Inflammatory Bowel Disease Environmental Risk Factors: Diet and Gut Microbiota
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INFLAMMATORY BOWEL DISEASE (M REGUEIRO, SECTION EDITOR)
Inflammatory Bowel Disease Environmental Risk Factors: Diet and Gut Microbiota Sarah Altajar 1
&
Alan Moss 2
Accepted: 25 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of review This review specifically explores the affect that diet has on the gut microbiota and its role on the increasing incidence of IBD around the world in developing countries. Recent findings This is a The emergence of IBD is consistently observed as a society becomes developed and westernized implicating the critical role that environmental factors play. Environmental factors that could play a significant role in the pathogenesis of IBD include westernization of diet and improved hygiene statust. Summary Westernization of diet is associated with changes in the gastrointestinal microbiota, which could affect the development of the immune system and thus influence the risk of disease occurrence. There remains an important need for extensive and rigorous studies focused on the role of environmental exposures on IBD management. Specifically, if environmental factors can be modified to decrease the possibility of relapse or improve patient quality of life. Keywords Inflammatory bowel disease . Dysbiosis . Gut microbiome . Mediterranean diet . Western-style diet
Emergence of IBD in Twentieth Century, and Incidence Trends in Western and Emerging Economies Presently, the annual incidence of Crohn’s disease (CD) is highest in North America where it is estimated to be 20.2 per 100,000 per person-years and the annual incidence of ulcerative colitis (UC) is highest in Europe estimated at 24.3 per 100,000 per person-years. The prevalence of both CD and UC is highest in Europe and North America and is much lower in other areas of the world. The prevalence of inflammatory bowel diseases (IBD) is affected by both incidence and This article is part of the Topical Collection on Inflammatory Bowel Disease * Sarah Altajar [email protected] Alan Moss [email protected] 1
Department of Medicine, Boston University School of Medicine, 72 East Concord St, Evans 124, Boston, MA 02118, USA
2
Department of Gastroenterology, Boston Medical Center, 85 East Concord Street, Suite 7700A, Boston, MA 02118, USA
duration of disease, and because IBD is a chronic disease without high mortality, the increase in prevalence may possibly be a result of earlier diagnoses and longer duration of disease [1]. However, IBD is rapidly emerging in many developing countries where it was previously considered uncommon. The rapid increase in the incidence of IBD correlates with the industrialization and westernization of these countries, suggesting the potential role of environmental factors in the etiology of IBD. In eastern Europe, Asia, and much of the developing world, UC has emerged first and after a certain period of time is followed by Crohn’s disease which mirrors the occurrence that took place in the Western world when IBD first appeared 75 years ago [2]. The discr
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