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Abstract

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, despite the increasing incidence, still do not have a specific etiology. Diet seems to be an important factor, modifying the occurrence of the disease and its course. Diet can affect the symptoms of IBD both directly, e.g., by alleviating diarrhea, bloating and constipation, and indirectly by shaping the microbiota. Bacterial meta-bolites produced under the influence of supplied nutrients may contribute to the modulation of pro- and anti-inflammatory pathways, depending on the diet used. So far, IBD has been associated with weight loss and malnutrition. In recent years, a trend of sarcopenic obesity with concomitant malnutrition has been observed. The new phenomenon is called malnubesity. This work aims to review the most commonly used diets in IBD in order to evaluate them in terms of alleviating ailments, but also maintaining proper nutritional status and lack of obesity. Low-fiber, low FODMAPs, Mediterranean diet and Crohn’s Disease Exclusion Diet diet were considered. We assume that diet is modifiable factor that is related to nutritional status and healthy body weight. In addition, the current knowledge on the relationship between nutrition strategies, obesity and IBD will be demonstrated.
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Authors and Affiliations

Agnieszka Dąbek
1
Olga Kaczmarczyk
2
Tomasz Dziubyna
2
Agnieszka Piątek-Guziewicz
2
Małgorzata Zwolińska-Wcisło
1 2

  1. Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Introduction: Inflammatory bowel disease (IBD) represents a group of chronic inflamma-tory disorders characterized by dysbiosis and altered short-chain fatty acid (SCFA) level. The association between individual SCFA levels and cytokine levels is unknown.
Objectives: We aimed to determine the fecal SCFA levels in patients with IBD in relation to disease severity and the serum levels of pro- and anti-inflammatory cytokines.
Patients and Methods: The study included 61 patients with IBD (inactive, 22; active, 39) and 16 controls. Fecal levels of organic acids (acetic, lactic, propionic, butyric, isovaleric, isobutyric, and valeric), serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), IL-17, and IL-22, complete blood count and C-reactive protein (CRP) were measured.
Results: Patients with active IBD had reduced butyric, acetic, valeric, and isovaleric acid levels and elevated lactic acid levels in stool. Hemoglobin levels were positively correlated with the levels of acetic and butyric acids ( R = 0.266 and R = 0.346, respectively; P <0.05). In addition, CRP levels were inversely correlated with butyric acid levels ( R = –0.573; P <0.05). Higher serum TNF-α levels were observed in patients with active IBD compared with controls (6.64 pg/ml vs 2.05 pg/ml, P <0.05). No relationship was noted between the SCFA profile and cytokine levels.
Conclusions: The study showed that determination of SCFA levels can be used to evaluate the activity of IBD. The relationship between individual SCFA and cytokine levels seems to be complex and requires further studies.
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Authors and Affiliations

Olga Kaczmarczyk
1
Agnieszka Dąbek-Drobny
2
Michał Woźniakiewicz
3
Paweł Paśko
4
Justyna Dobrowolska-Iwanek
4
Aneta Woźniakiewicz
3
Aneta Targosz
5
Agata Ptak-Belowska
5
Agnieszka Piątek-Guziewicz
1
Kacper Wcisło
6
Paweł Zagrodzki
4
Małgorzata Zwolińska-Wcisło
1 2

  1. Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
  2. Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland
  4. Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
  5. Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  6. Department of Pathomorphology, University Hospital, Kraków, Poland

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