Abstract
Notes
Funding Source
The authors received no financial support for the research, authorship, and/or publication of this article.
Conflict of Interest
Raja Ali RA is an editorial board member of the journal but did not involve in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.
Author Contribution
Conceptualization, methodology, writing - original draft preparation: Shafiee NH. Writing-review and editing: Shafiee NH, Manaf ZA, Mokhtar NM, Raja Ali RA. Approval of final manuscripts: all authors.
Non-Author Contribution
We are grateful to Barbara Olendzki, RD MPH, Director of the Center for Applied Nutrition UMass Medical School for her willingness to share the modified version of IBD-AID phases to be included in this review (Table 1).
REFERENCES
Table 1.
Table 2.
Study (year) | Disease | Anti-inflammatory diet/food | Study design | No. of IBD patients | Study duration (wk) | Results on clinical outcomes |
---|---|---|---|---|---|---|
Ishikawa et al. (2003) [22] | UC | Fermented milk | Randomized clinical trial | 11 | 52 | Maintenance of remission and prevention of relapse |
Kato et al. (2004) [23] | UC | Fermented milk | Randomized placebo control trial | 20 | 12 | Induction of remission |
Matsuoka et al. (2018) [24] | UC | Fermented milk | Randomized double-blind study | 195 | 48 | No effect on maintenance |
Lorea Baroja et al. (2007) [25] | CD and UC | Yogurt | Open-label study | 20 | 4 | Induction and maintenance of remission |
Shadnoush et al. (2013) [26] | CD and UC | Yogurt | Interventional study | 86 | 8 | Maintenance of remission |
Nyman et al. (2020) [29] | UC | Oat bran | Randomized controlled study | 47 | 24 | No significant difference on relapse rate |
Hallert et al. (2003) [30] | UC | Oat bran | Randomized control pilot study | 22 | 12 | No signs of an increase in colitis relapse |
Kanauchi et al. (2003) [32] | UC | Germinated barley foodstuff | Open trial, multicenter | 21 | 24 | Decrease in clinical activity index for long-term administration |
Hanai et al. (2004) [33] | UC | Germinated barley foodstuff | Open-label, non-randomized trial | 59 | 52 | Decrease in the cumulative recurrence rate |
Faghfoori et al. (2014) [34] | UC | Germinated barley foodstuff | Open-label, randomized control trial | 46 | 8 | Increased maintenance in remission |
Brotherton et al. (2014) [35] | CD | Wheat bran cereal | Randomized controlled single-blinded trial | 4 | 4 | Increase in maintenance of remission |
Grimstad et al. (2011) [38] | UC | Salmon fillet | Interventional pilot study | 12 | 8 | Induction of remission |
Scaioli et al. (2018) [39] | UC | Fish oil | Placebo-controlled trial | 60 | 36 | Maintenance of remission |
Yasueda et al. (2016) [40] | CD | Omega-3 emulsified formulation | Open-label clinical trial | 6 | 4 | Decrease the disease activity |
Jones et al. (1985) [44] | CD | Unrefined carbohydrates | Controlled trial | 20 | 24 | Relapse of disease |
Ritchie et al. (1987) [45] | CD | Refined carbohydrates | Randomized prospective single-blind trial | 352 | 104 | No effects on relapse |
Schreiner et al. (2019) [46] | IBD | Gluten-free diet | Prospective cross-sectional study | 1,223 | - | No significant difference on disease activity |
Tasson et al. (2017) [51] | CD | Meat | Cross-sectional study | 103 | 52 | Relapse of disease |
Barnes et al. (2017) [52] | UC | Fatty acids | prospective, multicenter, observational study | 412 | - | Increase disease flares |
Prince et al. (2016) [54] | CD and UC | Low FODMAP diet | Case note review study | 88 | 6 | Decreased disease severity |
Cox et al. (2017) [55] | CD and UC | Low FODMAP diet | Randomized, double-blind, placebo-controlled, cross-over, re-challenge trial | 32 | 3 day | Worsened the gastrointestinal symptoms |
Saw et al. (2019) [57] | DSS-induced colitis mice | Vitamin E | Clinical trial | - | 20 day | Improved disease severity |
Table 3.
Table 4.
Table 5.
In general | ||
IBD | 1. Eat smaller meals or snacks at more frequent intervals (every 3 or 4 hours) [66,70]. | |
2. Eat a variety of foods based on local healthy eating guidelines [69]. | ||
Dietary fiber | ||
IBD | 1. Decrease the amount of fiber during a disease flare such as seeds, nuts, green leafy vegetables, and whole-grains [66,67,70]. | |
2. During periods of no symptoms, slowly reintroduce high-fiber foods one at a time in small amounts [66,70]. | ||
CD | 1. Consider limiting the intake of dietary fiber or fibrous foods for stricturing CD [69,70]. | |
UC | 1. A high-residue diet may be indicated in cases of ulcerative proctitis [67]. | |
Vegetables and fruits | ||
IBD | 1. Avoid vegetables that are gas-producing when the disease is active such as broccoli, cauliflower, cabbage [70]. | |
2. When experiencing a disease flare, cooked, pureed, and peeled fruits and vegetables are better-tolerated [66,70]. | ||
Milk and dairy-based foods | ||
IBD | 1. Maintain dairy product intake unless the intolerance develops [67]. | |
2. Limit or eliminate the intake of milk and milk products if patients do not digest dairy foods well, or are lactose intolerant [66,70]. | ||
High-fat foods | ||
IBD | 1. Limit fats and oils to less than 8 teaspoons per day [66]. | |
2. If patients have diarrhea or bloating, reduce the fatty, greasy or fried foods [70]. | ||
Carbohydrates | ||
IBD | 1. Reducing dietary fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) may reduce symptoms of IBD [67,70]. | |
Meat or protein-based foods | ||
IBD | 1. Choose the lean source of protein such as fish, chicken, eggs, or tofu as it is may be more tolerable [70]. | |
2. Avoid fatty, greasy or highly processed meats such as sausages, nuggets [66,70]. | ||
3. Tender, well-cooked meat prepared without added fat [66]. | ||
Beverages | ||
IBD | 1. Drink enough fluids (at least 8 cups each day) to avoid dehydration [66,70]. | |
2. Avoid high sugary drinks, sweet juices, caffeine, and alcohol when the disease is active [66,70]. | ||
Probiotics | ||
IBD | 1. Eat foods with added probiotics and prebiotics [66]. | |
CD | 1. Probiotics should not be used in the treatment of active disease [68,69]. | |
UC | 1. Probiotic therapy can be considered for patients with mild to moderate UC [68]. | |
Dietary supplements | ||
IBD | 1. Iron supplementation is recommended in all IBD patients when iron deficiency anemia is present [68,69]. | |
2. Calcium and vitamin D supplementation are encouraged for those on steroid therapy [69,70]. | ||
3. Folic acid supplementation for those treated with sulphasalazine [68]. | ||
CD | 1. Vitamin B12 supplementation with more than 20 cm distal ileum resection [68]. | |
IBD, inflammatory bowel disease; CD, Crohn’s disease; UC, ulcerative colitis.
Adapted from: clinical practice guidelines [66-69] and informal dietary suggestion [70]. American Dietetic Association (ADA) [66]; World Gastroenterology Organization (WGO) [67]; European Society for Clinical Nutrition and Metabolism (ESPEN)[68]; British Dietetic Association (BDA) [69]; Crohn’s and Colitis Foundation of America (CCFA) [70].