Inflammation and malnutrition in inflammatory bowel disease

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, has become increasingly prevalent worldwide in the past decade. The nutritional status of patients with IBD is often impaired, with malnutrition presenting as imbalanced energy or nutrient intake, including protein-energy malnutrition, disease-related malnutrition, sarcopenia, and micronutrient deficiency. Additionally, malnutrition can manifest as overweight, obesity, and sarcopenic obesity. Malnutrition can lead to disturbances in gut microbiome composition that might alter homoeostasis and cause a dysbiotic state, potentially triggering inflammatory responses. Despite the clear link between IBD and malnutrition, little is known about the pathophysiological mechanisms beyond protein-energy malnutrition and micronutrient deficiencies that could promote inflammation through malnutrition, and vice versa. This Review focuses on potential mechanisms that trigger a vicious cycle between malnutrition and inflammation, and their clinical and therapeutic implications.

Automated summary

Inflammatory bowel disease (IBD) has been on the rise worldwide, with impaired nutritional status in patients presenting in various forms such as malnutrition, sarcopenia, and micronutrient deficiency, as well as overweight, obesity, and sarcopenic obesity. Malnutrition can disrupt the gut microbiome, leading to an imbalanced state that triggers inflammation. Despite the clear link between IBD and malnutrition, little is known about the underlying mechanisms that promote inflammation and malnutrition. This Review explores the potential mechanisms behind the vicious cycle of malnutrition and inflammation, and their implications for clinical treatment.