Nutrition in inflammatory bowel disease : Current Opinion in Clinical Nutrition & Metabolic Care (original) (raw)

Review Article

Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

Correspondence to Miquel A. Gassull, MD, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet, s/n E-08916 Badalona, Catalonia, Spain. Tel and fax: +34 93 497 8951; e-mail: [email protected]

Abbreviations

BMD: bone mineral density

DEXA: dual-energy X-ray absorptiometry

5-HT: 5-hydroxytryptamine

IBD: inflammatory bowel disease

IGF-1: insulin-like growth factor-1

NFκB: nuclear factor kappa B

PEM: protein-energy malnutrition

PUFA: n-3 polyunsaturated fatty acids

REE: resting energy expenditure

SCFA: short-chain fatty acids

TGF-β: transforming growth factor-β

TNBS: trinitrobenzene sulphonic acid

Abstract

Nutritional derangements are frequent in inflammatory bowel disease. In the past year significant work has been published examining the mechanisms of impaired food intake in animal models of inflammatory bowel disease, which allow a better understanding of these processes. Data from the same laboratory have shed further light on the relative role of underfeeding and inflammation on the growth retardation associated with intestinal inflammation. Other studies have provided further data on the risk factors and predictive biomarkers of bone loss in patients with inflammatory bowel disease. The potential role of enteral nutrition as primary therapy for Crohn's disease is particularly addressed in this review. Recent contributions to the field emphasized the special importance of this modality of therapy in paediatric patients. The possible mechanisms for such a therapeutic action are not well understood. Other nutrients may have a therapeutic potential in inflammatory bowel disease. In particular, recent data on the in-vivo anti-inflammatory actions of butyrate merit special mention. Finally, novel nutritional therapeutic strategies for inflammatory bowel disease, such as transforming growth factor-beta2-enriched enteral feeding, or hydrothermally processed cereals have recently been explored.