Journal
JOURNAL OF CROHNS & COLITIS
Volume 15, Issue 6, Pages 1068-1079Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ecco-jcc/jjaa254
Keywords
Emulsifiers; inflammation; colitis
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Funding
- Leona M. and Harry B. Helmsley Charitable Trust
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The global burden of inflammatory bowel disease [IBD] has increased over the 21st century, with factors such as a 'Western diet' and dietary emulsifiers potentially contributing to the rise in prevalence. These factors may trigger the pathogenesis of IBD through various mechanisms.
The global burden of inflammatory bowel disease [IBD] has increased over the 21st century. Despite multiple studies investigating the pathogenesis of IBD, the causative mechanisms pertaining to its increased prevalence remain unclear. There is growing evidence that aspects of a 'Western diet' increase the risk of developing IBD. More recently, evidence implicating dietary emulsifiers has accumulated, with ecological studies showing a positive correlation between inflammatory bowel disease and emulsifier consumption. Further to these, cell and animal studies have demonstrated plausible mechanisms by which dietary emulsifiers may contribute to IBD pathogenesis through mechanisms including: promotion of pro-inflammatory intestinal microbiota; disruption of mucus architecture; increased intestinal permeability; activation of inflammatory pathways; and disruption of the cell cycle.This review critically analyses the current evidence for these mechanisms that may be of pathological relevance to IBD, evaluates recent dietary trials, acknowledges the challenges of dietary intervention studies, and gives an overview of ongoing and future clinical trials in this important area.
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