The impact of dietary interventions on quality of life in adults with inflammatory bowel disease: a narrative review.

Symptoms associated with chronic inflammation have a negative impact on quality of life (QOL) in adults with inflammatory bowel disease (IBD). Dietary changes may assist in improving symptoms; however, they can be difficult to implement, causing increased stress and decreased QOL. The purpose of this narrative review was to investigate the impact of dietary interventions on QOL in adults with IBD. EBSCOhost was used to simultaneously search eight databases using the search terms 'inflammatory bowel disease' or 'IBD' or 'ulcerative colitis' or 'Crohn's disease' AND 'dietary interventions' or 'dietary advice' or 'dietary recommendations'. Inclusion criteria included adults with IBD and a validated QOL measure. After screening 1054 studies, 15 clinical trials were identified. Among these studies, dietary interventions included the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (n = 4), Immunoglobulin G (IgG) diet (n = 2), Anti-Inflammatory Diet (AID) (n = 1), highly restricted organic diet (n = 1), Autoimmune Protocol Diet (AIP) (n = 1), Dietary Modified Program (DMP) (n = 1), Dietary Modified Framework (DMF) (n = 1), Mediterranean diet (n = 2), and a high fibre diet (n = 2). QOL was measured using various validated questionnaires. Significant improvements in QOL were found in two of the low FODMAP diet studies, both IgG diet studies, the DMP, and one high fibre diet study. The Anti-inflammatory Diet, Dietary Modified Framework, Autoimmune Protocol Diet, highly restricted organic diet, and Mediterranean diet did not significantly improve QOL. Future research should focus on comparing dietary interventions, longer study durations, diet adherence and QOL. Due to the complexity in the various diets, dietitians with expertise in IBD are needed to assist with diet management.