Research: HUNTER, Addenbrooke

Listed in Issue 35

Abstract

HUNTER, Addenbrookes Hospital, Gastroenterology Research Unit, Cambridge, UK writes that there has been a growing interest in the importance of nutritional factors involved in the pathogenesis of inflammatory bowel disease .

Background

Methodology

Results

Thus far, there have not been any definite links established between ulcerative colitis and diet ; however, links with Crohns disease have been studied by epidemiologists and clinicians. Retrospective epidemiological studies have suggested that Crohns patients eat more sugar and sweets than control individuals; however, little clinical benefit has been seen when dietary sugar is restricted. In Crohns disease, the clinical approach to nutrition has been via the use of elemental diets, which have produced symptomatic and objective remission in up to 90% of compliant patients . Patients who return to normal eating soon relapse, but in some studies patients have enjoyed prolonged remission on exclusion diets. The foods excluded have not been sugar, but predominantly cereals, dairy products and yeast. Clinical attention has now switched to the possible harmful role of fat in Crohns disease . The efficacy of elemental feeds appears to depend upon the amount of long chain triglyceride present, not upon the presentation of nitrogen. Increases in recent years in the frequency of Crohns disease in Japan have been associated with increased intake of dietary fat and a recent study has suggested that omega-3 fatty acids, which are metabolised by immunomodulatory leukotrienes and prostaglandins may have a beneficial role to play.

Conclusion

The links between nutrition and Crohns disease have now been established to be strong and the role of fat may be pivotal and highly significant.

References

Hunter JO. Nutritional factors in inflammatory bowel disease. Eur J Gastroenterol Hepatol 10(30): 235-7. March 1998.

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