Efficacy of Whole-Food Based Anti-inflammatory Dietary Interventions in the Management of Ulcerative Colitis: A Systematic Review and Meta-Analysis.

BACKGROUND

Ulcerative Colitis (UC) is a chronic inflammatory colon condition with multifactorial causation. Recent interest has grown around the role of diet in managing symptoms and disease progression. Due to the absence of definitive evidence, no consistent dietary guidelines exist for UC management.

AIMS: This research investigates the impact of anti-inflammatory diets on disease activity and inflammation in patients with UC.

METHODS

PubMed, Cochrane, Embase and ClinicalTrials.gov were systematically searched from inception until April 2025. Dichotomous outcomes were pooled as risk ratio (RR) and continuous outcomes as mean differences (MD) with 95% confidence intervals (CI), using random-effects models. Heterogeneity was assessed using I2 and X2 statistics. Statistical analyses were performed using RevMan 5.4 and P<0.05 was considered significant.

RESULTS

Six RCTs involving 359 patients aged 12-75 years, having mild-to-moderate active UC, quiescent UC or UC in clinical remission, were included. Anti-inflammatory diets did not significantly affect the clinical remission (RR = 1.59, 95% CI [0.77 to 3.28], P = 0.21, I2 = 76%) or relapse rates (RR = 0.62, 95% CI [0.30 to 1.25], P = 0.18, I2 = 0%) in quiescent UC. However, improved clinical response was observed (RR = 1.82, 95% CI [1.20 to 2.75], P = 0.004, I2 = 0%) in active disease. Moreover, FCP levels were significantly reduced (MD = - 210.01, 95% CI [- 359.77 to - 60.25], P = 0.006, I2 = 0%), particularly during remission.

CONCLUSION

Anti-inflammatory diet complements conventional therapy in UC by promoting clinical response in active disease and reducing intestinal inflammation during remission.