Crohn's disease and nutrition: current perspectives on dietary therapy and nutritional support

Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology, characterized by a progressive course and the development of complications that require surgical intervention in a significant proportion of patients. The pathogenesis of the disease involves a disruption of gut microbiota, influenced by environmental factors, with diet playing a key role. Current evidence confirms the negative impact of ultra-processed foods on microbiota composition and the increased risk of developing CD. This article reviews modern approaches to dietary therapy and nutritional support for patients with CD, including assessment of nutritional status, macroand micronutrient requirements, and correction of identified deficiencies. It evaluates the effectiveness of exclusive enteral nutrition (EEN) and alternative dietary approaches, such as the Crohn’s Disease Exclusion Diet (CDED), in combination with specialized enteral nutrition in achieving remission, promoting mucosal healing, and reducing inflammation. Additionally, it explores dietary strategies for maintaining remission and optimizing perioperative nutritional support. It emphasizes the key role of dietitians in the multidisciplinary team managing CD patients and the need for an individualized approach to dietary therapy, considering cultural preferences and food habits. Based on a review of current evidence, the article concludes that nutritional support and dietary therapy should be integral components of comprehensive CD treatment, while further research is needed to optimize personalized dietary strategies.