Multidimensional Impact of Mediterranean Diet on IBD Patients

Inflammatory Bowel Diseases - Tập 27 Số 1 - Trang 1-9 - 2021
Fabio Chicco1,2, Salvatore Magrì1,2, Arianna Cingolani1,2, Danilo Paduano1,2, Mario Pesenti1,2, Federica Zara1,2, Francesca Tumbarello1,2, Emanuela Urru1,2, Alessandro Melis1,2, Laura Casula1,2, Massimo Claudio Fantini1,2, Paolo Usai1,2
1Department of Medical Sciences and Public Health, University of Cagliari, Italy; Presidio Policlinico of Monserrato, Cagliari, Italy
2Presidio Policlinico of Monserrato, Cagliari, Italy

Tóm tắt

Abstract Background & Aims Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to ameliorate both obesity and NAFLD, the aim of this study was to analyze the impact of Md on the nutritional state, liver steatosis, clinical disease activity, and quality of life (QoL) in IBD patients. Methods Patients with IBD, both Crohn’s disease (CD) and ulcerative colitis (UC), followed Md for 6 months. Their body mass index (BMI), body tissue composition, liver steatosis and function, serum lipid profile, clinical disease activity, and inflammatory biomarkers (C-reactive protein and fecal calprotectin) were collected at baseline (T0) and compared with those obtained after 6 months (T180) to evaluate the impact of Md. Results One hundred forty-two IBD patients, 84 UC and 58 CD, followed Md for 6 months. At T180, diet-adherent CD and UC improved BMI (UC −0.42, P = 0.002; CD −0.48, P = 0.032) and waist circumference (UC −1.25 cm, P = 0.037; CD −1.37 cm, P = 0.041). Additionally, the number of patients affected by liver steatosis of any grade was significantly reduced in both groups (UC T0 31 of 84 [36.9%] vs T180 18 of 84 [21.4%], P = 0.0016; CD T0 27 of 58 [46.6%] vs T180 18 of 58 [31.0%], P < 0.001) after dietary intervention. Finally, after 6 months of the diet, fewer UC and CD patients with stable therapy had active disease (UC T0 14 of 59 [23.7%] vs T180 4 of 59 [6.8%], P = 0.004; CD T0 9 of 51 [17.6%] vs T180 2 of 51 [3.0%], P = 0.011) and elevated inflammatory biomarkers. Mediterranean diet improved QoL in both UC and CD, but neither serum lipid profile nor liver function were modified by the diet. Conclusions A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.

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Tài liệu tham khảo

Gomollón, 2017, 3rd European Evidence-based Consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management, J Crohns Colitis., 11, 3, 10.1093/ecco-jcc/jjw168

Magro, 2017, Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders, J Crohns Colitis., 11, 649, 10.1093/ecco-jcc/jjx008

Becker, 2015, Living with inflammatory bowel disease: a Crohn’s and Colitis Canada survey, Can J Gastroenterol Hepatol., 29, 77, 10.1155/2015/815820

Agarwal, 2014, Spice up your life: adipose tissue and inflammation, J Lipids., 2014, 182575, 10.1155/2014/182575

Honda, 2016, The microbiota in adaptive immune homeostasis and disease, Nature., 535, 75, 10.1038/nature18848

Mouries, 2019, Microbiota-driven gut vascular barrier disruption is a prerequisite for non-alcoholic steatohepatitis development, J Hepatol., 71, 1216, 10.1016/j.jhep.2019.08.005

Gäbele, 2011, DSS induced colitis increases portal LPS levels and enhances hepatic inflammation and fibrogenesis in experimental NASH, J Hepatol., 55, 1391, 10.1016/j.jhep.2011.02.035

Wahlström, 2016, Intestinal crosstalk between bile acids and microbiota and its impact on host metabolism, Cell Metab., 24, 41, 10.1016/j.cmet.2016.05.005

Long, 2011, Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease, Inflamm Bowel Dis., 17, 2162, 10.1002/ibd.21585

Lomer, 2019, A multicentre study of nutrition risk assessment in adult patients with inflammatory bowel disease attending outpatient clinics, Ann Nutr Metab., 74, 18, 10.1159/000495214

Singh, 2017, Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes, Nat Rev Gastroenterol Hepatol., 14, 110, 10.1038/nrgastro.2016.181

Magrì, 2019, Nonalcoholic fatty liver disease in patients with inflammatory bowel disease: beyond the natural history, World J Gastroenterol., 25, 5676, 10.3748/wjg.v25.i37.5676

Saroli Palumbo, 2019, Screening for nonalcoholic fatty liver disease in inflammatory bowel diseases: a cohort study using transient elastography, Inflamm Bowel Dis., 25, 124, 10.1093/ibd/izy200

Song, 2015, Nutrients, foods, and colorectal cancer prevention, Gastroenterology., 148, 1244, 10.1053/j.gastro.2014.12.035

