Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2016; 22(3): 895-905
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.895
Diet and nutritional factors in inflammatory bowel diseases
Danuta Owczarek, Tomasz Rodacki, Renata Domagała-Rodacka, Dorota Cibor, Tomasz Mach
Danuta Owczarek, Renata Domagała-Rodacka, Dorota Cibor, Tomasz Mach, Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, 31-531 Cracow, Poland
Tomasz Rodacki, Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 30-688 Cracow, Poland
Author contributions: Owczarek D and Rodacki T designed the paper, searched and analyzed the literature, drafted and revised the paper, approved the final version; Domagała-Rodacka R wrote the tables, drafted and revised the paper, approved the final version; Cibor D and Mach T searched and analyzed the literature, drafted and revised the paper, approved the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Danuta Owczarek, MD, PhD, Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, 5 Śniadeckich St., 31-531 Cracow, Poland. owczarek@su.krakow.pl
Telephone: +48-12-4247340 Fax: +48-12-4247380
Received: June 26, 2015
Peer-review started: June 27, 2015
First decision: August 31, 201
Revised: October 14, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: January 21, 2016
Processing time: 203 Days and 8.8 Hours

Inflammatory bowel disease (IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.

Keywords: Crohn’s disease, Diet, Nutrition, Supplementation, Ulcerative colitis

Core tip: The role of dietary factors in inflammatory bowel diseases (IBD) development seems to be underestimated although approximately 70% of IBD patients are known to employ elimination diets while in remission, affecting their social and family life. We would like to draw attention to this growing problem. The objective of our paper is to present up to date information regarding the effect of diet on IBD morbidity and course, together with the effect of IBD on the nutritional status of patients.