The role of a plant-based diet in the pathogenesis, etiology and management of the inflammatory bowel diseases

ABSTRACT

Introduction: Inflammatory Bowel Disease (IBD) carries a significant burden on an individual’s quality-of-life and on the healthcare system. The majority of patients use dietary modifications to manage their symptoms, despite limited research to support these changes. There is emerging data that a plant-based diet will be of benefit to IBD patients.

Areas covered: A literature review on the pathogenesis and potential benefits of dietary management of IBD.

Expert opinion: A Westernized diet has been associated with IBD risk and relapse; hence a plant-based diet may be of benefit to IBD patients through reducing inflammation and restoring symbiosis. Dietary therapy can be an important adjunct therapy, however, better quality studies are still required.

KEYWORDS:

• Inflammatory bowel disease
• ulcerative colitis
• crohn’s disease
• diet
• plant-based diet
• vegetarian diet
• gut microbiome
• short chain fatty acids

Article Highlights

• Increasing worldwide prevalence of Inflammatory Bowel Disease (IBD) represents a growing public health concern; particularly in countries adopting a Westernized diet as this diet correlates to an increased risk of IBD.

• A plant-based diet high in dietary fiber has been associated with a favorable shift in the gut microbiota, Short Chain Fatty Acid (SCFA) levels and greater diversity whereas typical IBD microbiota is associated with a decrease in species richness and diversity (dysbiosis), reduced SCFA levels and an increase in potential toxic metabolites.

• Future research should focus on dietary interventions that are anti-inflammatory and have the potential to restore symbiosis in the longer term. Good quality RCT study designs are needed to review the effects of a plant-based diet in IBD.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper has not been funded