Diet and Nutrition in Inflammatory Bowel Disease: Current Evidence and Therapeutic Strategies
Abstract
Background. Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are chronic immune-mediated disorders involving genetic susceptibility, environmental factors, the intestinal microbiota and mucosal immune responses. Diet may influence disease risk and inflammation, while IBD can adversely affect nutritional status. Aim. This review aimed to summarize current evidence on the role of diet and nutrition in IBD, focusing on dietary patterns and disease risk, dietary interventions, enteral nutrition and nutritional deficiencies. Materials and Methods. A narrative literature review was conducted using PubMed/MEDLINE. Clinical guidelines, systematic reviews, meta-analyses, randomized trials and relevant prospective studies were included, with preference given to recent evidence. Results. Dietary patterns may influence IBD risk. Higher consumption of ultra-processed foods has been associated with increased risk, whereas fiber-rich, minimally processed patterns appear favorable. Exclusive enteral nutrition has an established role in pediatric Crohn’s disease. The Crohn’s Disease Exclusion Diet combined with partial enteral nutrition is supported by randomized trials, while a Mediterranean-style diet represents a less restrictive approach with potential benefits. A low-FODMAP diet may improve persistent functional gastrointestinal symptoms in patients with quiescent IBD, but should not be considered an anti-inflammatory treatment. Malnutrition, iron deficiency and other micronutrient deficiencies remain important clinical concerns requiring screening and correction. Conclusions. Diet and nutrition should be considered an integral part of comprehensive IBD management. Dietary strategies should be individualized according to disease activity, phenotype, nutritional status and symptoms, while unnecessary restrictions should be avoided. Nutritional interventions should complement, rather than replace, established medical treatment.