This review sets out where dietary intervention now sits in inflammatory bowel disease. The argument is that Western dietary patterns act as a driver of gut inflammation rather than as background, that particular constituents have been linked to both the development and the course of disease, and that nutritional support has consequently become a modifiable treatment rather than an adjunct to one.
It covers exclusive enteral nutrition, which has the strongest evidence and is already standard induction therapy in paediatric Crohn's disease, and the solid-food diets developed to reproduce its effect in a form adults will actually follow. The authors compare what the efficacious solid-food diets have in common in order to derive a general dietary pattern, rather than endorsing any one branded regimen — which is the more useful output, because the branded regimens are hard to obtain and harder to sustain.
This is a narrative review and it should be read as a synthesis of direction rather than as evidence of effect size. Its practical value is in reframing the conversation: a patient asking what they should eat is asking a question that now has a partial answer, and 'diet does not cause or treat this' is no longer that answer. In Indian practice the relevant translation is the shift toward processed food and away from traditional dietary patterns, which is the exposure the review implicates.
- Ask about diet at review and record the pattern, not just whether there are trigger foods
- Consider exclusive enteral nutrition for induction in paediatric Crohn's disease
- Discuss reducing ultra-processed food intake as part of management, not as general advice
- Involve a dietitian before a patient adopts a restrictive regimen found online
Why it matters
The answer to 'what should I eat' has moved from 'it makes no difference' to something a clinician has to engage with.
Don't overread it
A narrative review — it summarises a direction of evidence rather than establishing that any specific diet changes disease course in adults.
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