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Qin X. Antibacterial Agents May Have Shifted Impacts on Inflammatory Bowel Diseases Along with Decrease in Gut Bacteria. Inflamm Bowel Dis 2024; 30:1228-1231. [PMID: 38457489 DOI: 10.1093/ibd/izae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Indexed: 03/10/2024]
Abstract
Lay Summary
This article discussed the likely bell-shaped complicated impacts of antibacterial agents such as food additives like some artificial sweeteners on inflammatory bowel diseases including ulcerative colitis and Crohn’s disease along with decrease in gut bacteria.
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Affiliation(s)
- Xiaofa Qin
- GI Biopharam Inc, 918 Willow Grove Road, Westfield, NJ 07090, USA
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Fitzpatrick JA, Gibson PR, Taylor KM, Halmos EP. Development of Novel High and Low Emulsifier Diets Based upon Emulsifier Distribution in the Australian Food Supply for Intervention Studies in Crohn's Disease. Nutrients 2024; 16:1922. [PMID: 38931276 PMCID: PMC11206755 DOI: 10.3390/nu16121922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The aims of this study were to develop and evaluate a high/low-emulsifier diet and compare emulsifier content with preclinical studies that have associated Crohn's disease with emulsifiers. METHODS Supermarkets were audited with a seven-day high- (HED) and low-emulsifier diet (LED) meal plan developed. The emulsifier content of food was sought from food manufacturers, compared to acceptable daily intake (ADI), and doses were provided in trials. Nutritional composition analysis was completed. Healthy adults ate these diets for seven days in a randomized single-blinded cross-over feeding study to assess palatability, tolerability, satiety, food variety, dietary adherence, blinding and the ease of following the meal plan via visual analogue scale. RESULTS A database of 1680 foods was created. There was no difference in nutritional content between the HED and LED, except HED had a higher ultra-processed food content (p < 0.001). The HED contained 41 emulsifiers, with 53% of the products able to be quantified for emulsifiers (2.8 g/d), which did not exceed the ADI, was similar to that in observational studies, and was exceeded by doses used in experimental studies. In ten participants, diets were rated similarly in palatability-HED mean 62 (5% CI 37-86) mm vs. LED 68 (54-82) mm-in tolerability-HED 41 (20-61) mm vs. LED 55 (37-73) mm-and in satiety HED 57 (32-81) mm vs. LED 49 (24-73) mm. The combined diets were easy to follow (82 (67-97) mm) with good variety (65 (47-81)) and excellent adherence. CONCLUSION Nutritionally well-matched HED and LED were successfully developed, palatable and well tolerated.
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Affiliation(s)
- Jessica A. Fitzpatrick
- Department of Gastroenterology, School of Translational Medicine, Monash University, Melbourne 3004, Australia; (P.R.G.); (E.P.H.)
| | - Peter R. Gibson
- Department of Gastroenterology, School of Translational Medicine, Monash University, Melbourne 3004, Australia; (P.R.G.); (E.P.H.)
| | - Kirstin M. Taylor
- Department of Gastroenterology, Alfred Health, Melbourne 3004, Australia
| | - Emma P. Halmos
- Department of Gastroenterology, School of Translational Medicine, Monash University, Melbourne 3004, Australia; (P.R.G.); (E.P.H.)
