Nutritional Treatment in Crohn's Disease

Abstract

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) which can affect any part of the whole gastrointestinal tract (from mouth to anus). Malnutrition affects 65-75% of CD patients, and it is now well acknowledged that diet is of paramount importance in the management of the disease. In this review, we would like to highlight the most recent findings in the field of nutrition for the treatment of CD. Our analysis will cover a wide range of topics, from the well-established diets to the new nutritional theories, along with the recent progress in emerging research fields, such as nutrigenomics.

Keywords: Crohn’s disease; enteral nutrition; inflammatory bowel disease; low FODMAP diet; nutrigenomics; parenteral nutrition; specific carbohydrate diet.

Figure 1

Synoptic view summarizing the different dietary regimens for the treatment of CD.

Figure 2

Suggested food supplements for the treatment of CD.

Figure 3

Nutrigenomics: effects of food on the modulation of gene expression and their influence on CD evolution. Abbreviations: EGCG, EpiGalloCatechin Gallate; STAT3, Signal Transducer and Activator of Transcription 3; SCFAs, Short-Chain Fatty Acids; FFAR2, Free Fatty Acid Receptor 2 gene; IBD, Inflammatory Bowel Disease; SNPs, Single-Nucleotide Polymorphism; OCTN1, Sodium-Dependent Organic Cation Transporter gene; TXNIP, Thioredoxin-Interacting Protein; NF-κB, Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B cells.

Figure 4

Effects of genetic variation on CD onset and outcomes. Abbreviations: IBD, Inflammatory Bowel Disease; PPAR-γ Peroxisome proliferator-activated receptor gamma; miR-595, MicroRNA 595; miR-1246, MicroRNA 1246; BCMO1, β,β-carotene-15,15′-monooxygenase 1; FFAR2, Free Fatty Acid Receptor 2; FADS1, Fatty Acid Desaturase 1; FADS2, Fatty Acid Desaturase 2; PPARA, Peroxisome Proliferator Activated Receptor Alpha; PPARG, Peroxisome Proliferator-Activated Receptor Gamma; XRCC1, X-ray Repair Cross Complementing 1; SCD1, Stearoyl-CoA Desaturase-1; LC-PUFA-omega-3 and omega-6, Long Chain Polyunsaturated Fatty Acids-omega-3 and omega-6; FUT2, Fucosyltransferase 2.