title: Nutritional modulators of ulcerative colitis: clinical efficacies and mechanistic view.
abstract: Ulcerative colitis (UC) is an inflammation-associated disease of the colon and rectum. The onset and progress of the disease are directly influenced by the nature of the intestinal microflora, the intestinal barrier function, and the immunological responses of the host. The epithelial invasion of pathogenic bacteria due to excess contact and/or barrier dysfunction is related to inflammation mediated by intestinal immune responses. Although the etiology of UC is not clearly understood, recent studies have shown a rising incidence of UC worldwide, and this phenomenon is more prominent in Asian countries and in Asian immigrants in Western countries. The increased prevalence of UC also contributes to an increased risk of developing colorectal cancer. Environmental factors, including changes in dietary habits, have been suggested as major risk factors of UC. A systematic review showed a negative association between UC risk and vegetable intake, whereas total fat, omega-6 fatty acids and meat intake were positively associated with an increased risk of UC. Individual dietary factors and energy balance have been suggested as having important roles in inducing changes in the microbial population and intestinal barrier integrity and in regulating inflammatory immune responses, directly or indirectly. Excess energy intake is now known to increase pathogenic microbial populations. Likewise, the application of appropriate probiotics may reverse the pathogenic progression of the disease. In the meantime, dietary anti-inflammatory compounds, including omega-3 fatty acids and other phytochemicals, may directly suppress inflammatory responses in the course of UC development. In this review, the increased prevalence of UC and its management are interpreted from the standpoint of nutritional modulation to regulate the intestinal microflora population, intestinal epithelium permeability, and inflammatory responses.
authors: Department of Food and Nutrition, Sookmyung Women's University, Seoul 140-742, South Korea. mksung@sm.ac.kr
authors: Mi-Kyung
authors: MK
authors: Sung
authors: Mi-Young
authors: MY
authors: Park
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology* / Q000628:therapy; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake; D005247:Feeding Behavior; D006801:Humans; D007422:Intestines / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D010539:Permeability; D015995:Prevalence; D019936:Probiotics; D011379:Prognosis; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants
keywords: Antioxidants; Clinical; Immunity; Inflammation; Intestinal microflora; Obesity; Omega-3 fatty acids; Probiotics; Ulcerative colitis