Mediterranean Diet in IBD: IJG March 2026

Introduction

Diet plays an important role in the pathogenesis and management of inflammatory bowel disease (IBD). Among various dietary patterns, the Mediterranean diet (MD)—rich in fruits, vegetables, whole grains, olive oil, legumes, nuts, and fish—has been associated with anti-inflammatory and microbiome-modulating effects. Because chronic intestinal inflammation in IBD is influenced by diet, there is growing interest in evaluating whether the Mediterranean diet could serve as an adjunctive therapeutic strategy alongside standard medical therapy.

Summary

This systematic review and meta-analysis evaluated the effectiveness of the Mediterranean diet in patients with Crohn’s disease (CD) and ulcerative colitis (UC).

Key findings:

Eight studies were included in the analysis.

Seven studies (223 patients) provided data on remission outcomes.

The pooled clinical remission rate with the Mediterranean diet was 62% (95% CI 0.39–0.80).

Remission rates were similar between Crohn’s disease and ulcerative colitis:

CD: RR 0.67

UC: RR 0.56

When compared with control diets, the Mediterranean diet did not show a statistically significant advantage for inducing remission (OR 0.98).

Endoscopic and histological outcomes were not reported in the available studies.

Conclusion

The Mediterranean diet, when used alongside conventional medical therapy, is associated with a moderate clinical remission rate (~62%) in IBD, with comparable benefits in both CD and UC. However, current evidence is limited by small sample sizes, heterogeneity in study design, and lack of objective outcomes such as endoscopic healing.

Further well-designed randomised controlled trials are required to determine the true impact of the Mediterranean diet on mucosal healing, disease activity, and long-term outcomes in IBD.