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.
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.
Introduction: The global incidence of inflammatory bowel disease (IBD) continues to rise, particularly in newly industrialized countries. This comprehensive systematic review evaluated how race, ethnicity, geography, and migration influence the clinical phenotype and outcomes of...
Introduction: Acute severe ulcerative colitis (ASUC) remains one of the most life-threatening emergencies in inflammatory bowel disease. Despite advances in IBD therapy, first-line management has changed little over the past two decades, and colectomy continues...
Introduction: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with a rising global burden. Although current therapies are effective, many patients fail treatment or experience adverse effects. Fecal microbiota transplantation (FMT) has emerged as...
Introduction: Despite major advances with biologics and small molecules, many patients with IBD continue to have refractory disease or lose treatment response. This Perspective explores engineered cellular therapies designed to restore immune tolerance rather than...
Introduction: Randomized clinical trials (RCTs) are the cornerstone for approving biologic therapies in inflammatory bowel disease (IBD). However, strict eligibility criteria may exclude many patients encountered in routine clinical practice, raising concerns about the real-world...
Introduction: Mirikizumab, a selective IL-23p19 inhibitor, has demonstrated efficacy in phase III clinical trials for moderate-to-severe ulcerative colitis (UC). This multicenter Italian real-world study evaluated its effectiveness and safety in routine clinical practice, including patients...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.