Nutrition and inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) are always interested in the effects of diet on their disease and are often puzzled by the apparent lack of concern in this regard expressed by their doctors. This lack of concern too often reflects the lack of knowledge but it must be recognized that the evidence base for nutritional interventions is weak and compares poorly with that underlying the use of modern biologic drugs. The past year has had its usual collection of personal and systematic reviews of the topic and a regrettably large number of poor quality publications on nutrition in IBD. The present contribution aims to highlight some of the more original articles of the past year and to identify areas where useful progress is being made both in cause (sugar perhaps less important than was thought) and habitual diet (where more fruit and less red meat are cautiously promoted). With regard to specific interventions, there is a swing back toward an exclusion diet in children with Crohn's disease and to dietary management of persistent symptoms in IBD patients in whom objective evidence of disease activity is absent or very low. The quality of articles in the field is slowly improving and it is encouraging to find several pertinent publications in the highest caliber journals. Hopefully, this will encourage improvement in clinical practice and further investment in research.