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. 2024 Jun 3;18(6):920-942.
doi: 10.1093/ecco-jcc/jjad204.

The Impact of Dietary Interventions on the Microbiota in Inflammatory Bowel Disease: A Systematic Review

Cheenie Nieva  1   2   3 , Jennifer Pryor  1   2   3 , Georgina M Williams  1   2   3 , Emily C Hoedt  1   2   3 , Grace L Burns  1   2   3 , Guy D Eslick  1   2 , Nicholas J Talley  1   2   3 , Kerith Duncanson  1   2   3 , Simon Keely  1   2   3
Affiliations

The Impact of Dietary Interventions on the Microbiota in Inflammatory Bowel Disease: A Systematic Review

Cheenie Nieva et al. J Crohns Colitis. .

Abstract

Background and aims: Diet plays an integral role in the modulation of the intestinal environment, with the potential to be modified for management of individuals with inflammatory bowel disease [IBD]. It has been hypothesised that poor 'Western-style' dietary patterns select for a microbiota that drives IBD inflammation and, that through dietary intervention, a healthy microbiota may be restored. This study aimed to systematically review the literature and assess current available evidence regarding the influence of diet on the intestinal microbiota composition in IBD patients, and how this may affect disease activity.

Methods: MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library were searched from January 2013 to June 2023, to identify studies investigating diet and microbiota in IBD.

Results: Thirteen primary studies met the inclusion criteria and were selected for narrative synthesis. Reported associations between diet and microbiota in IBD were conflicting due to the considerable degree of heterogeneity between studies. Nine intervention studies trialled specific diets and did not demonstrate significant shifts in the diversity and abundance of intestinal microbial communities or improvement in disease outcomes. The remaining four cross-sectional studies did not find a specific microbial signature associated with habitual dietary patterns in IBD patients.

Conclusions: Diet modulates the gut microbiota, and this may have implications for IBD; however, the body of evidence does not currently support clear dietary patterns or food constituents that are associated with a specific microbiota profile or disease marker in IBD patients. Further research is required with a focus on robust and consistent methodology to achieve improved identification of associations.

Keywords: Inflammatory bowel disease; diet; microbiome.

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Conflict of interest statement

CN, JP, ECH, GMW, GDE, GLB and KD and have no disclosures to report. NJT reports personal fees from Allakos, Aviro Health, from Antara Life Sciences, Arlyx, Bayer, Danone, Planet Innovation, Takeda, Viscera Labs, twoXAR, Viscera Labs, Dr Falk Pharma, Censa, Cadila Pharmaceuticals, Progenity, Sanofi-aventis, Glutagen, ARENA Pharmaceuticals, IsoThrive, BluMaiden, non-financial support from HVN National Science Challenge NZ, and research collaboration with Alimetry outside the submitted work. NJT has a patent ‘Diagnostic marker for functional gastrointestinal disorders’ [PCT/AU2022/050556 international publication number -WO2022256861A1], a patent Licensing Questionnaires Talley Bowel Disease Questionnaire licensed to Mayo/Talley, and copyright, Nepean Dyspepsia Index [NDI] 1998; editorial: Medical Journal of Australia [Emeritus Editor in Chief], Up to Date [Section Editor], Precision and Future Medicine, Sungkyunkwan University School of Medicine, South Korea, Med [Journal of Cell Press]. NJT participates in committees: MBS Review Taskforce [2016-2020], NHMRC Principal Committee, Research Committee [2016-2021], NHMRC Council [2021-2024] Asia Pacific Association of Medical Journal Editors [APAME] [President]. NJT community and patient advocacy groups and advisory board: IFFGD [International Foundation for Functional GI Disorders]. SK reports consultancy and positions held on advisory boards for: Gossamer Bio [Scientific Advisory Board], Anatara Lifescience [Scientific Advisory Board], Microba Life Science [consultancy], and Immuron [consultancy].

Figures

Figure 1
Figure 1
Flow diagram depicting records identified, included, and excluded for review and the reasons for exclusion.
Figure 2
Figure 2
Schematic representation, summarising significant changes in symptoms or quality of life [blue] and microbiota diversity and relative abundances [purple] found in IBD patients post-dietary intervention [green] trial. IBD, inflammatory bowel disease; FODMAP, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; QoL, quality of life; sIgA, serum immunoglobulin A; IBS, irritable bowel syndrome. Created with BioRender.com.
See this image and copyright information in PMC

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