MANEJO NUTRICIONAL DAS DOENÇAS INFLAMATÓRIAS INTESTINAIS:
INTERVENÇÕES NUTRICIONAIS PARA A MITIGAÇÃO DOS SINTOMAS NA FASE ATIVA E REMISSÃO
Palavras-chave:
Ingesta dietética, Terapia nutricional, Estado nutricional
Resumo
Diante do crescente número de estudos que associam a alimentação ao desenvolvimento e manejo das Doenças Inflamatórias Intestinais (DII), esta revisão sistemática analisou o impacto de diferentes padrões alimentares — como a dieta mediterrânea, dieta anti-inflamatória, dieta com baixo teor de FODMAPs e a Dieta com Carboidratos Específicos — sobre a atividade inflamatória, sintomas clínicos e qualidade de vida de pacientes com DII. A revisão seguiu os critérios PRISMA, resultando na seleção de 10 artigos publicados entre 2020 e 2025, nas bases PubMed, SciELO e Cochrane Library, em português e inglês. Os achados evidenciam que intervenções dietéticas individualizadas, baseadas em evidências, contribuem para melhora clínica, redução de marcadores inflamatórios e favorecimento da remissão. Destaca-se, assim, a importância da atuação nutricional na abordagem multiprofissional. No entanto, ainda são necessários estudos adicionais que definam com maior precisão quais padrões alimentares são mais eficazes no manejo das DII.
Referências
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CHICCO, F. et al. Multidimensional Impact of Mediterranean Diet on IBD Patients. Inflammatory Bowel Diseases, v. 27, n. 1, p. 1-9, 2021.
COX, S. R. et al. Effects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized Trial. Gastroenterology, v. 158, n. 1, p. 176-188, 2020.
DE CASTRO, M. M. et al. Dietary Patterns Associated to Clinical Aspects in Crohn’s Disease Patients. Scientific Reports, v. 10, n. 1, p. 1-9, 2020.
DE CASTRO, M. M. et al. Role of diet and nutrition in inflammatory bowel disease. World Journal of Experimental Medicine, v. 11, n. 1, p. 1-16, 2021.
DE FILIPPIS, F. et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut, v. 65, n. 11, p. 1812-1821, 2016.
FORD, C. K. Nutrition Considerations in Patients with Functional Diarrhea. Current Gastroenterology Reports, v. 25, n. 9, p.198-203, 2023.
FRITSCH, J. et al. Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis. Clinical Gastroenterology and Hepatology, v. 19, n. 6, p. 1189-1199, 2021.
GALVAO, T.; PANSANI, A.; HARRAD, D. Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiol Serv Saúde, n. 24, v. 2, p. 335-341, 2015.
GALVÃO, T. F.; PEREIRA, M. G.. Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiologia e Serviços de Saúde, v. 23, n. 1, p. 183-184, 2014.
GODNY, L. et al. Mechanistic Implications of the Mediterranean Diet in Patients With Newly Diagnosed Crohn’s Disease: Multiomic Results From a Prospective Cohort. Gastroenterology, v. 128, n. 5, p. 851-1042, 2025.
HASKEY, N. et al. Dietary adherence to the Mediterranean diet pattern in a randomized clinical trial of patients with quiescent ulcerative colitis. Frontiers in Nutrition, v. 9, p. 1-12, 2022.
KESHTELI, A. H. et al. Anti-Inflammatory Diet Prevents Subclinical Colonic Inflammation and Alters Metabolomic Profile of Ulcerative Colitis Patients in Clinical Remission. Nutrients, v. 14, n. 16, p. 1-18, 2022.
KHALILI, H. et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: Results from two large prospective cohort studies. Gut, v. 69, n. 9, p. 1637-1644, 2020.
LEWIS, J. D. et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn’s Disease. Gastroenterology, v. 161, n. 3, p. 837- 852, 2021.
LIMKETKAI, B. N. et al. Dietary Interventions for the Treatment of Inflammatory Bowel Diseases: An Updated Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology. v. 21, n. 10, p. 2508-2525, 2023.
MARSH, A. et al. A pilot randomized controlled trial investigating the effects of an antiinflammatory dietary pattern on disease activity, symptoms and microbiota profile in adults with inflammatory bowel disease. European Journal of Clinical Nutrition, v. 78, n. 12, p. 1072-1081, 2024.
