Subscribe to RSS
DOI: 10.1055/s-2003-36671
Ernährung
NutritionPublication History
Publication Date:
16 January 2003 (online)

Ernährungsfaktoren in der Ätiopathogenese von Morbus Crohn
Konsens
Es gibt derzeit keinerlei überzeugende Hinweise, dass Ernährungsgewohnheiten und/oder bestimmte Nahrungsmittelinhaltsstoffe ursächlich an der Entstehung des M. Crohn beteiligt sind (B).
Erläuterung
Die Beobachtung, dass chronisch entzündliche Darmkrankheiten bis Ende der 50er-Jahre extrem selten waren und seit dieser Zeit in allen westlichen Industrieländern erheblich zugenommen haben, veranlasste zur Annahme, dass Änderungen in der Ernährung eine wesentliche oder gar eine mögliche Ursache für die Häufigkeitszunahme, insbesondere für M. Crohn sind.
Angeschuldigt wurden der nach Kriegsende angestiegene Konsum an raffinierten Kohlenhydraten, chemisch aufbereitete Fette, die Abnahme des Verzehrs an Ballaststoffen, allergische Reaktionen auf Bäckerhefe sowie wie der Ersatz von Muttermilch durch Kuhmilch in der Säuglingsernährung [15].
Trotz der steigenden Inzidenz von CED und der geänderten Lebens- und Ernährungsweise in den modernen Industriestaaten konnte in keiner der bisher publizierten Studien ein zwingender Beweis für eine mögliche Rolle von Ernährungsfaktoren in der Ätiopathogenese von M. Crohn erbracht werden. Prospektive Studien zur Auslösung des M. Crohn durch bestimmte Nahrungsmittel fehlen.
Literatur
- 1
Weinand I, Jordan A, Caspary W F. et al .
Nutrition in the etiopathogenesis of chronic inflammatory
bowel diseases.
Z Gastroenterol.
1997;
35
637-649 (III)
MissingFormLabel
- 2
Tragnone A, Valpiani D, Miglio F. et al .
Dietary habits as risk factors for inflammatory bowel
disease.
Eur J Gastroenterol Hepatol.
1995;
7
47-51 (IIb)
MissingFormLabel
- 3
Riordan A M, Ruxton C H, Hunter J O.
A review of associations between Crohn’s disease and
consumption of sugars.
Eur J Clin Nutr.
1998;
52
229-238 (III)
MissingFormLabel
- 4
Shoda R, Matsueda K, Yamato S. et al .
Epidemiologic analysis of Crohn disease in Japan: increased
dietary intake of n-6 polyunsaturated fatty acids and animal protein relates
to
the increased incidence of Crohn disease in Japan.
Am J Clin Nutr.
1996;
63
741-745 (IIb)
MissingFormLabel
- 5
Koletzko S, Sherman P, Corey M. et al .
Role of infant feeding practices in development of
Crohn’s disease in childhood.
BMJ.
1989;
298
1617-1618 (IIb)
MissingFormLabel
- 6
Rath H C, Caesar I, Roth M. et al .
Nutritional deficiencies and complications in chronic
inflammatory bowel diseases.
Med Klin.
1998;
93
6-10 (III)
MissingFormLabel
- 7
Kastin D A, Buchman A L.
Malnutrition and gastrointestinal disease.
Curr Opin Clin Nutr Metab Care.
2002;
5
699-706 (III)
MissingFormLabel
- 8
Sentongo T A, Semaeo E J, Stettler N. et al .
Vitamin D status in children, adolescents, and young adults
with Crohn disease.
Am J Clin Nutr.
2002;
76
1077-1081 (Ib)
MissingFormLabel
- 9
Sentongo T A, Semeao E J, Piccoli D A. et al .
Growth, body composition, and nutritional status in children
and adolescents with Crohn’s disease.
J Pediatr Gastroenterol Nutr.
2000;
31
33-40 (IIa)
MissingFormLabel
- 10
Philipsen-Geerling B J, Brummer R J.
Nutrition in Crohn’s disease.
Curr Opin Clin Nutr Metab Care.
