Diet strategy for patients with inflammatory bowel disease (IBD) with authoritative guideline recommendation table

Introduction Inflammatory bowel disease (IBD) is a non-specific, chronic, recurrent, inflammatory disease of the gastrointestinal tract of unknown etiology, mainly including ulcerative colitis (UC) and Crohn's disease (CD)
.

Diet plays an important role in the pathogenesis of IBD, and to explore its relationship with IBD, so as to formulate a reasonable diet plan, is of great significance to reduce the incidence and recurrence of IBD
.

This article summarizes potentially harmful/beneficial diets for IBD as described below
.

Potentially Harmful Diets for IBD: High-fat, high-protein, and high-sugar diets High-fat, high-protein, and high-sugar diets are damaging diets for IBD
.

In addition, the following diets may induce the occurrence and recurrence of IBD, or exacerbate the condition of IBD: indigestible crude fiber foods; raw seafood and raw milk; spicy foods; raw, cold and greasy foods
.

1.
High-fat, high-protein, and high-sugar diets Much epidemiological evidence suggests that excess fat intake is associated with IBD
.

The main sources of protein are meat, cheese, milk, fish, soy products and eggs, which may be associated with IBD
.

In addition, a large number of studies have shown that eating too much sugar is associated with IBD
.

2.
Crude fiber food Crude fiber food is difficult to digest, which may increase the load of intestinal digestion and absorption, and aggravate the condition of IBD
.

3.
Raw seafood and raw milk seafood are highly immunogenic.
In addition to increasing the load of intestinal digestion and absorption, raw seafood and river fresh fish such as fish can often cause obvious or even serious immune responses, thereby inducing or aggravating the disease
.

Therefore, no matter in the active period or the remission period, IBD patients should not eat raw seafood and river fish such as fish
.

Raw milk has strong immunogenicity, and contains lactose, rich protein and fat, which may induce or aggravate the symptoms of IBD patients
.

Therefore, IBD patients, especially active patients, should not drink raw milk
.

Patients in remission can try raw fresh milk cautiously and as appropriate
.

4.
Irritant food Spicy and irritating food will directly damage the mucous membrane of the digestive tract, and also stimulate the peristalsis and mucus secretion of the digestive tract, causing or aggravating abdominal pain and diarrhea
.

Therefore, IBD patients should not eat spicy food
.

5.
Raw, cold and greasy food IBD patients can easily cause gastrointestinal dysfunction by eating raw and cold food, which can induce or aggravate symptoms
.

Therefore, IBD patients, especially active patients, should not eat cold food and cold drinks
.

It is not strictly contraindicated for IBD patients in remission to eat raw fruit, but they should pay attention to the amount and speed of consumption
.

Potentially beneficial diets for IBD: Balanced, light, digestible diet There is evidence that the following diets can reduce the occurrence and recurrence of IBD, or alleviate the disease, and are beneficial for IBD: low-fat, low-sugar, moderate protein diet; moderate dietary fiber Diet; moderate vitamin diet; light and digestible diet
.

1.
Low-fat, low-sugar, moderate-protein diet Because IBD is closely related to a high-fat, high-protein, and high-sugar diet, patients should pay attention to reducing the intake of fat, protein, and sugar, thereby reducing the occurrence and recurrence of IBD
.

2.
Moderate amount of dietary fiber Dietary fiber is a polysaccharide that cannot be digested and absorbed by the gastrointestinal tract, nor can it produce energy
.

IBD patients should adjust their dietary fiber intake according to their specific conditions
.

For IBD patients with mild activity or remission, necessary dietary fiber can be eaten in moderation; for IBD patients with obvious inflammation and intestinal stenosis or penetrating lesions, they should eat a digestible low-fiber diet and avoid foods rich in dietary fiber.
Foods with dietary fiber
.

3.
Appropriate vitamin diet IBD patients should supplement vitamins as appropriate according to the type and degree of vitamin deficiency, and pay attention to the following: ① receive sufficient sunlight; ② eat foods rich in vitamin D (such as sea fish, animal liver, egg yolk, etc.
)
.

However, some foods that are also rich in high fiber or high fat may not be suitable for IBD patients, and they should be selected according to their tolerance to food; ③ If necessary, vitamin D preparations should be supplemented under the guidance of a doctor
.

4.
Light and easy-to-digest diet Because IBD, especially CD patients, have different degrees of abnormal digestive and absorption functions of the digestive tract, they should avoid eating greasy food cooked by frying, and should eat light and digestible food cooked by steaming
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International Organization for the Study of Inflammatory Bowel Disease: Dietary Guidelines for Patients with IBD The International Organization for the Study of Inflammatory Bowel Disease has established an expert panel to publish a dietary guideline for patients with IBD that focuses on the best dietary patterns to control and prevent recurrence of IBD
.

With the exception of pasteurized dairy products, the panel reached consensus on the role of all potentially harmful/beneficial foods mentioned in the literature for IBD, as follows
.

References: [1] Chinese Medical Association Enteral and Parenteral Nutrition Branch, Chinese Medical Education Association Inflammatory Bowel Disease Professional Committee.
Chinese Consensus on Nutritional Diagnosis and Treatment of Inflammatory Bowel Disease [J].
Chinese Journal of Digestive Diseases and Imaging (Electronic Edition) , 2021,11(01):8-15.
[2] Li Xiaoyu, Miao Yinglei.
Effects of diet on inflammatory bowel disease[J].
Parenteral and Enteral Nutrition, 2014,21(02):123-125+ 128.
[3] Li Mingsong, Shi Hanping, Yang Hua.
Expert advice on dietary management of inflammatory bowel disease in China [J].
Chinese Journal of Digestive Diseases and Imaging (Electronic Edition), 2021,11(03):97-105.
[4 ] Levine A, Rhodes JM, Lindsay JO, et al.
Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases[J].
Clin Gastroenterol Hepatol.
2020 May;18(6):1381-1392.
doi: 10.
1016/ j.
cgh.
2020.
01.
046.
Submission email: tougao@medlive.
cn