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Tuesday, 3 December 2013

Colitis - The Diet

Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Diet to prevent colitis
1. Glutamine, dietary fiber, and Oligosaccharide (GFO)
According to the study to whether GFO has suppressive effects on mucosal damage in ulcerative colitis in an experimental mouse model, showed that intestinal inflammation was significantly attenuated in mice treated with GFO. Furthermore, treatment with GFO significantly inhibited the dextran sulfate sodium-induced increase in the mRNA expression of interleukin-1β. As GFO may have a potential therapeutic value as an adjunct therapy for ulcerative colitis(52).

2. Low-fat diets, medium-chain triglycerides, and perhaps omega-3 fatty acids and Fermentable fiber
According to the study by , in regarding the possible therapeutic role of some dietary components in IBD, low-fat diets seem to be particularly useful. Also, some lipid sources, such as olive oil, medium-chain triglycerides, and perhaps omega-3 fatty acids, might have a therapeutic effect. Fermentable fiber may have a role in preventing relapses in inactive UC(53).

3. Avoid Zinc deficiency
Zinc deficiency may cause a modulation of TNFα production of that can influence disease activity in DSS-induced colitis(54). Other study indicated that DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity(55).

4. Glutamine
In the study to investigate the role of L-glutamine and short-chain fatty acids, both via enema and oral administration, on mucosal healing in experimental colitis by Uludağ University, School of Medicine, Bursa, showed that L-glutamine enema can accelerate mucosal healing and regeneration in experimentally induced colitis in rats. When compared to glutamine in this study, short-chain fatty acids showed no beneficial effect on colitis(56).

5. Soybean and fish oil mixture
Soybean and fish oil mixture may be effective in improving colonic injury and DNA damage, and it could be an important complementary therapy in UC to reduce the use of anti-inflammatory drugs and prevent colorectal cancer, according to the study by the Universidade Federal de São Paulo(57). Other suggested that the soybean and fish oil mixture, more than the fish oil alone, could be a complementary therapy to achieve a cytokine balance in UC(58).

6. Nutritional and probiotic supplementation
 Dietary supplementation with essential nutrients known to be in short supply in the diet in IBD patients and with other molecules believed to provide beneficial anti-inflammatory effects, as well as with probiotic organisms that stimulate immune functions and resistance to infection has been tested in colitis models(59).

7.  Risk of colitis in Monotonous dietary intake
The relapsing nature and varying geographical prevalence of ulcerative colitis (UC) implicates environmental factors such as diet in its aetiology study showed that
monotonous dietary intake may decrease mammalian vulnerability against colitis in association with microbiota separation(60).

8. Blueberry husks, rye bran and multi-strain probiotics
Acombination of probiotics and blueberry husks or rye bran enhanced the anti-inflammatory effects compared with probiotics or dietary fibres alone. These combinations can be used as a preventive or therapeutic approach to dietary amelioration of intestinal inflammation(61).

In summerization, we would like to quote the study by Medical Department, Viborg Regional Hospital, "Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case-control studies are encumbered with methodological problems. Prospective studies on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty acids may be protective. No effect was found of intake of dietary fibres, sugar, macronutrients, total energy, vitamin C, D, E, Carotene, or Retinol (vitamin A) on risk of ulcerative colitis. No prospective data was found on risk related to intake of fruits, vegetables or food microparticles (titanium dioxide and aluminium silicate)"(61a).

8. Etc.
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Sources
(52) http://www.ncbi.nlm.nih.gov/pubmed/23274091
(53) http://www.ncbi.nlm.nih.gov/pubmed/22876032
(54) http://www.ncbi.nlm.nih.gov/pubmed/23268956
(55) http://www.ncbi.nlm.nih.gov/pubmed/22039323
(56) http://www.ncbi.nlm.nih.gov/pubmed/17602355
(57) http://www.ncbi.nlm.nih.gov/pubmed/20615224
(58) http://www.ncbi.nlm.nih.gov/pubmed/20363597
(59) http://www.ncbi.nlm.nih.gov/pubmed/22736018
(60) http://www.ncbi.nlm.nih.gov/pubmed/23085891
(61) http://www.ncbi.nlm.nih.gov/pubmed/19670079
(61a) http://www.ncbi.nlm.nih.gov/pubmed/22055893