2000;
3
305-309 (III)
MissingFormLabel
- 11
Gassull M A, Cabre E.
Nutrition in iflammatory bowel disease.
Curr Opin Clin Nutr Metab Care.
2001;
4
561-569 (III)
MissingFormLabel
- 12
Geerling B J, Badart-Smook A, Stockbruegger R W. et al .
Comprehensive nutritional status in recentely diagnosed
patients with inflammatory bowel disease compred with population controls.
Eur J Clin Nutr.
2000;
54
514-521 (IIa)
MissingFormLabel
- 13
Capristo E.
Body composition and metabolic features in Crohn’s
disease: an update.
Eur Rev Med Pharmacol Sci.
1998;
2
111-113 (III)
MissingFormLabel
- 14
Barot L R, Rombeau J L, Feurer I D. et al .
Caloric requirements in patients with inflammatory bowel
disease.
Ann Surg.
1982;
195
214-218 (Ib)
MissingFormLabel
- 15
Chan A TH, Fleming R, OŽFallon W M. et al .
Estimated versus measured basal energy requirements in
patients with CrohnŽdisease.
Gastroenterology.
1986;
91
75-80 (IIb)
MissingFormLabel
- 16
Stokes M A, Hill G L.
Total energy expenditure in patients with Crohn‘s
disease: measurement by the combined body scan technique.
J Parent Ent Nutr.
1993;
17
3-7 (IIa)
MissingFormLabel
- 17
Schneeweiss B, Lochs H, Zauner C. et al .
Energy and substrate metabolism in patients with active
crohnŽs disease.
J Nutr.
1999;
129
844-848 (Ib)
MissingFormLabel
- 18
Al-Jaouni R, Hebuterne X, Pouget I. et al .
Energy metabolism and substrate oxidation in patients with
crohnŽs disease.
Nutrition.
2000;
16
173-178 (Ib)
MissingFormLabel
- 19
Mingrone G, Capristo E, Greco A V. et al .
Elevetated diet-induced thermogenesis and lipid oxidation
rate in CrohnŽs disease patients.
Am J Clin Nutr.
1999;
69
235-330 (Ib)
MissingFormLabel
- 20
Galland L.
Magnesium and inflammatory bowel disease.
Magnesium.
1988;
7
78-83 (III)
MissingFormLabel
- 21
Swinson C M, Perry J, Lumb M. et al .
Role of sulphasalazine in the aetiology of folate deficiency
in ulcerative colitis.
Gut.
1981;
22
456-461 (IIa)
MissingFormLabel
- 22
Montori V M, Basu A, Erwin P J. et al .
Posttransplantation diabetes: a systematic review of the
literature.
Diabetes Care.
2002;
25
583-592 (Ia)
MissingFormLabel
- 23
Higgens C S, Keighley M R, Allan R N.
Impact of preoperative weight loss and body composition
changes on postoperative outcome in surgery for inflammatory bowel
disease.
Gut.
1984;
25
732-736 (III)
MissingFormLabel
- 24
Lindor K D, Fleming C R, Ilstrup D M.
Preoperative nutritional status and other factors that
influence surgical outcome in patients with Crohn’s disease.
Mayo Clin Proc.
1985;
60
393-396 (III)
MissingFormLabel
- 25
Capristo E, Mingrone G, Addolorato G. et al .
Effect of a vegetable-protein-rich polymeric diet treatment
on body composition and energy metabolism in inactive Crohn’s
disease.
Eur J Gastroenterol Hepatol.
2000;
12
5-11 (IIa)
MissingFormLabel
- 26
Anstee Q M, Forbes A.
The safe use of percutaneous gastrostomy for enteral
nutrition in patients with Crohn’s disease.
Eur J Gastroenterol Hepatol.
2000;
12
1089-1093 (IIa)
MissingFormLabel
- 27
Thomas T S, Berto E, Scribano M L. et al .
Treatment of esophageal Crohn’s disease by enteral
feeding via percutaneous endoscopic gastrostomy.
JPEN J Parenter Enteral Nutr.
2000;
24
176-179 (III)
MissingFormLabel
- 28
Gasche C, Dejaco C, Waldhoer T. et al .