Ananthakrishnan, 2015, High school diet and risk of Crohn’s disease and ulcerative colitis, Inflamm Bowel Dis., 21, 2311

Saadeh, 2002, The utility of radiological imaging in nonalcoholic fatty liver disease, Gastroenterology., 123, 745, 10.1053/gast.2002.35354

Bach-Faig, 2011, Mediterranean diet pyramid today. Science and cultural updates, Public Health Nutr., 14, 2274, 10.1017/S1368980011002515

Zhou, 2012, NOD1 activation induces innate immune responses and insulin resistance in human adipocytes, Diabetes Metab., 38, 538, 10.1016/j.diabet.2012.08.001

Zulian, 2012, Visceral adipocytes: old actors in obesity and new protagonists in Crohn’s disease?, Gut., 61, 86, 10.1136/gutjnl-2011-300391

Landers, 2002, Selected loss of tolerance evidenced by Crohn’s disease-associated immune responses to auto- and microbial antigens, Gastroenterology., 123, 689, 10.1053/gast.2002.35379

Vetrano, 2008, Unique role of junctional adhesion molecule-a in maintaining mucosal homeostasis in inflammatory bowel disease, Gastroenterology., 135, 173, 10.1053/j.gastro.2008.04.002

Miranda-Ribera, 2019, Exploiting the zonulin mouse model to establish the role of primary impaired gut barrier function on microbiota composition and immune profiles, Front Immunol., 10, 2233, 10.3389/fimmu.2019.02233

McHenry, 2019, Crohn’s disease is associated with an increased prevalence of nonalcoholic fatty liver disease: a cross-sectional study using magnetic resonance proton density fat fraction mapping, Clin Gastroenterol Hepatol., 17, 2816, 10.1016/j.cgh.2019.02.045

Kolodziejczyk, 2019, The role of the microbiome in NAFLD and NASH, EMBO Mol Med., 11, 10.15252/emmm.201809302

Wang, 2019, Role of bile acids in dysbiosis and treatment of nonalcoholic fatty liver disease, Mediators Inflamm., 2019, 7659509, 10.1155/2019/7659509

Arpaia, 2013, Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation, Nature., 504, 451, 10.1038/nature12726

De Filippis, 2016, High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome, Gut., 65, 1812, 10.1136/gutjnl-2015-309957

Walker, 2011, High-throughput clone library analysis of the mucosa-associated microbiota reveals dysbiosis and differences between inflamed and non-inflamed regions of the intestine in inflammatory bowel disease, BMC Microbiol., 11, 7, 10.1186/1471-2180-11-7

Marlow, 2013, Transcriptomics to study the effect of a Mediterranean-inspired diet on inflammation in Crohn’s disease patients, Hum Genomics., 7, 24, 10.1186/1479-7364-7-24

Mayr, 2019, Ad libitum Mediterranean diet reduces subcutaneous but not visceral fat in patients with coronary heart disease: a randomised controlled pilot study, Clin Nutr ESPEN., 32, 61, 10.1016/j.clnesp.2019.05.001

Panizza, 2019, Effects of intermittent energy restriction combined with a mediterranean diet on reducing visceral adiposity: a randomized active comparator pilot study, Nutrients., 11, 10.3390/nu11061386

Baratta, 2017, Adherence to mediterranean diet and non-alcoholic fatty liver disease: effect on insulin resistance, Am J Gastroenterol., 112, 1832, 10.1038/ajg.2017.371

Chan, 2015, Diet-quality scores and prevalence of nonalcoholic fatty liver disease: a population study using proton-magnetic resonance spectroscopy, PLoS One., 10, e0139310, 10.1371/journal.pone.0139310

Kontogianni, 2014, Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease, Clin Nutr., 33, 678, 10.1016/j.clnu.2013.08.014

Ryan, 2013, The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease, J Hepatol., 59, 138, 10.1016/j.jhep.2013.02.012

Henríquez Sánchez, 2012, Adherence to the Mediterranean diet and quality of life in the SUN Project, Eur J Clin Nutr., 66, 360, 10.1038/ejcn.2011.146

Katz, 2000, Impact of obesity on health-related quality of life in patients with chronic illness, J Gen Intern Med., 15, 789, 10.1046/j.1525-1497.2000.90906.x

Lemstra, 2016, Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative, J Multidiscip Healthc., 9, 103

Halmos, 2015, Dietary management of IBD–insights and advice, Nat Rev Gastroenterol Hepatol., 12, 133, 10.1038/nrgastro.2015.11

Papada, 2020, Adherence to mediterranean diet in Crohn’s disease, Eur J Nutr., 59, 1115, 10.1007/s00394-019-01972-z

Khalili, 2020, Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies, Gut., 10.1136/gutjnl-2019-319505

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Inflammatory Bowel Diseases

Tập 27 Số 1

1-9

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