Gut health: Influence of Mediterranean diet on inflammatory bowel disease

Abstract

Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a chronic, immune-mediated disorder of the gastrointestinal tract characterized by persistent inflammation, intestinal dysbiosis, and epithelial barrier dysfunction. With the rising global prevalence of IBD and the limited long-term efficacy and side effects of pharmacological interventions, there is growing interest in dietary strategies that modulate disease activity and promote gut health. The Mediterranean Diet (MD), rich in fruits, vegetables, whole grains, legumes, fish, and olive oil, has gained recognition for its anti-inflammatory and microbiota-modulating properties. This review explores the complex interplay between IBD pathogenesis and gut microbiota composition and discusses how adherence to MD principles may support intestinal homeostasis. Key components of the MD such as polyphenols, omega-3 fatty acids, and dietary fibers are known to reduce systemic inflammation, improve immune regulation, and enhance microbial diversity. The MD encourages the growth of short-chain fatty acid (SCFA)-producing bacteria like Faecalibacterium prausnitzii, which play a critical role in mucosal healing and immune modulation. Additionally, this diet inhibits pro-inflammatory cytokines (e.g., TNF-α, IL-6) while upregulating anti-inflammatory mediators like IL-10. Clinical and experimental findings suggest that MD adherence is associated with reduced flare frequency, improved quality of life, and potentially delayed disease progression. Furthermore, practical application of the MD in IBD requires individualized dietary plans that consider disease activity, food tolerances, and nutritional deficiencies. With professional guidance, the Mediterranean Diet offers a feasible, non-pharmacological approach to managing IBD and supporting gut health. Future research should focus on long-term interventional studies to confirm the causal benefits of the MD in various IBD phenotypes.