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Personalized Nutrition and Emerging Dietary Approaches in Inflammatory Bowel Disease

A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: 5 January 2027 | Viewed by 1957

Editor


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Guest Editor
1. Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, 20097 San Donato Milanese, Italy
2. Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina 56, 20132 Milan, Italy
Interests: ulcerative colitis; Crohn’s disease; inflammatory bowel disease; genetic predisposition; risk factors

Special Issue Information

Dear Colleagues, 

Adequate nutrition and diet play a crucial role in managing inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, in both children and adults. Malnutrition is common in IBD due to reduced intake, malabsorption, and increased nutrient needs, especially during active disease phases. In children, inadequate nutrition can impair growth and development, making dietary support essential. Traditionally, diet is considered a form of supportive care, aimed at correcting deficiencies and minimizing symptoms. However, recent advances have highlighted diet not only as a supportive measure but also as a potential therapeutic tool. Specific dietary interventions, such as exclusive enteral nutrition (EEN), have shown efficacy in inducing remission in pediatric Crohn’s disease, comparable to corticosteroids but without systemic side effects. Emerging dietary approaches, such as the Crohn’s Disease Exclusion Diet (CDED), the Specific Carbohydrate Diet (SCD), and the low FODMAP diet, are being investigated for their anti-inflammatory potential and evidence of microbiome modulation. Personalized nutrition based on individual tolerance and microbiota composition is gaining attention as a promising adjunct in medical therapy. Overall, our evolving understanding of the role of diet in IBD suggests that tailored nutritional strategies can help manage symptoms, maintain remission, and potentially reduce reliance on pharmacologic treatments in both children and adults.

Dr. Vito Annese
Guest Editor

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Keywords

  • nutrition status
  • Mediterranean diet
  • CDED
  • FODMAP
  • enteral nutrition
  • IBD
  • ulcerative colitis
  • Crohn’s disease
  • disease activity

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Published Papers (2 papers)

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Research

15 pages, 751 KB  
Article
Testing-Yield Mismatch in Inpatient Micronutrient Assessment in Inflammatory Bowel Disease: A Real-World Implementation-Gap Analysis
by Amir Y. Kamel, Christopher Miquel-Chambers, Yasmeen Saker, Devika Dixit, Melanie Rolfe, Zachary D. Johnson, Isabela Hernandez, Thakul Rattanasuwan, Nofel Iftikhar, Naueen Chaudhry, Angela Pham, S. Devi Rampertab and Ellen Zimmermann
Nutrients 2026, 18(16), 2648; https://doi.org/10.3390/nu18162648 - 13 Aug 2026
Viewed by 441
Abstract
Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies [...] Read more.
Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies describe how comprehensively these recommendations are applied during hospitalization. This study aimed to characterize inpatient testing practices for vitamins B1, B6, B12, and zinc in hospitalized IBD patients, quantify deficiency frequency among those tested, and identify gaps between guideline-recommended and actual micronutrient assessment. Methods: A retrospective chart review was performed on adults with Crohn’s disease (CD) or ulcerative colitis (UC) hospitalized for an IBD flare at a tertiary care center. Demographics, comorbidities, and deficiency-associated clinical features were recorded. Yield was defined as the proportion of tested patients meeting institutional deficiency thresholds. Yield for each non-B12 micronutrient was compared with B12 as an internal benchmark. Results: Among 356 patients (285 CD, 71 UC), inpatient micronutrient testing was markedly imbalanced: B12 was tested in 97.2%, whereas B6, B1, and zinc were tested in only 34.8%, 30.6%, and 18.8%, respectively. Among those tested, deficiencies were common: B6 40.3%, zinc 32.8%, B1 22.9%, and B12 9.0%. Each non-B12 micronutrient yielded deficiency significantly more often per test than B12 (all p < 0.001), a testing-yield mismatch interpreted cautiously given selective testing of non-B12 nutrients. Deficiency frequencies did not differ significantly between CD and UC. Clinical contexts included tachycardia and edema (B1); elevated inflammatory markers and thromboembolism history (B6); anemia and neuropathy (B12); and diarrhea and hypoalbuminemia (zinc). Conclusions: Inpatient micronutrient assessment in IBD is heavily skewed toward B12, with B1, B6, and zinc under-tested despite a substantially higher yield of identified deficiency per test. This testing-yield mismatch represents a measurable implementation gap between guideline-recommended comprehensive assessment and actual inpatient practice; whether systematic panel-based assessment improves clinical outcomes warrants prospective evaluation. Full article
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20 pages, 1038 KB  
Article
A Randomised Controlled Trial Comparing the Effects of Personalised Diet and Physical Activity Intervention Versus Usual Care on Cardiometabolic Risk Factors in Adults with Inactive Inflammatory Bowel Disease
by Jia Min Yap, Catherine L. Wall, Kim Meredith-Jones, Ella Iosua, Hamish Osborne and Michael Schultz
Nutrients 2026, 18(5), 785; https://doi.org/10.3390/nu18050785 - 27 Feb 2026
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Abstract
Background: Adults with inflammatory bowel disease (IBD) have a high prevalence of modifiable cardiometabolic risk factors. This study investigates the impact of a personalised diet and physical activity intervention versus usual care on the risk factors. Methods: A 6-month randomised controlled [...] Read more.
Background: Adults with inflammatory bowel disease (IBD) have a high prevalence of modifiable cardiometabolic risk factors. This study investigates the impact of a personalised diet and physical activity intervention versus usual care on the risk factors. Methods: A 6-month randomised controlled trial was conducted at three hospitals in New Zealand (NZ) from 2023 to 2024. Adults with IBD in remission, a body mass index > 25 kg/m2, and a low fibre intake < 25 g/day were recruited. Participants were randomised to receive either generic healthy eating and physical activity education or personalised heart-healthy eating education based on the NZ Heart Foundation and a self-led physical activity program. The primary outcome was change in body fat, and secondary outcomes included disease activity, biomarkers, quality of life, physical activity, and dietary intake. Between-group differences were analysed using multivariable regression. Results: Sixty-four participants were randomised, and 51 (80%) completed the intervention. The median age was 47 years (LQ, UQ: 37, 55), 59% participants were female, 61% had Crohn’s disease, and 85% had faecal calprotectin < 150 µg/g. Common cardiometabolic risks were high waist circumference (88%) and abnormal lipid profile (56%). There were no significant differences in primary or secondary outcomes except for dietary intakes: increased fruit (0.5 serves/day; 95% CI: 0.1, 1.0) and dietary fibre (3.1 g/1000 kcal/day; 95% CI: 1.1, 5.1); reduced discretionary food and drink (−1.7 serves/day; 95% CI: −3.0, −0.3), and sodium (−911 mg/day; 95% CI: −1783, −40). Conclusions: Personalised dietitian advice led to meaningful dietary changes without exacerbating disease activity. More intensive activity modalities can be recommended to support body composition improvements. Full article
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