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Precise Nutrition Therapy to Inflammatory Bowel Diseases

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 5 February 2026 | Viewed by 4028

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Guest Editor
Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
Interests: clinical nutrition; immunology; omics; autoimmune; allergy; metabolism
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Special Issue Information

Dear Colleagues,

Nutritional deficiencies are common in patients with inflammatory bowel disease (IBD). However, the potential of precise nutrition therapy to prevent and treat malnutrition and intestinal failure in IBD, particularly in Crohn’s disease, offers a hopeful outlook. The increased requirements of energy and protein, especially in young children and adolescents with retarded growth, underscore the importance of this approach. Furthermore, the common occurrence of iron deficiency in Crohn’s disease and the necessity for proper forms and sufficient iron supplements in parenteral nutrition highlight the potential of nutritional therapy in IBD management.

Recent studies have provided insights into the efficacy of dietary interventions, such as exclusive or partial enteral or parenteral nutrition combined with oral feeding if possible. The nutrition therapy should include all required nutrients and functional bioactive compounds such as antioxidants, fat modifiers (if necessary), fish oil, and other resources of n-3 fatty acids, butyrate, prebiotics, and probiotics to maintain remission in IBD, especially in severe Crohn’s disease. Although not all the underlying mechanisms are known in the pathology of IBD, there is some evidence regarding medical nutritional therapy in this group of patients.

Understanding the nutrient requirements for patients with IBD is crucial. It not only informs our approach to nutritional therapy, but also guides our research into novel immune-modulatory compounds in safe doses. Improving patient motivation and adherence to various types of nutrition therapy or their combinations is a promising but challenging aspect of managing ulcerative colitis and Crohn’s disease. This emphasis on understanding and knowledge is key to our collective efforts in IBD management.

Dr. Mahsa Jalili
Guest Editor

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Keywords

  • inflammatory bowel disease
  • enteral nutrition
  • parenteral nutrition
  • malnutrition
  • immunomodulation

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Published Papers (4 papers)

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Research

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12 pages, 910 KiB  
Article
The Relationship Between Nutritional Status, Micronutrient Deficiency, and Disease Activity in IBD Patients: A Multicenter Cross-Sectional Study
by Marco Valvano, Susanna Faenza, Fabio Cortellini, Antonio Vinci, Fabio Ingravalle, Mauro Calabrò, Lorenza Scurti, Mariagiulia Di Nezza, Sergio Valerio, Angelo Viscido and Giovanni Latella
Nutrients 2025, 17(16), 2690; https://doi.org/10.3390/nu17162690 - 20 Aug 2025
Viewed by 149
Abstract
Background and aim: Inflammatory bowel diseases (IBD) are chronic conditions that affect the gastrointestinal tract. The chronic inflammatory state promotes a catabolic environment that contributes to undernutrition, while mucosal damage often impairs nutrient absorption. The aim of this study is to evaluate the [...] Read more.
Background and aim: Inflammatory bowel diseases (IBD) are chronic conditions that affect the gastrointestinal tract. The chronic inflammatory state promotes a catabolic environment that contributes to undernutrition, while mucosal damage often impairs nutrient absorption. The aim of this study is to evaluate the relationship between nutritional status—including micronutrient deficiencies—and clinical as well as laboratoristics disease activity in a cohort of patients with IBD. Methods: This is a cross-sectional study conducted across three care centers in Italy. Baseline data, clinical disease activity, and laboratory test results were collected. Micronutrient evaluation included measurements of iron, ferritin, vitamin B12, vitamin D, and folate. In addition, hemoglobin and albumin levels were assessed. Pearson correlation analysis was performed to explore the relationship between disease activity and nutritional status. Additionally, receiver operating characteristics (ROC) analysis were performed to identify patients with active diseases. Results: 110 IBD patients (40 Crohn Disease; 70 Ulcerative Colitis) were included. The serum level of Hb, iron, ferritin and vitamin D was different among the active and inactive group (p: 0.007; p: 0.001; p: 0.005; p: 0.003) while no difference was found among the other micronutrients evaluated (folic acid, vitamin B12) and albumin. Iron and vitamin D levels demonstrated the highest accuracy in the ROC analysis, with Area Under the Curve (AUC) of 0.76 (p < 0.001) and 0.68 (p = 0.013), respectively. Vitamin D and Ferritin showed the better performance (based on calprotectin levels). However, their AUC were sub-optimal (AUC 0.68; p < 0.001; AUC 0.66; p = 0.19. Conclusions: Hemoglobin, iron, ferritin, and vitamin D were associated with disease activity status. However, despite this correlation, their accuracy in discriminating between active and inactive disease appeared to be suboptimal. Folic acid, vitamin B12, and albumin showed poor concordance with disease activity status. Full article
(This article belongs to the Special Issue Precise Nutrition Therapy to Inflammatory Bowel Diseases)
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13 pages, 482 KiB  
Article
The Association Between Fast Food Consumption and Inflammatory Bowel Disease: A Case-Control Study and Meta-Analysis
by Anas Almofarreh, Haytham A. Sheerah, Ahmed Arafa, Abdulatif M. AlBassam, Mshari A. Alassaf, Faisal M. AlBassam, Faisal B. Alsaif, Khalid M. Alkwai, Faisal A. Alzahrani, Mohammed A. Allift, Shahad AlBassam, Aseel AlBassam, Mohammed Alshehri, Khalid O. Alshammari, Njoud M. Alenezi and Fahad A. Alamri
Nutrients 2025, 17(11), 1838; https://doi.org/10.3390/nu17111838 - 28 May 2025
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Abstract
Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions influenced by various factors, including diet. This study examined the association between fast food consumption and IBD risk through a case-control study and a meta-analysis of epidemiological [...] Read more.
Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions influenced by various factors, including diet. This study examined the association between fast food consumption and IBD risk through a case-control study and a meta-analysis of epidemiological evidence. Methods: We analyzed data from a hospital-based case-control study conducted in Riyadh. The study included 158 UC patients, 244 CD patients, and 395 controls without IBD. Fast food consumption was assessed using a self-administered questionnaire distributed before diagnoses were made. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) of UC and CD for individuals who reported daily fast food consumption. Then, we merged our results with those from other studies investigating the same association into a meta-analysis. Results: In the case-control study, daily consumption of fast food was strongly associated with UC and CD among Saudi people: age- and sex-adjusted ORs (95% CIs) = 6.29 (3.89, 10.16) and 5.92 (3.98, 8.80), respectively. The associations remained robust after further adjustments: ORs (95% CIs) = 6.61 (3.93, 11.12) and 5.90 (3.89, 8.94), respectively. Similarly, the meta-analysis revealed higher odds of fast food intake associated with UC and CD, with pooled odds ratios (95% CIs) of 2.41 (1.07, 5.45) and 2.65 (1.23, 5.70), respectively. Conclusions: Our findings highlight the potential role of fast food consumption in the development of IBD. From a preventive medicine perspective, fast food consumption should be discouraged to reduce the risk of IBD. Full article
(This article belongs to the Special Issue Precise Nutrition Therapy to Inflammatory Bowel Diseases)
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Review

