To Fiber or Not to Fiber: The Swinging Pendulum of Fiber Supplementation in Patients with Inflammatory Bowel Disease

Nutrients. 2023 Feb 21;15(5):1080. doi: 10.3390/nu15051080.

Abstract

Evidence-based dietary guidance around dietary fiber in inflammatory bowel disease (IBD) has been limited owing to insufficient reproducibility in intervention trials. However, the pendulum has swung because of our increased understanding of the importance of fibers in maintaining a health-associated microbiome. Preliminary evidence suggests that dietary fiber can alter the gut microbiome, improve IBD symptoms, balance inflammation, and enhance health-related quality of life. Therefore, it is now more vital than ever to examine how fiber could be used as a therapeutic strategy to manage and prevent disease relapse. At present, there is limited knowledge about which fibers are optimal and in what form and quantity they should be consumed to benefit patients with IBD. Additionally, individual microbiomes play a strong role in determining the outcomes and necessitate a more personalized nutritional approach to implementing dietary changes, as dietary fiber may not be as benign as once thought in a dysbiotic microbiome. This review describes dietary fibers and their mechanism of action within the microbiome, details novel fiber sources, including resistant starches and polyphenols, and concludes with potential future directions in fiber research, including the move toward precision nutrition.

Keywords: dietary fiber; inflammatory bowel disease; novel fiber sources; prebiotic.

Publication types

  • Review

MeSH terms

  • Dietary Fiber / therapeutic use
  • Dietary Supplements
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Quality of Life*
  • Reproducibility of Results

Substances

  • Dietary Fiber

Grants and funding

This research received no external funding.