Diet, Gut Microbiome and Epigenetics: Emerging Links with Inflammatory Bowel Diseases and Prospects for Management and Prevention

被引:127
作者
Aleksandrova, Krasimira [1 ]
Romero-Mosquera, Beatriz [2 ]
Hernandez, Vicent [2 ]
机构
[1] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nutr Immun & Metab Start Lab, Arthur Scheunert Allee 114-116, D-14558 Nuthetal, Germany
[2] Estrutura Org Xest Integrada Vigo, Inst Invest Sanitaria Galicia Sur, Dept Gastroenterol, Vigo 36312, Spain
来源
NUTRIENTS | 2017年 / 9卷 / 09期
关键词
diet; gut microbiota; epigenetics; inflammatory bowel diseases; CROHNS-DISEASE; ULCERATIVE-COLITIS; ADAPTIVE IMMUNITY; ENVIRONMENTAL-FACTORS; ECHINACEA-PURPUREA; TNF-ALPHA; IBD; METAANALYSIS; ASSOCIATION; PREBIOTICS;
D O I
10.3390/nu9090962
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Inflammatory bowel diseases (IBD) represent a growing public health concern due to increasing incidence worldwide. The current notion on the pathogenesis of IBD is that genetically susceptible individuals develop intolerance to dysregulated gut microflora (dysbiosis) and chronic inflammation develops as a result of environmental triggers. Among the environmental factors associated with IBD, diet plays an important role in modulating the gut microbiome, influencing epigenetic changes, and, therefore, could be applied as a therapeutic tool to improve the disease course. Nevertheless, the current dietary recommendations for disease prevention and management are scarce and have weak evidence. This review summarises the current knowledge on the complex interactions between diet, microbiome and epigenetics in IBD. Whereas an overabundance of calories and some macronutrients increase gut inflammation, several micronutrients have the potential to modulate it. Immunonutrition has emerged as a new concept putting forward the importance of vitamins such as vitamins A, C, E, and D, folic acid, beta carotene and trace elements such as zinc, selenium, manganese and iron. However, when assessed in clinical trials, specific micronutrients exerted a limited benefit. Beyond nutrients, an anti-inflammatory dietary pattern as a complex intervention approach has become popular in recent years. Hence, exclusive enteral nutrition in paediatric Crohn's disease is the only nutritional intervention currently recommended as a first-line therapy. Other nutritional interventions or specific diets including the Specific Carbohydrate Diet (SCD), the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol (FODMAP) diet and, most recently, the Mediterranean diet have shown strong anti-inflammatory properties and show promise for improving disease symptoms. More work is required to evaluate the role of individual food compounds and complex nutritional interventions with the potential to decrease inflammation as a means of prevention and management of IBD.
引用
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页码:1 / 13
页数:13
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