Inflammatory Bowel Disease (IBD) & Western Diet (WD) / Western Pattern Diet

Epidemiological trends have led to a growing consensus that Food / Diets / Nutrients plays a central role in the etiopathogenesis of Inflammatory Bowel Disease (IBD) . A Western diet high in ultra-processed foods has been linked to an increased prevalence of Inflammatory Bowel Disease (IBD) worldwide. Much attention has been paid to the components of the Western diet, including its high-fat content, lack of fiber, added sugars , and use of additives such as carrageenan and other emulsifiers . Less attention has been paid to the effects of high salt intake , an integral part of ultra-processed foods , which has increased dramatically in the US diet over the past 50 years. Recent studies have shown that high dietary salt intake is pro-inflammatory and contributes to chronic inflammatory conditions. Salt intake is likely a contributory factor to inflammatory bowel diseases’ pathogenesis and severity.
Kuang et al. 2023 Inflammatory Bowel Diseases 29(1): 140-150

Western Diet (WD) / Western Pattern Diet, characterized by high consumption of total fats, omega-6 fatty acids, and meat, has been linked to intestinal inflammation and the recurrence of inflammatory bowel disease. Plant-based diets, unlike Western diets, typically lead to a lower consumption of total fats and meats while increasing the intake of plant fibers. This shift in dietary habits can help decrease intestinal inflammation in individuals with active inflammatory bowel disease (IBD), lessen the severity of the disease, and aid in maintaining clinical remission.
Antoniussen et al. 2021 Front. Nutr. 8: 733433

A recent case-control study indicated that a high-protein dietary pattern is positively related to the risk of Inflammatory Bowel Disease (IBD), whereas a high-vegetable dietary pattern may reduce Inflammatory Bowel Disease (IBD) risk
Tayyem et al. 2021 Nutrients 13(6): 1889

A diet high in saturated (milk-derived) fats (MF) but not in Polyunsaturated Fatty Acids (PUFAs) promotes taurine conjugation of cholic acid to taurocholic acid, which is associated with increased organic sulfur availability. This encourages the spread of the sulfite-reducing pathobiont Bilophila wadsworthia, which uses the sulfur. This, in turn, promotes the pro-inflammatory CD4+ Th1 Cell Responses with an increased incidence of colitis in mice when the immunosuppressive counter-regulation fails.
Devkota et al. 2012 Nature 487: 104

Mechanisms

The high glucose intake can increase the permeability of the gut barrier and the sensitivity of pro-inflammatory cytokines.
He et al. 2022a Adv Nutr doi: 10.1093/advances/nmac029

A high-protein or high-fat diet increases oxidative stress in the endoplasmic reticulum (ER) and decreases the expression of MUCIN-2 (MUC2) and Claudin-1 / CLDN1 in the colon tissues of mice.
He et al. 2022a Adv Nutr doi: 10.1093/advances/nmac029

The gut barrier is disrupted, and an inflammatory response is triggered.
He et al. 2022a Adv Nutr doi: 10.1093/advances/nmac029

These can activate Transforming growth factor beta (TGF-beta) by upregulating reactive oxygen species in T cells, thereby promoting the differentiation of CD4+ Th17 cells and triggering colitis in mice
Zhang et al. 2019 Immunity 51(4): 671-81

A recent study found that activation of the MTOR signal transduction pathway / mTOR (mammalian target of rapamycin) is the basis of Western Diet (WD) / Western Pattern Diet-induced gut dysfunction and inflammation (Xie et al. 2020d J Clin Invest 130(4): 2111-28) and that the excessive inflammatory responses upset the balance of intestinal T helper 17 (Th17) and further disrupt regulatory T (Treg) cells, which ultimately increase the risk of Inflammatory Bowel Disease (IBD)
Khalili et al. 2018 Nat Rev Gastroenterol Hepatol 15(9): 525-35
Schroeder et al. 2018a Cell Host & Microbe 23(1): 27-40

In addition, Western Diet (WD) / Western Pattern Diet can upregulate the levels of toll-like receptors (TLRs) such as Toll-like receptor 2 (TLR-2) and CD284 (Toll-Like Receptor 4 (TLR-4)), which are also significantly elevated in patients with Inflammatory Bowel Disease (IBD)
de Souza & Fiocchi 2016 Nat. Rev. Gastroenterol. Hepatol. 13: 13–27
Torres et al. 2017 Lancet North Am Ed 389(10080): 1741-55

The balance between nonclassical natural killer T cells and Treg cells is disrupted, ultimately exacerbating experimental colitis
Ma et al. 2007 Clin Exp Immunol 151(1): 130-8
Gulhane et al. 2016 Sci Rep 6(1): 28990

A Western Diet (WD) / Western Pattern Diet could inhibit the expression of MUCIN-2 (MUC2), the first line of defense against microbial invasion in the gut, thereby increasing the permeability of the epithelial barrier
Peterson & Artis 2014 Nat. Rev. Immunol. 14: 141-153

Proofs

A systematic review (including 2609 Inflammatory Bowel Disease (IBD) patients and over 4000 controls) indicated that a high intake of total fat, PUFAs, and meat is positively associated with the risk of Ulcerative colitis (UC) and Crohn's disease (CD)
He et al. 2022a Adv Nutr doi: 10.1093/advances/nmac029

They conducted another large prospective population-based cohort, which further found that Western Diet (WD) / Western Pattern Diet and carnivorous patterns were associated with the development of Crohn's disease (CD) and Ulcerative colitis (UC), respectively
Peters et al. 2022 J Crohns Colitis 16(6): 931-939

A recent Dutch cohort study with a 2-y longitudinal clinical follow-up found that a dietary pattern considered a “Western” way was associated with Inflammatory Bowel Disease (IBD) exacerbation
Peters et al. 2021b J Crohns Colitis 15(8): 1305-15

However, another study demonstrated that controlling the consumption of red and processed meat in patients with Crohn's disease (CD) in remission does not reduce the incidence of disease (time to any (P = 0.61) or moderate/severe (P = 0.50) relapse)
Albenberg et al. 2019 Gastroenterology 157(1): 128-36

A recent study showed that a Western Diet (WD) / Western Pattern Diet significantly aggravated dextran sodium sulfate (DSS)-induced experimental colitis in BALB/c mice, but switching to a healthy diet reduced colon inflammation
Groschel et al. 2019 Nutrients 12(1): 45

A large (n = 366,351) European prospective cohort study found a positive correlation between the intake of sugar and soft drinks and the risk of Ulcerative colitis (UC) (P trend= 0.02)
Racine et al. 2016 Inflamm Bowel Dis 22(2): 345-54

see also:
Food / Diets / Nutrients & Inflammatory Bowel Disease (IBD)
Food / Diets / Nutrients & Inflammatory Bowel Disease (IBD)
Western Diet (WD) / Western Pattern Diet