Diets and Inflammatory Bowel Disease (IBD) Diet affects IBD by 3 mechanisms 1. Microbiome ( ↓ diversity) 2. Mucosal integrity, Short chain fatty acids (↑ permeability, ↓ mucosal thickness) 3. Immune response (↑ inflammatory markers) Key Points • Nutrition as complement therapy/bridge therapy to medical Rx → more research is needed • Effect of diet therapy CD > UC • Patient Experience: ~60% voters changed diet at some point, most self-directed → improvement in Sx, but not disease activity • There is no ONE diet recommended → all agree needs to be balanced, nutritious Table summarizes main diets discussed: • EEN (Exclusive Enteral Nutrition) - Elemental, semi-elemental or polymeric liquid formulas to provide 120 to 150% of the total daily recommended energy intake x 8-12 weeks (orally, NG tube); • CD-TREAT - Solid food-based diet that replicate the nutrients and food ingredients of EEN Partial Enteral Nutrition (PEN) - EN liquid formula to cover 25-50% of total daily requirements +regular meal • Crohn's Disease Exclusion Diet (CDED) - 3 phase whole-food diet+ PEN in declining amounts, with the last stage maintaining 25% of daily intake from PEN • Specific Carbohydrate Diet (SCD) - Exclusion of grains, milk products (except hard cheeses, fermented yogurt > 24 hours), processed/added sugars. Focuses on diverse fruits and veggies, nuts/nut butters, fish, aged cheeses, yogurts • IBD-Anti-inflammatory Diet (AID) - 3 Phase Diet derived from SCD: includes more prebiotic and probiotic foods • FODMAP - Eliminates poorly absorbed short-chain carbohydrates that may trigger abdominal bloating, abdominal pain, wind and diarrhea - Dr. Malorie Simons @DrMalSimons #Diets #Inflammatory #BowelDisease #IBD #Nutrition #comparison #table #management #treatment