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Babaei A, Pourmotabbed A, Talebi S, Mehrabani S, Bagheri R, Ghoreishy SM, Amirian P, Zarpoosh M, Mohammadi H, Kermani MAH, Fakhari H, Moradi S. The association of ultra-processed food consumption with adult inflammatory bowel disease risk: a systematic review and dose-response meta-analysis of 4 035 694 participants. Nutr Rev 2024; 82:861-871. [PMID: 37632227 DOI: 10.1093/nutrit/nuad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
CONTEXT There is an inconsistency between the results obtained from observational studies regarding intake of ultra-processed foods (UPFs) and the risk of inflammatory bowel disease (IBD). OBJECTIVES A dose-response meta-analysis was performed to evaluate the relationship between UPF intake and the risk of IBD. DATA SOURCES Searches were performed in the PubMed, ISI Web of Science, and Scopus databases up to November 2, 2022. DATA EXTRACTION Data were available from 24 studies including a total of 4 035 694 participants from 20 countries. DATA ANALYSIS Risk ratios for IBD were analyzed by a random-effects model. Outcomes indicated that UPF intake was linked to an increased risk of IBD (relative risk [RR], 1.13; 95%CI, 1.06-1.21; P = 0.001; I2 = 73.2%; n = 59; N = 4 035 694). This association was significant, especially for the risk of Crohn's disease (CD) (RR, 1.19; 95%CI, 1.00-1.41; I2 = 78.2%; P = 0.046; n = 23; N = 2 167 160), unlike the risk of ulcerative colitis (UC) (RR = 1.11; 95%CI, 0.99-1.26; P = 0.085; I2 = 60.3%; n = 27; N = 2 167 918). Also, results revealed that each 10% enhancement in daily UPF intake was not related to the risk of IBD (RR, 1.05; 95%CI, 0.98-1.14; P = 0.168; I2 = 31.9%; n = 4) or the risk of UC (RR, 1.01; 95%CI, 0.92-1.11; P = 0.876; I2 = 34.7%; n = 2) in adults. However, results suggested that for every 10% increase in daily UPF intake, there was a 19% increase in the risk of CD (RR, 1.19; 95%CI, 1.01-1.32; P = 0.021; I2 = 0.0%; n = 2) among adults. In addition, the results showed a positive linear relation between UPF intake with CD risk (Pnonlinearity = 0.431; Pdose response = 0.049) but not risk of IBD or UC. CONCLUSION High intake of UPFs was linked with an enhanced IBD risk, a specific risk of CD. However, conducting more observational studies among several ethnicities and using specific tools that accurately assess the amount of UPF consumption, components of UPFs, and food additives may be necessary. Systematic Review Registration: PROSPERO registration no. CRD42023390258.
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Affiliation(s)
- Atefeh Babaei
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Pourmotabbed
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mehrabani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Parsa Amirian
- General Practitioner, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Zarpoosh
- General Practitioner, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Fakhari
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Meng MJ, Huang J, Tsou YK, Pan YB, Chiu CT, Lin YT, Le PH. Diet and the risk of inflammatory bowel disease: A retrospective cohort study in Taiwan. J Formos Med Assoc 2024:S0929-6646(24)00280-8. [PMID: 38851916 DOI: 10.1016/j.jfma.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/25/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND/PURPOSE The incidence of inflammatory bowel disease (IBD) rapidly increases in Asia, and western dietary pattern is suspected to be the major risk factor. Despite this, there has been a lack of studies analyzing the relationship between dietary patterns and IBD in Taiwan. This study examines the dietary habits of Taiwanese individuals with and without IBD to inform clinical dietary recommendations for IBD patients. METHODS We collected baseline characteristics and dietary habits from both IBD patients and healthy controls from February and August 2022 in Chang Gung memorial hospital using a structured and validated food frequency questionnaire. The dietary habits of IBD patients in this study were focused on the six months leading up to their IBD diagnosis. RESULTS Our study recruited 98 IBD patients and 184 healthy controls. In demographic characteristics, cigarette smoking is more common in IBD group. Besides, distinct dietary patterns were observed between groups. The healthy controls demonstrated a higher consumption of whole foods and antioxidants. By contrast, the IBD group consumed more western-style foods but the difference didn't reach statistical significance. CONCLUSION Our study found that healthy controls in Taiwan embraced a dietary pattern rich in whole foods that may prevent IBD or reduce IBD disease activity. Nonetheless, a larger sample size is needed to further provide valuable dietary guidance for general population in Taiwan for IBD prevention or for patients with IBD for disease activity control.