MOHER D, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews. n. 1, v. 4, p. 1-9, 2015.
NAQVI, S. A. et al. Dietary patterns, food groups and nutrients in Crohn’s disease: associations with gut and systemic inflammation. Scientific Reports, v. 11, n. 1, p. 1-9, 2021.
NARIMANI, B. et al. Effectiveness of a novel diet in attenuation of clinical activity of disease in patients with ulcerative colitis: a randomized, clinical trial. Scientific Reports, v. 14, n. 1, p. 1-11, 2024.
NG, S. C. et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. The Lancet, v. 390, n. 10114, p. 2769-2778, 2017.
OLENDZKI, B. et al. Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: Pilot study. Gut Microbes, v. 14, n. 1, p. 1-21, 2022.
OLI, A.K. et al. Incidence of inflammatory bowel disease: a single centre retrospective study. Arquivos de Gastroenterologia, v. 59, n. 3, p. 345-351, 2022.
PEDERSEN, N. et al. Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease. World Journal of Gastroenterology, v. 23, n. 18, p. 3356-3366, 2017.
REHMAN, R. et al. Nutritional Management of Inflammatory Bowel Disease. Rhode Island Medical Journal, v. 105, n.10, p. 31-37, 2022.
ROSA, C. O. B.; HERMSDORFF, H. H. M. Fisiopatologia da nutrição e dietoterapia. 1. ed. Rio de Janeiro: Rubio, 2020. 696p.
PASQUALOTTO, A. S.; CARDOSO, V. M.; DA COSTA, R. S. L. Perfil Epidemiológico dos Casos de Doença Inflamatória Intestinal em Indivíduos na Região Norte do Brasil Entre 2019 e 2022. Recima21 - Revista Científica Multidisciplinar - ISSN 2675-6218, v. 4, n. 6, p. 1-10, 2023.
SELVARATNAM, S. et al. Epidemiology of inflammatory bowel disease in South America: A systematic review. World Journal of Gastroenterology, v. 25, n. 47, p. 6866-6875, 2019.
SERRA-MAJEM, L. et al. Dietary patterns and nutritional adequacy in a Mediterranean country. British Journal of Nutrition, v. 101, n. SUPPL. 2, p. 21- 28, 2009.
TAYYEM, R. F. et al. Dietary patterns and the risk of inflammatory bowel disease: Findings from a case-control study. Nutrients, v. 13, n. 6, p. 1-10, 2021.
ZHANG, J. L.; VOOTUKURU, N.; NIEWIADOMSKI, O.. The effect of solid food diet therapies on the induction and maintenance of remission in Crohn’s disease: a systematicreview. BMC Gastroenterology, v. 26, n. 1, p. 1-22, 2024.
CHICCO, F. et al. Multidimensional Impact of Mediterranean Diet on IBD Patients. Inflammatory Bowel Diseases, v. 27, n. 1, p. 1-9, 2021.
COX, S. R. et al. Effects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized Trial. Gastroenterology, v. 158, n. 1, p. 176-188, 2020.
DE CASTRO, M. M. et al. Dietary Patterns Associated to Clinical Aspects in Crohn’s Disease Patients. Scientific Reports, v. 10, n. 1, p. 1-9, 2020.
DE CASTRO, M. M. et al. Role of diet and nutrition in inflammatory bowel disease. World Journal of Experimental Medicine, v. 11, n. 1, p. 1-16, 2021.
DE FILIPPIS, F. et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut, v. 65, n. 11, p. 1812-1821, 2016.
FORD, C. K. Nutrition Considerations in Patients with Functional Diarrhea. Current Gastroenterology Reports, v. 25, n. 9, p.198-203, 2023.
FRITSCH, J. et al. Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis. Clinical Gastroenterology and Hepatology, v. 19, n. 6, p. 1189-1199, 2021.
GALVAO, T.; PANSANI, A.; HARRAD, D. Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiol Serv Saúde, n. 24, v. 2, p. 335-341, 2015.
GALVÃO, T. F.; PEREIRA, M. G.. Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiologia e Serviços de Saúde, v. 23, n. 1, p. 183-184, 2014.
