Review article: Evidence‐based dietary management of inflammatory bowel disease,Alimentary Pharmacology & Therapeutics

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Review article: Evidence‐based dietary management of inflammatory bowel disease
Alimentary Pharmacology & Therapeutics ( IF 6.6 ) Pub Date : 2024-08-22 , DOI: 10.1111/apt.18214
Peter R Gibson ₁ , C K Yao ₁ , Emma P Halmos ₁

Affiliation

SummaryBackgroundDietary management of patients with inflammatory bowel disease (IBD) involves more than defining a therapeutic diet. The profusion of ‘expert advice’ is not necessarily built on evidence.AimsTo provide evidence‐based guidance on all clinically relevant aspects of nutritional and dietary management of patients with IBD.MethodsA comprehensive review of the published literature was made.ResultsFour pillars of management should be considered in all patients. First, nutritional status should be optimised, since myopenia and visceral obesity are associated with poorer outcomes, which can be improved with attention to their correction. Accurate point‐of‐care measurement of body composition is advocated to identify problems, guide interventions and monitor outcomes. Second, exclusive enteral nutrition and the Crohn's Disease Exclusion Diet with partial enteral nutrition in reducing intestinal inflammation in patients with Crohn's disease have sufficient evidence to be advocated. Multiple other dietary approaches, while promising, have insufficient evidence to be recommended. Third, dietary approaches are important in symptomatic control in many non‐inflammatory scenarios. Finally, guidance on following a healthy diet is fundamental to the general health of patients. Multiple approaches are advocated, but the optimal strategy is unclear. The precarious nutritional status of patients with IBD together with the risks of nutritional inadequacy and maladaptive eating behaviours associated with restrictive diets dictate involvement of expert dietitians in assessment and personalised delivery of dietary interventions.ConclusionsFour pillars of nutritional management require specific assessment and interventional strategies that should be chosen by evidence. Optimal delivery requires the skills of a specialised dietitian.

中文翻译：

评论文章：炎症性肠病的循证饮食管理

摘要背景炎症性肠病 (IBD) 患者的饮食管理不仅仅涉及定义治疗饮食。大量的“专家建议”不一定建立在证据的基础上。旨在为 IBD 患者营养和饮食管理的所有临床相关方面提供循证指导。方法对已发表的文献进行了全面回顾。结果管理的四大支柱应所有患者均应考虑。首先，应优化营养状况，因为肌少和内脏肥胖与较差的预后相关，通过注意纠正可以改善营养状况。提倡对身体成分进行准确的护理点测量，以发现问题、指导干预措施和监测结果。其次，单纯肠内营养和部分肠内营养的克罗恩病排除饮食在减少克罗恩病患者肠道炎症方面有足够的证据值得提倡。其他多种饮食方法虽然有希望，但没有足够的证据值得推荐。第三，饮食方法对于许多非炎症情况下的症状控制很重要。最后，遵循健康饮食的指导对于患者的整体健康至关重要。提倡多种方法，但最佳策略尚不清楚。 IBD 患者不稳定的营养状况，以及与限制性饮食相关的营养不足和适应不良饮食行为的风险，要求营养师专家参与评估和个性化饮食干预。结论营养管理的四大支柱需要具体的评估和干预策略，这些策略应通过证据来选择。最佳分娩需要专业营养师的技能。

更新日期：2024-08-22

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