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Newsletter #4
Summer 2021

Letter from the Editors

Welcome to the Summer Issue of Nutritional Therapy for IBD’s quarterly newsletter.
The data from research and publications continue to expand, increasing our knowledge of the central role of dietary therapy in the management of IBD. We are further expanding our channels of timely communication of this material using social media. Please follow our Twitter account for the most recent nutritional updates.  

Publications and Research Updates

We have added several new and interesting publications to the website since last quarter, including the following:
Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study
Authors: Narula N et al
Citation: BMJ. 2021;374:n1554

A prospective study of 116,087 adults across 21 low, middle, and high income countries from seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China), who completed food frequency questionnaires at least every 3 years for a median follow-up of 9.7 years (range 8.9-11.2 years). After adjustment for potential confounding factors, higher intake of ultra-processed food was associated with a higher risk of incident IBD (hazard ratio 1.82, 95% confidence interval 1.22 to 2.72 for ≥5 servings/day and 1.67, 1.18 to 2.37 for 1-4 servings/day compared with <1 serving/day, P=0.006 for trend). Different subgroups of ultra-processed food, including soft drinks, refined sweetened foods, salty snacks, and processed meat, each were associated with higher hazard ratios for IBD.
Gut-microbiota-targeted diets modulate human immune status
Authors: Wastyk HC et al
Citation: Cell. 2021;S0092-8674(21)00754-6. doi:10.1016/j.cell.2021.06.019.

A 17-week prospective randomized study (n=18/arm) of high fiber and high fermented food diets evaluated by -omics measurements of microbiome and host and extensive immune profiling, found specific diet-related effects. The high fiber diet increased microbiome carbohydrate active enzymes with stable microbial diversity, while high fermented food diet increased microbial diversity and decreased inflammatory markers, highlighting the potential for benefit by coupling them together, utilizing immune and microbiome profiling for individual insight.
Long-term dietary patterns are associated with pro-inflammatory and anti-inflammatory features of the gut microbiome
Authors: Bolte LA et al
Gut.. 2021;70(7):1287-1298. doi:10.1136/gutjnl-2020-322670.

The relationship between 173 dietary factors and the microbiome across four cohorts (CD, UC, IBS, and the general population of 1425 individuals) is examined. Authors identify dietary patterns that consistently correlate with groups of bacteria with shared functional roles in health and disease. Processed foods and animal-derived foods were consistently associated with higher abundances of Firmicutes, Ruminococcus species of the Blautia genus, and endotoxin synthesis pathways. The opposite was found for plant foods and fish, which were positively associated with short-chain fatty acid-producing commensals and pathways of nutrient metabolism.
The role of precision nutrition in the modulation of microbial composition and function in people with inflammatory bowel disease
Authors: Sasson AN, Ingram RJM et al
Lancet Gastroenterol Hepatol.. 2021;S2468-1253(21)00097-2. doi:10.1016/S2468-1253(21)00097-2.

The authors review the role of dietary patterns, their influence on the structure and function of the gut microbiome, and their effects on inflammation and immunity in individuals with inflammatory bowel disease. A recommended food pyramid for patients with IBD is provided suggesting optimal intake of dietary food groups based upon the combined results of dietary intervention trials. The authors propose future design of microbiome targeted dietary interventions utilizing metabolic, genomic, and microbial profiles to develop precision nutrition for the management of IBD.
Low-fat, high-fiber diet reduces markers of inflammation and dysbiosis and improves quality of life in patients with ulcerative colitis
Authors: Fritsch J et al
Clin Gastroenterol Hepatol.. 2021;19(6):1189-1199.e30. doi:10.1016/j.cgh.2020.05.026.

A parallel crossover study of 17 patients with UC in remission or mild disease were randomized to either a low fat (10% of calories) high fiber diet for 4 weeks, or 4 weeks of improved standard American diet (iSAD) (35-40% of calories from fat with increased fruits, vegetables and fiber) followed by 2 week washout and crossover. Both study diets were healthier than patient's baseline diet. Compared to baseline, both diets significantly improved quality of life scores. Only the low-fat high fiber diet significantly reduced serum amyloid A concentration. CRP decreased numerically in the low-fat high fiber diet, but did not reach statistical significance. Intestinal dysbiosis was reduced in the low-fat high fiber diet measured by significant increases in F. prausnitzii and decreases in Actinobacteria with significant increases in acetate (an anti-inflammatory metabolite) found in fecal samples.

News and Events


We hope to see you live and in person at NASPGHAN 2021 (November 4-6 in Nashville, TN). Please stop by our booth, Nutritional Therapy for IBD, for interactive discussion with experts in the field and discover new resources to offer patients the benefits of nutritional therapy.

Nutritional Updates from ECCO 2021

The 16th Congress of the European Crohn's and Colitis Organisation was held virtually on July 2-3 and July 8-10, 2021. Links to highlights from the meeting can be found on our Nutritional Updates from ECCO 2021 page.


We thank all of the Medical Advisors on our Medical Advisory Board for their contributions to content, nutritional research, and participation at exhibits providing lectures and/or sharing their medical expertise to field questions regarding nutrition and IBD. 

We welcome our newest medical advisors, Professor Maria Abreu and Dr. Oriana Damas. Professor Abreu is the Director of the Crohn’s and Colitis Center, Professor of Medicine and Professor of Microbiology and Immunology, as well as Vice Chair of Research for the Department of Medicine at the University of Miami Miller School of Medicine. Dr. Damas is an Assistant Professor of Medicine at the University of Miami Crohn's and Colitis Center in the Division of Gastroenterology and the Director of Translational Studies for the Center. More information about their extensive contributions to the field of nutrition and IBD can be found on our Medical Advisory Board page.

Thank you for reading the updates from Nutritional Therapy for IBD. We appreciate your interest in advocacy for nutritional therapy in the management of IBD!

NTforIBD Publishing Team

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