Nutritional Therapies and Their Influence on the Intestinal Microbiome in Pediatric Inflammatory Bowel Disease

Lara Hart; Charlotte M Verburgt; Eytan Wine; Mary Zachos; Alisha Poppen; Mallory Chavannes; Johan Van Limbergen; Nikhil Pai

doi:10.3390/nu14010004

Nutritional Therapies and Their Influence on the Intestinal Microbiome in Pediatric Inflammatory Bowel Disease

Nutrients. 2021 Dec 21;14(1):4. doi: 10.3390/nu14010004.

Authors

Lara Hart^{1

2}, Charlotte M Verburgt^{3

4

5}, Eytan Wine⁶, Mary Zachos^{1

2}, Alisha Poppen⁷, Mallory Chavannes⁸, Johan Van Limbergen^{3

4

9}, Nikhil Pai^{1

2

10

11}

Affiliations

¹ Department of Paediatrics, Division of Paediatric Gastroenterology & Nutrition, McMaster University, Hamilton, ON L8N 3Z5, Canada.
² McMaster Children's Hospital, Hamilton, ON L8N 3Z5, Canada.
³ Department of Pediatric Gastroenterology and Nutrition, Amsterdam University Medical Centers, Emma Children's Hospital, 1105 AZ Amsterdam, The Netherlands.
⁴ Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
⁵ Amsterdam Reproduction & Development Research Institute, Amsterdam University Medical Centers, Emma Children's Hospital, 1105 AZ Amsterdam, The Netherlands.
⁶ Edmonton Paediatric IBD Clinic, Division of Paediatric Gastroenterology and Nutrition, Departments of Paediatrics & Physiology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
⁷ College of Medicine and Health, University College Cork, T12 K8AF Cork, Ireland.
⁸ Department of Paediatrics, Division of Paediatric Gastroenterology and Nutrition, Children's Hospital of Los Angeles, Los Angeles, CA 90027, USA.
⁹ Department of Paediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
¹⁰ Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8N 3Z5, Canada.
¹¹ Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON L8N 3Z5, Canada.

Abstract

Inflammatory bowel disease (IBD) is a chronic, autoimmune disorder of the gastrointestinal tract with numerous genetic and environmental risk factors. Patients with Crohn's disease (CD) or ulcerative colitis (UC) often demonstrate marked disruptions of their gut microbiome. The intestinal microbiota is strongly influenced by diet. The association between the increasing incidence of IBD worldwide and increased consumption of a westernized diet suggests host nutrition may influence the progression or treatment of IBD via the microbiome. Several nutritional therapies have been studied for the treatment of CD and UC. While their mechanisms of action are only partially understood, existing studies do suggest that diet-driven changes in microbial composition and function underlie the diverse mechanisms of nutritional therapy. Despite existing therapies for IBD focusing heavily on immune suppression, nutrition is an important treatment option due to its superior safety profile, potentially low cost, and benefits for growth and development. These benefits are increasingly important to patients. In this review, we will describe the clinical efficacy of the different nutritional therapies that have been described for the treatment of CD and UC. We will also describe the effects of each nutritional therapy on the gut microbiome and summarize the strength of the literature with recommendations for the practicing clinician.

Keywords: CD; CD-TREAT; CDED; EEN; FODMAP; IBD; Mediterranean; PEN; SCD; UC; UCED; diet; microbiome; nutrition.

Publication types

Review

MeSH terms

Child
Diet
Disease Management
Disease Susceptibility
Enteral Nutrition / methods
Gastrointestinal Microbiome*
Humans
Inflammatory Bowel Diseases / diagnosis
Inflammatory Bowel Diseases / diet therapy*
Inflammatory Bowel Diseases / etiology
Nutrition Therapy / methods*
Randomized Controlled Trials as Topic
Risk Factors
Treatment Outcome