Intravenous iron and erythropoietin for anemia associated
with Crohn disease. A randomized, controlled trial.
Ann Intern Med.
1997;
126
782-787 (Ia)
MissingFormLabel
- 29
Fernandez-Banares F, Cabre E, Esteve-Comas M. et al .
How effective is enteral nutrition in inducing clinical
remission in active Crohn’s disease? A meta-analysis of the randomized
clinical trials.
J Parenter Enteral Nutr.
1995;
19
356-364 (Ia)
MissingFormLabel
- 30
Griffiths A M, Ohlsson A, Sherman P M. et al .
Meta-analysis of enteral nutrition as a primary treatment of
active Crohn’s disease.
Gastroenterology.
1995;
108
1056-1067 (Ia)
MissingFormLabel
- 31
Zachos M, Tondeur M, Griffiths A M.
Enteral nutritional therapy for inducing remission of
Crohn’s disease.
Cochrane Database Syst Rev.
2001;
3 CD000542 (Ia)
MissingFormLabel
- 32
González-Huix F, De León R, Fernández-Bañares F. et al .
Polymeric enteral diets as primary treatment of active
Crohn’s disease: a prospective steroid controlled trial.
Gut.
1993;
34
778-782 (Ib)
MissingFormLabel
- 33
Lochs H, Steinhardt H J, Klaus-Wentz B. et al .
Comparison of enteral nutrition and drug treatment in active
Crohn’s disease. Results of European Co-operative Crohn’s disease
Study IV.
Gastroenterology.
1991;
101
881-888 (Ib)
MissingFormLabel
- 34
Osullivan M, Omorain C.
Liquid diets in Crohn disease.
Gut.
2001;
48
757 (III)
MissingFormLabel
- 35
Verma S, Brown S, Kirkwood B. et al .
Polymeric versus elemental diet as primary treatment in
active Crohn’s disease: a randomized, double-blind trial.
Am J Gastroenterol.
2000;
95
735-739 (Ib)
MissingFormLabel
- 36
Sanderson I R, Udeen S, Davies P SW. et al .
Remission induced by an elemental diet in small bowel
Crohn’s disease.
Arch Dis Child.
1987;
61
123-127 (IIa)
MissingFormLabel
- 37
Thomas A G, Taylor F, Miller V.
Dietary intake and nutritional treatment in childhood
Crohn’s disease.
J Pediatr Gastroenterol Nutr.
1993;
17
75-81 (IIa)
MissingFormLabel
- 38
Ruemmele F M, Roy C C, Levy E. et al .
Nutrition as primary therapy in pediatric Crohn’s
disease: fact or fantasy?.
J Pediatr.
2000;
136
285-289 (III)
MissingFormLabel
- 39
Heuschkel R B, Menache C C, Megerian J T. et al .
Enteral nutrition and corticosteroids in the treatment of
acute Crohn’s disease in children.
J Pediatr Gastroenterol Nutr.
2000;
31
8-15 (Ib)
MissingFormLabel
- 40
Fell J M, Paintin M, Arnaud-Battandier F. et al .
Mucosal healing and a fall in mucosal pro-inflammatory
cytokine mRNA induced by a specific oral polymeric diet in paediatric
Crohn’s disease.
Aliment Pharmacol Ther.
2000;
14
281-289 (Ib)
MissingFormLabel
- 41
Akobeng A K, Miller V, Stanton J. et al .
Double-blind randomized controlled trial of
glutamine-enriched polymeric diet in the treatment of active Crohn’s
disease.
J Pediatr Gastroenterol Nutr.
2000;
30
78-84 (Ib)
MissingFormLabel
- 42
Verma S, Holdsworth C D, Giaffer M H.
Does adjuvant nutritional support diminish steroid dependency
in Crohn disease?.
Scand J Gastroenterol.
2000;
36
383-388 (IIa)
MissingFormLabel
- 43
Lashner B A, Evans A A, Hanauer S B.
Preoperative total parenteral nutrition for bowel resection
in Crohn’s disease.
Dig Dis Sci.
1988;
34
741-746 (IIa)
MissingFormLabel
- 44
Klein S, Kinney J, Jeejeebhoy K. et al .