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20 pages, 770 KiB  
Review
Histamine Metabolism in IBD: Towards Precision Nutrition
by Dimitra Kanta, Eleftherios Katsamakas, Anna Maia Berg Gudiksen and Mahsa Jalili
Nutrients 2025, 17(15), 2473; https://doi.org/10.3390/nu17152473 - 29 Jul 2025
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Abstract
Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain [...] Read more.
Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain largely unexplored. This narrative review aims to summarize the existing literature on the complex interplay between IBD and histamine metabolism and propose a novel dietary framework for managing IBD progression in patients with histamine intolerance (HIT). Relevant studies were identified through a comprehensive literature search of PubMed/MEDLINE, Google Scholar, ScienceDirect, Scopus, and Web of Science. The proposed low-histamine diet (LHD) aims to reduce the overall histamine burden in the body through two primary strategies: (1) minimizing exogenous intake by limiting high-histamine and histamine-releasing foods and (2) reducing endogenous histamine production by modulating gut microbiota composition, specifically targeting histamine-producing bacteria. In parallel, identifying individuals who are histamine-intolerant and understanding the role of histamine-degrading enzymes, such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are emerging as important areas of focus. Despite growing interest in the role of histamine and mast cell activation in gut inflammation, no clinical trials have investigated the effects of a low-histamine diet in IBD populations. Therefore, future research should prioritize the implementation of LHD interventions in IBD patients to evaluate their generalizability and clinical applicability. Full article
(This article belongs to the Special Issue Precise Nutrition Therapy to Inflammatory Bowel Diseases)
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21 pages, 1012 KiB  
Review
The Role of Vitamin D in Inflammatory Bowel Diseases: From Deficiency to Targeted Therapeutics and Precise Nutrition Strategies
by Giuseppe Dell’Anna, Fabrizio Fanizzi, Alessandra Zilli, Federica Furfaro, Virginia Solitano, Tommaso Lorenzo Parigi, Ambra Ciliberto, Jacopo Fanizza, Francesco Vito Mandarino, Lorenzo Fuccio, Antonio Facciorusso, Gianfranco Donatelli, Mariangela Allocca, Sara Massironi, Vito Annese, Laurent Peyrin-Biroulet, Silvio Danese and Ferdinando D’Amico
Nutrients 2025, 17(13), 2167; https://doi.org/10.3390/nu17132167 - 29 Jun 2025
Viewed by 1382
Abstract
Background: Vitamin D plays a crucial role in immune modulation, gut barrier integrity, and inflammation regulation, making it highly relevant in inflammatory bowel disease (IBD). IBD patients often exhibit vitamin D deficiency, which has been linked to increased disease activity, impaired mucosal healing, [...] Read more.
Background: Vitamin D plays a crucial role in immune modulation, gut barrier integrity, and inflammation regulation, making it highly relevant in inflammatory bowel disease (IBD). IBD patients often exhibit vitamin D deficiency, which has been linked to increased disease activity, impaired mucosal healing, and a higher risk of complications, including infections and osteoporosis. Methods: This review examines the biological functions of vitamin D in maintaining intestinal homeostasis, particularly in the context of IBD. It discusses the prevalence and consequences of vitamin D deficiency in IBD, including its potential to exacerbate disease progression, impair treatment efficacy, and negatively impact long-term health outcomes. Furthermore, therapeutic strategies to address vitamin D deficiency are explored, including supplementation approaches, dosing strategies, and precision nutrition interventions that aim to personalize vitamin D management based on individual patient needs and disease characteristics. Results: By synthesizing the latest evidence, this review highlights the critical role of vitamin D in IBD management, underlining how optimal vitamin D levels may not only improve disease control but also enhance patient quality of life and reduce the risk of long-term complications associated with the disease. Conclusions: Understanding the importance of vitamin D in IBD could help refine treatment strategies and promote better health outcomes for affected individuals. Full article
(This article belongs to the Special Issue Precise Nutrition Therapy to Inflammatory Bowel Diseases)
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