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Affiliation(s)
- Ming Jung Meng
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Jyun Huang
- Department of Clinical Nutrition Therapy, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Chang Gung Inflammatory Bowel Disease Center, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Yung Kuan Tsou
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Yu Bin Pan
- Biostatistical Section, Clinical Trial Center, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Cheng Tang Chiu
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Taiwan Association of the Study of Intestinal Disease (TASID), 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Chang Gung Inflammatory Bowel Disease Center, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Chang Gung Microbiota Therapy Center, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Yan Ting Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan
| | - Puo Hsien Le
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Taiwan Association of the Study of Intestinal Disease (TASID), 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Chang Gung Inflammatory Bowel Disease Center, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan; Chang Gung Microbiota Therapy Center, Linkou, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan.
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5
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Whelan K, Bancil AS, Lindsay JO, Chassaing B. Ultra-processed foods and food additives in gut health and disease. Nat Rev Gastroenterol Hepatol 2024; 21:406-427. [PMID: 38388570 DOI: 10.1038/s41575-024-00893-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/24/2024]
Abstract
Ultra-processed foods (UPFs) and food additives have become ubiquitous components of the modern human diet. There is increasing evidence of an association between diets rich in UPFs and gut disease, including inflammatory bowel disease, colorectal cancer and irritable bowel syndrome. Food additives are added to many UPFs and have themselves been shown to affect gut health. For example, evidence shows that some emulsifiers, sweeteners, colours, and microparticles and nanoparticles have effects on a range of outcomes, including the gut microbiome, intestinal permeability and intestinal inflammation. Broadly speaking, evidence for the effect of UPFs on gut disease comes from observational epidemiological studies, whereas, by contrast, evidence for the effect of food additives comes largely from preclinical studies conducted in vitro or in animal models. Fewer studies have investigated the effect of UPFs or food additives on gut health and disease in human intervention studies. Hence, the aim of this article is to critically review the evidence for the effects of UPF and food additives on gut health and disease and to discuss the clinical application of these findings.
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Affiliation(s)
- Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, UK.
| | - Aaron S Bancil
- Department of Nutritional Sciences, King's College London, London, UK
| | - James O Lindsay
- Blizard Institute, Queen Mary University of London, Barts and the London School of Medicine, London, UK
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Gonza I, Goya-Jorge E, Douny C, Boutaleb S, Taminiau B, Daube G, Scippo ML, Louis E, Delcenserie V. Food additives impair gut microbiota from healthy individuals and IBD patients in a colonic in vitro fermentation model. Food Res Int 2024; 182:114157. [PMID: 38519184 DOI: 10.1016/j.foodres.2024.114157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/24/2024]
Abstract
Intestinal fibrosis is a long-term complication of inflammatory bowel diseases (IBD). Changes in microbial populations have been linked with the onset of fibrosis and some food additives are known to promote intestinal inflammation facilitating fibrosis induction. In this study, we investigated how polysorbate 80, sucralose, titanium dioxide, sodium nitrite and maltodextrin affect the gut microbiota and the metabolic activity in healthy and IBD donors (patients in remission and with a flare of IBD). The Simulator of the Human Intestinal Microbial Ecosystem (SHIME®) with a static (batch) configuration was used to evaluate the effects of food additives on the human intestinal microbiota. Polysorbate 80 and sucralose decreased butyrate-producing bacteria such as Roseburia and Faecalibacterium prausnitzii. Both compounds, also increased bacterial species positively correlated with intestinal inflammation and fibrosis (i.e.: Enterococcus, Veillonella and Mucispirillum schaedleri), especially in donors in remission of IBD. Additionally, polysorbate 80 induced a lower activity of the aryl hydrocarbon receptor (AhR) in the three groups of donors, which can affect the intestinal homeostasis. Maltodextrin, despite increasing short-chain fatty acids production, promoted the growth of Ruminococcus genus, correlated with higher risk of fibrosis, and decreased Oscillospira which is negatively associated with fibrosis. Our findings unveil crucial insights into the potential deleterious effects of polysorbate 80, sucralose and maltodextrin on human gut microbiota in healthy and, to a greater extent, in IBD patients.
