. Among the various environmental factors, it now seems clear that the diet plays the major role in IBD onset and progression. Several clinical studies have attempted to understand the impact of diet in the development and progression of these diseases in order to establish useful guidelines for their management. However, the modest and sometimes contradictory results did not lead to the definition of shared dietary suggestions. On the other hand, food fads and recommendations based on anecdotal episodes are often followed by IBD patients to improve their diet. This review provides a critical overview of existing data on the role of diet as a risk factor for IBD. The methodology used was that of analyzing the results of clinical studies conducted on diet and IBD over the last 12 years through PubMed, as well as analyzing the most relevant studies on nutrients and their possible roles in IBD through the knowledge of the mechanisms by which they can modulate the microbiota or the intestinal physiology.

Keywords: Inflammatory Bowel Disease (IBD); Mediterranean Diet; Nutritional Approach; Western-style Diet (WSD).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Factors implicated in the modulation of the microbiota ecology (A) and complex microbiota interactions with the gastrointestinal physiology (B). PYY, Peptide YY; GLP-1, Glucagon-like peptide-1; CCK, Cholecystokinin; GIP, Gastric inhibitory polypeptide; 5-HT, 5-hydroxytryptamine or Serotonin.
Figure 2
Figure 2
Variation in average food consumption of the population in Italy, one of the countries where the Mediterranean diet was initially discovered, from the end of the 1800s to the early 2000s. The basis of comparison (100%) is the period 1861–1871. Data source: Italian National Research Institute for Food and Nutrition (INRAN), 2013.
Figure 3
Figure 3
Comparison between the Mediterranean diet (upper) and the Western-style diet (lower) pyramids. The Mediterranean diet pyramid is inspired by the eating habits of Greece, Southern Italy, and Spain before 1950s. The principal aspects of this diet include high consumption of fruits, vegetables, unrefined cereals, legumes and olive oil, moderate to high consumption of fish, moderate consumption of dairy products and low consumption of non-fish meat.
Figure 4
Figure 4
A possible diet for IBD: dietary foods and factors potentially affecting positively or negatively host intestinal barrier, immunity and microbioma in IBD patients.
See this image and copyright information in PMC

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