Impact of Dietary Choices on Inflammatory Bowel Disease Risk

Association Between Dietary Inflammatory Index and Ulcerative Colitis

The dietary inflammatory index (DII) has been established as a tool to assess the inflammatory potential of a diet. Higher DII scores suggest a pro-inflammatory dietary pattern, while lower scores indicate anti-inflammatory potential. A study conducted by Pan et al. (2025) found that individuals with UC had significantly higher DII scores compared to healthy controls. This suggests that a pro-inflammatory diet may contribute to the development and exacerbation of ulcerative colitis.

In their case-control study, Pan et al. reported that patients with higher DII had a 4.50 times greater likelihood of having UC compared to those with lower DII scores. Additionally, the study indicated that each one-unit increase in DII was associated with a 3.64 times increase in the risk of UC, even after adjusting for confounding variables such as body mass index (BMI) and total energy intake (Pan et al., 2025). These findings underscore the importance of dietary choices in managing IBD and suggest that adopting a diet with a lower inflammatory index could be beneficial for individuals at risk of developing UC.

Table 1: Dietary Inflammatory Index and Ulcerative Colitis Risk

Dietary Patterns and Their Role in Inflammatory Bowel Disease

Research has shown that dietary patterns play a significant role in the management of IBD. The composition of a person’s diet can influence gut microbiota diversity, inflammatory responses, and overall gut health. A shift towards a diet rich in fruits, vegetables, whole grains, and lean proteins may exert protective effects against the development of IBD. Conversely, diets high in saturated fats, sugar, and processed foods can exacerbate inflammation and promote disease activity.

The Mediterranean diet, characterized by high consumption of fruits, vegetables, legumes, nuts, and healthy fats, has been associated with a lower risk of IBD and improved outcomes in patients with established disease. Studies suggest that the anti-inflammatory properties of this diet may help to modulate gut microbiota and reduce the severity of IBD symptoms (Khalili et al., 2018).

Table 2: Dietary Patterns and Their Impact on IBD

Internalized Stigma and Psychological Effects on IBD Patients

The psychological burden of living with IBD can significantly affect patients’ quality of life. Internalized stigma, which refers to the internalization of society’s negative perceptions of a condition, is prevalent among IBD patients. A study by Reynolds et al. (2025) indicated that 40.5% of participants with IBD experienced internalized stigma, which correlated with poorer health-related quality of life and increased psychological distress.

Higher levels of psychological inflexibility were associated with greater internalized stigma, lower committed action, and poorer self-efficacy in managing IBD symptoms. This suggests that addressing psychological factors, including stigma and inflexibility, could be crucial in improving patient outcomes and overall well-being.

Table 3: Psychological Outcomes and Internalized Stigma in IBD Patients

The Influence of Psychological Inflexibility on IBD Outcomes

Psychological inflexibility, characterized by the inability to adapt to challenging thoughts and feelings, was found to mediate the relationship between internalized stigma and various patient outcomes. Inflexibility was linked to increased psychological distress and lower health-related quality of life in individuals with IBD (Reynolds et al., 2025). This implicates the importance of promoting psychological flexibility through therapeutic interventions, such as Acceptance and Commitment Therapy (ACT), as a means to improve IBD management and patient well-being.

Benefits of A2 Milk on Gut Microbiota and Symptoms Management

Recent research has highlighted the potential benefits of A2 milk, which contains only A2 β-casein, in managing gastrointestinal symptoms associated with milk consumption. A randomized, double-blind study demonstrated that A2 milk consumption led to significant shifts in gut microbiota, with increases in beneficial microbes such as Bifidobacterium and Blautia (Song et al., 2025). These changes were associated with improvements in gastrointestinal symptoms, including reduced abdominal pain and discomfort.

The study indicated that A2 milk consumption resulted in a significant shift in gut microbiota composition compared to A1/A2 milk. Notably, participants experienced greater improvements in symptoms and reductions in inflammatory markers, suggesting that A2 milk may be a suitable alternative for individuals who experience gastrointestinal discomfort from traditional milk.

Table 4: Gut Microbiota Changes After A2 Milk Consumption

Frequently Asked Questions (FAQ)

What dietary changes can help manage IBD?

A diet rich in anti-inflammatory foods such as fruits, vegetables, whole grains, and healthy fats can help manage IBD symptoms. Avoiding processed foods and high sugar diets is also recommended.

How does the Dietary Inflammatory Index relate to IBD?

The Dietary Inflammatory Index assesses the inflammatory potential of dietary patterns, with higher scores correlating with increased risk of IBD.

Can psychological factors affect IBD symptoms?

Yes, psychological factors such as internalized stigma and psychological inflexibility can significantly impact the quality of life and disease outcomes in individuals with IBD.

What is the benefit of A2 milk for gut health?

A2 milk, which contains only A2 β-casein, has been shown to improve gastrointestinal symptoms and promote beneficial changes in gut microbiota compared to regular milk.

Are there specific psychological therapies recommended for IBD patients?

Acceptance and Commitment Therapy (ACT) is one approach that has shown promise in improving psychological flexibility and reducing internalized stigma among IBD patients.

References

1. Pan, H., Zhai, L., Cui, M., Liu, Y., Shao, L., & Yao, P. (2025). Association between Dietary Inflammatory Index and Ulcerative Colitis: a case–control study. BMC Gastroenterology, 30, 1-14. Retrieved from https://doi.org/10.1186/s12876-025-03869-0

2. Reynolds, D. P., Chalder, T., & Henderson, C. (2025). The mediating role of psychological inflexibility on internalized stigma and patient outcomes in a sample of adults with inflammatory bowel disease. Journal of Crohn’s & Colitis, 27, 1-10. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12060869/

3. Song, C., Kim, N., Choi, Y., & Lee, S. (2025). Beneficial effect of consuming milk containing only A2 beta-casein on gut microbiota: A single-center, randomized, double-blind, cross-over study. PLoS One, 440. Retrieved from https://doi.org/10.1371/journal.pone.0323016

4. Khalili, H., Chan, S. S. M., Lochhead, P., Ananthakrishnan, A. N., Hart, A. R., & Chan, A. T. (2018). The role of diet in the aetiopathogenesis of inflammatory bowel disease. Nature Reviews Gastroenterology & Hepatology, 15(6), 525-535. Retrieved from https://doi.org/10.1038/s41575-018-0022-9

5. Witkowski, M., Witkowski, M., Gagliani, N., & Huber, S. (2020). Recipe for IBD: can we use food to control inflammatory bowel disease? Seminars in Immunopathology, 40(1), 145-156. Retrieved from https://doi.org/10.1007/s00281-017-0658-5