Diet and Inflammatory Bowel Disease: What Quality Standards Should Be Applied in Clinical and Laboratory Studies?

Mol Nutr Food Res. 2021 Mar;65(5):e2000514. doi: 10.1002/mnfr.202000514. Epub 2021 Feb 22.

Abstract

Many patients suffering from inflammatory bowel disease (IBD) follow restrictive diets, as many respective recommendations circulate. Efforts are made to evaluate and summarize the published information, for example, in a recent consensus manuscript by the International Organization for the Study of IBD (IOIBD). However, the standards that should be applied to make claims about dietary effects are poorly defined. In this manuscript, the scientific basis of recommendations for nutritional interventions in IBD is analyzed. Epidemiological evidence on diet in IBD is always biased by numerous factors, and the number of robust dietary intervention studies is limited due to methodological difficulties. Therefore, animal models are used to test hypotheses with respect to dietary factors and intestinal inflammation. Naturally, animal models have limitations, and knowledge of key characteristics of colitis animal models is crucial to understand their advantages and disadvantages. In recent years the important role of the microbiota for IBD and dietary factors has been discovered. Microbiota data are added to many publications on IBD and nutrition. The quality of those data varies largely. Subsequently, quality standards for microbiota analyses also are discussed. Finally, quality requirements to be applied on recommendations for dietary changes in patients with IBD are suggested.

Keywords: animal experiments; diet interventions; diet recommendations; inflammatory bowel disease; quality criteria.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic / standards*
  • Colitis / chemically induced
  • Colitis / diet therapy*
  • Colitis / microbiology
  • Diet
  • Disease Models, Animal*
  • Gastrointestinal Microbiome
  • Humans
  • Inflammatory Bowel Diseases / diet therapy*
  • Inflammatory Bowel Diseases / etiology