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Affiliation(s)
- Irma Gonza
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Elizabeth Goya-Jorge
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Caroline Douny
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Samiha Boutaleb
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Bernard Taminiau
- Laboratory of Microbiology, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Georges Daube
- Laboratory of Microbiology, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Marie-Louise Scippo
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Edouard Louis
- Hepato - Gastroenterology and Digestive Oncology Department, CHU of Liège, Liège, Belgium.
| | - Véronique Delcenserie
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
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7
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Katsoudas N, Tavakoli P, Wu N, Shapiro A, Leach ST, Williams AJ, Paramsothy R, Ghaly S, Connor SJ, Samocha-Bonet D, Lambert K, Hold GL. Dietary Emulsifier Exposure in People With Inflammatory Bowel Disease Compared With Healthy Controls: Is There a Cause for Concern? Inflamm Bowel Dis 2024:izad318. [PMID: 38244236 DOI: 10.1093/ibd/izad318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Emulsifiers are implicated in the pathogenesis of inflammatory bowel disease (IBD). Few studies have examined emulsifier intake in people with existing IBD. We aimed to describe the frequency of exposure to 6 selected emulsifiers in a contemporary cohort of people with IBD and compare intake with healthy controls (HCs). METHODS Baseline food records from participants in an Australian prospective cohort study examining the microbiome of IBD patients and HCs were analyzed. Exposure to inflammatory emulsifiers polysorbate-80 (P80); carboxymethylcellulose (CMC); carrageenan; xanthan gum (XG); lecithin (soy and sunflower) and mono- and diglycerides of fatty acids (MDGs) were determined by examining ingredient lists. Frequency of emulsifier exposure between groups (IBD vs HC, Crohn's disease [CD] vs ulcerative colitis [UC], IBD children vs adults, active disease vs remission) was examined after controlling for confounders. RESULTS Records from 367 participants were analyzed (n = 176 IBD, of which there were 101 CD, 75 UC, and 191 HC patients). In total, 5022 unique food items were examined, with 18% containing 1 or more emulsifier of interest. Inflammatory bowel disease participants had significantly higher total daily emulsifier exposure compared with HCs (2.7 ± 1.8 vs 2.3 ± 1.6, P = .02). In IBD participants, emulsifiers with the highest daily exposure were MDGs (1.2 ± 0.93), lecithin (0.85 ± 0.93), and XG (0.38 ± 0.42). There were no recorded exposures to P80. CONCLUSIONS Inflammatory bowel disease participants were exposed to more emulsifiers than HCs. Intake of inflammatory emulsifiers were low or nonexistent, suggesting their presence in the food supply are not as common as frequently stated.