GODNY, L. et al. Mechanistic Implications of the Mediterranean Diet in Patients With Newly Diagnosed Crohn’s Disease: Multiomic Results From a Prospective Cohort. Gastroenterology, v. 128, n. 5, p. 851-1042, 2025.
HASKEY, N. et al. Dietary adherence to the Mediterranean diet pattern in a randomized clinical trial of patients with quiescent ulcerative colitis. Frontiers in Nutrition, v. 9, p. 1-12, 2022.
KESHTELI, A. H. et al. Anti-Inflammatory Diet Prevents Subclinical Colonic Inflammation and Alters Metabolomic Profile of Ulcerative Colitis Patients in Clinical Remission. Nutrients, v. 14, n. 16, p. 1-18, 2022.
KHALILI, H. et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: Results from two large prospective cohort studies. Gut, v. 69, n. 9, p. 1637-1644, 2020.
LEWIS, J. D. et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn’s Disease. Gastroenterology, v. 161, n. 3, p. 837- 852, 2021.
LIMKETKAI, B. N. et al. Dietary Interventions for the Treatment of Inflammatory Bowel Diseases: An Updated Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology. v. 21, n. 10, p. 2508-2525, 2023.
MARSH, A. et al. A pilot randomized controlled trial investigating the effects of an antiinflammatory dietary pattern on disease activity, symptoms and microbiota profile in adults with inflammatory bowel disease. European Journal of Clinical Nutrition, v. 78, n. 12, p. 1072-1081, 2024.
MOHER D, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews. n. 1, v. 4, p. 1-9, 2015.
NAQVI, S. A. et al. Dietary patterns, food groups and nutrients in Crohn’s disease: associations with gut and systemic inflammation. Scientific Reports, v. 11, n. 1, p. 1-9, 2021.
NARIMANI, B. et al. Effectiveness of a novel diet in attenuation of clinical activity of disease in patients with ulcerative colitis: a randomized, clinical trial. Scientific Reports, v. 14, n. 1, p. 1-11, 2024.
NG, S. C. et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. The Lancet, v. 390, n. 10114, p. 2769-2778, 2017.
OLENDZKI, B. et al. Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: Pilot study. Gut Microbes, v. 14, n. 1, p. 1-21, 2022.
OLI, A.K. et al. Incidence of inflammatory bowel disease: a single centre retrospective study. Arquivos de Gastroenterologia, v. 59, n. 3, p. 345-351, 2022.
PEDERSEN, N. et al. Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease. World Journal of Gastroenterology, v. 23, n. 18, p. 3356-3366, 2017.
REHMAN, R. et al. Nutritional Management of Inflammatory Bowel Disease. Rhode Island Medical Journal, v. 105, n.10, p. 31-37, 2022.
ROSA, C. O. B.; HERMSDORFF, H. H. M. Fisiopatologia da nutrição e dietoterapia. 1. ed. Rio de Janeiro: Rubio, 2020. 696p.
PASQUALOTTO, A. S.; CARDOSO, V. M.; DA COSTA, R. S. L. Perfil Epidemiológico dos Casos de Doença Inflamatória Intestinal em Indivíduos na Região Norte do Brasil Entre 2019 e 2022. Recima21 - Revista Científica Multidisciplinar - ISSN 2675-6218, v. 4, n. 6, p. 1-10, 2023.
SELVARATNAM, S. et al. Epidemiology of inflammatory bowel disease in South America: A systematic review. World Journal of Gastroenterology, v. 25, n. 47, p. 6866-6875, 2019.
SERRA-MAJEM, L. et al. Dietary patterns and nutritional adequacy in a Mediterranean country. British Journal of Nutrition, v. 101, n. SUPPL. 2, p. 21- 28, 2009.
TAYYEM, R. F. et al. Dietary patterns and the risk of inflammatory bowel disease: Findings from a case-control study. Nutrients, v. 13, n. 6, p. 1-10, 2021.
ZHANG, J. L.; VOOTUKURU, N.; NIEWIADOMSKI, O.. The effect of solid food diet therapies on the induction and maintenance of remission in Crohn’s disease: a systematicreview. BMC Gastroenterology, v. 26, n. 1, p. 1-22, 2024.
Publicado
2025-12-17
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