Nutrition support in clinical practice: review of published
data and recommendations for future research directions.
Am J Clin Nutr.
1997;
66
683-706 (III)
MissingFormLabel
- 45
Makhdoom Z A, Komar M J, Still C D.
Nutrition and enterocutaneous fistulas.
J Clin Gastroenterol.
2000;
31
195-204 (III)
MissingFormLabel
- 46
Ettinger B, Pak C Y, Citron J T. et al .
Potassium-magnesium citrate is an effective prophylaxis
against recurrent calcium oxalate nephrolithiasis.
J Urol.
1997;
158
2069-2073 (Ib)
MissingFormLabel
- 47
Carlsson E, Berglund B, Nordgren S.
Living with an ostomy and short bowel syndrome: practical
aspects and impact on daily life.
J Wound Ostomy Continence Nurs.
2001;
28
96-105 (III)
MissingFormLabel
- 48
Eusufzai S.
Bile acid malabsorption: mechanisms and treatment.
Dig Dis 1995; 13: 312-321 (III).
MissingFormLabel
- 49
Wilschanski M, Sherman P, Pencharz P. et al .
Supplementary enteral nutrition maintains remission in
paediatric Crohn’s disease.
Gut.
1996;
38
543-548 (IIa)
MissingFormLabel
- 50
Verma S, Kirkwood B, Brown S. et al .
Oral nutritional supplementation is effective in the
maintenance of remission in Crohn’s disease.
Dig Liver Dis.
2000;
32
769-774 (IIa)
MissingFormLabel
- 51
Norday A.
Is there a rational role for N-3 fatty acids (fish oil) in
clinical medicine?.
Drugs.
1991;
42
331 (III)
MissingFormLabel
- 52
Tsujikawa T, Satoh J, Uda K. et al .
Clinical importance of n-3 fatty acid-rich diet and
nutritional education for the maintenance of remission in Crohn’s
disease.
J Gastroenterol.
2000;
35
99-104 (IIa)
MissingFormLabel
- 53
Belluzzi A, Brignola C, Campieri M. et al .
Effect of an enteric-coated fish-oil preparation on relapses
in Crohn’s disease.
N Engl J Med.
1996;
334
1557-1560 (Ib)
MissingFormLabel
- 54
Lorenz-Meyer H, Bauer P, Nicolay C. et al .
Omega-3 fatty acids and low carbohydrate diet for maintenance
of remission in Crohn’s disease. A randomized controlled multicenter
trial.
Study Group Members. Scand J Gastroenterol.
1996;
31
778-785 (Ib)
MissingFormLabel
- 55
Stange E F, Schmid U, Fleig W E. et al .
Exclusion diet in Crohn disease: controlled, randomised
study.
Z Gastroenterol.
1990;
28
561-564 (Ib)
MissingFormLabel
- 56
Ballegaard M, Bjergstrom A, Brondum S. et al .
Self-reported food intolerance in chronic inflammatory bowel
disease.
Scand J Gastroenterol.
1997;
32
569-571 (IIb)
MissingFormLabel
- 57
Van den Bogarde J, Cahill J, Emmanuel A V. et al .
Gut mucosal response to food antigens in CrohnŽs
disease.
Aliment Pharmacol Ther.
2002;
16
1903-915 (IIa)
MissingFormLabel
- 58
Kobayashi K, Katsumata T, Yokoyama K. et al .
A randomised controlled trial of total parenteral nutrition
and enteral nutrition by elemental and polymeric diet as primary therapy in
active phase of Crohn’s disease.
Jap J Gastroenterol.
1998;
95
1212-1221 (Ib)
MissingFormLabel
- 59
Scolapio J S.
The role of total parenteral nutrition in the management of
patients with acute attacks of IBD.
J Clin Gastroenterol.
1999;
29
223-224 (III)
MissingFormLabel
- 60
Seo M, Okada M, Yao T. et al .
The role of total parenteral nutrition in the management of
patients with acute attacks of inflammatory bowel disease.
J Clin Gastroenterol.
1999;
29
270-275 (IIa)
MissingFormLabel