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Affiliation(s)
- Natasha Katsoudas
- School of Medical, Indigenous and Health Science, University of Wollongong, New South Wales, Australia
| | - Paris Tavakoli
- Microbiome Research Centre, University of New South Wales, Kogarah, New South Wales, Australia
- St Vincent's Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - Nan Wu
- Microbiome Research Centre, University of New South Wales, Kogarah, New South Wales, Australia
| | - Amanda Shapiro
- Department of Paediatrics, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Steven T Leach
- Department of Paediatrics, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Astrid-Jane Williams
- Liverpool Hospital Dept of Gastroenterology and Hepatology, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- South West Sydney Clinical Campuses, University of New South Wales Medicine & Health, University of New South Wales, Sydney, Australia
| | - Ramesh Paramsothy
- Centre for Gastrointestinal Health Castle Hill, New South Wales, Australia
| | - Simon Ghaly
- St Vincent's Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - Susan J Connor
- Liverpool Hospital Dept of Gastroenterology and Hepatology, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- South West Sydney Clinical Campuses, University of New South Wales Medicine & Health, University of New South Wales, Sydney, Australia
| | - Dorit Samocha-Bonet
- Garvan Institute of Medical Research and School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, University of New South Wales Medicine & Health, University of New South Wales, Sydney, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Science, University of Wollongong, New South Wales, Australia
| | - Georgina L Hold
- Microbiome Research Centre, University of New South Wales, Kogarah, New South Wales, Australia
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Tosi M, Montanari C, Bona F, Tricella C, Agostinelli M, Dolor J, Chillemi C, Di Profio E, Tagi VM, Vizzuso S, Fiore G, Zuccotti G, Verduci E. Dietary Inflammatory Potential in Pediatric Diseases: A Narrative Review. Nutrients 2023; 15:5095. [PMID: 38140353 PMCID: PMC10745369 DOI: 10.3390/nu15245095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Inflammatory status is one of the main drivers in the development of non-communicable diseases (NCDs). Specific unhealthy dietary patterns and the growing consumption of ultra-processed foods (UPFs) may influence the inflammation process, which negatively modulates the gut microbiota and increases the risk of NCDs. Moreover, several chronic health conditions require special long-term dietary treatment, characterized by altered ratios of the intake of nutrients or by the consumption of disease-specific foods. In this narrative review, we aimed to collect the latest evidence on the pro-inflammatory potential of dietary patterns, foods, and nutrients in children affected by multifactorial diseases but also on the dietetic approaches used as treatment for specific diseases. Considering multifactorial diet-related diseases, the triggering effect of pro-inflammatory diets has been addressed for metabolic syndrome and inflammatory bowel diseases, and the latter for adults only. Future research is required on multiple sclerosis, type 1 diabetes, and pediatric cancer, in which the role of inflammation is emerging. For diseases requiring special diets, the role of single or multiple foods, possibly associated with inflammation, was assessed, but more studies are needed. The evidence collected highlighted the need for health professionals to consider the entire dietary pattern, providing balanced and healthy diets not only to permit the metabolic control of the disease itself, but also to prevent the development of NCDs in adolescence and adulthood. Personalized nutritional approaches, in close collaboration between the hospital, country, and families, must always be promoted together with the development of new methods for the assessment of pro-inflammatory dietary habits in pediatric age and the implementation of telemedicine.
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Affiliation(s)
- Martina Tosi
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy;
| | - Chiara Montanari
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Federica Bona
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Chiara Tricella
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Marta Agostinelli
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Jonabell Dolor
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Claudia Chillemi
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Elisabetta Di Profio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy;
| | - Veronica Maria Tagi
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy;
| | - Sara Vizzuso
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy;
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.T.); (C.M.); (F.B.); (C.T.); (M.A.); (J.D.); (C.C.); (E.D.P.); (V.M.T.); (S.V.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, 20146 Milan, Italy;
- Metabolic Diseases Unit, Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy
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Narula N, Chang NH, Mohammad D, Wong ECL, Ananthakrishnan AN, Chan SSM, Carbonnel F, Meyer A. Food Processing and Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2023; 21:2483-2495.e1. [PMID: 36731590 DOI: 10.1016/j.cgh.2023.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND & AIMS Several studies have been published on the association between food processing and risks of Crohn's disease (CD) and ulcerative colitis (UC), with some variability in results. We performed a systematic literature review and meta-analysis to study this association. METHODS From PubMed, Medline, and Embase until October 2022, we identified cohort studies that studied the association between food processing and the risk of CD or UC. Risk of bias of the included studies was assessed by the Newcastle-Ottawa scale. We computed pooled hazard ratios (HRs) and 95% confidence intervals (CIs) using random-effects meta-analysis based on estimates and standard errors. RESULTS A total of 1,068,425 participants were included (13,594,422 person-years) among 5 cohort studies published between 2020 and 2022. Four of the 5 included studies were scored as high quality. The average age of participants ranged from 43 to 56 years; 55%-83% were female. During follow-up, 916 participants developed CD, and 1934 developed UC. There was an increased risk for development of CD for participants with higher consumption of ultra-processed foods compared with those with lower consumption (HR, 1.71; 95% CI, 1.37-2.14; I2 = 0%) and a lower risk of CD for participants with higher consumption of unprocessed/minimally processed foods compared with those with lower consumption (HR, 0.71; 95% CI, 0.53-0.94; I2 = 11%). There was no association between risk of UC and ultra-processed foods (HR, 1.17; 95% CI, 0.86-1.61; I2 = 74%) or unprocessed/minimally processed foods (HR, 0.84; 95% CI, 0.68-1.02; I2 = 0%). CONCLUSIONS Higher ultra-processed food and lower unprocessed/minimally processed food intakes are associated with higher risk of CD but not UC.
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Affiliation(s)
- Neeraj Narula
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
| | - Nicole H Chang
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Danah Mohammad
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Emily C L Wong
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Simon S M Chan
- Department of Gastroenterology, Norfolk and Norwich University Hospital and Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Franck Carbonnel
- Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris and Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Antoine Meyer
- Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris and Université Paris-Saclay, Le Kremlin Bicêtre, France
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Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6461. [PMID: 37569002 PMCID: PMC10419141 DOI: 10.3390/ijerph20156461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.
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Affiliation(s)
- Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Selena Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA 16802, USA;
| | - Nina Overby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, 4630 Kristiansand, Norway;
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
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Atagozli T, Elliott DE, Ince MN. Helminth Lessons in Inflammatory Bowel Diseases (IBD). Biomedicines 2023; 11:1200. [PMID: 37189818 PMCID: PMC10135676 DOI: 10.3390/biomedicines11041200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Helminths are multicellular invertebrates that colonize the gut of many vertebrate animals including humans. This colonization can result in pathology, which requires treatment. It can also lead to a commensal and possibly even a symbiotic relationship where the helminth and the host benefit from each other's presence. Epidemiological data have linked helminth exposure to protection from immune disorders that include a wide range of diseases, such as allergies, autoimmune illnesses, and idiopathic inflammatory disorders of the gut, which are grouped as inflammatory bowel diseases (IBD). Treatment of moderate to severe IBD involves the use of immune modulators and biologics, which can cause life-threatening complications. In this setting, their safety profile makes helminths or helminth products attractive as novel therapeutic approaches to treat IBD or other immune disorders. Helminths stimulate T helper-2 (Th2) and immune regulatory pathways, which are targeted in IBD treatment. Epidemiological explorations, basic science studies, and clinical research on helminths can lead to the development of safe, potent, and novel therapeutic approaches to prevent or treat IBD in addition to other immune disorders.
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Affiliation(s)
- Tyler Atagozli
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Iowa Carver College of Medicine, Iowa City, IA 52246, USA
| | - David E. Elliott
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Iowa Carver College of Medicine, Iowa City, IA 52246, USA
- Iowa City Veterans Affairs Medical Center, Iowa City, IA 52246, USA
| | - Mirac Nedim Ince
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Iowa Carver College of Medicine, Iowa City, IA 52246, USA
- Iowa City Veterans Affairs Medical Center, Iowa City, IA 52246, USA
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Calvo MS, Uribarri J. Food Additive Use in Ultraprocessed Foods: Can Processing Use of Industrial Additives Contribute to Adverse Health Outcomes in Children? J Acad Nutr Diet 2023; 123:861-864. [PMID: 36682684 DOI: 10.1016/j.jand.2023.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Affiliation(s)
- Mona S Calvo
- The Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Jaime Uribarri
- The Icahn School of Medicine at Mount Sinai, New York, New York.
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