Ultra-Processed Foods in Inflammatory Bowel Disease and Irritable Bowel Syndrome: Epidemiology, the Intestinal Microenvironment and Implications for Dietary Management

Ultra-processed foods (UPFs) provide more than half of daily energy intake in several high-income countries, and their consumption is increasing worldwide. Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic gastrointestinal conditions whose burden has grown alongside industrialized dietary patterns. Here, we summarize the epidemiological, mechanistic and clinical evidence linking UPF consumption to both conditions. Most prospective cohorts and meta-analyses associate higher UPF intake with incident Crohn’s disease, whereas associations with ulcerative colitis are weaker and inconsistent. In IBS, observational studies, including a large prospective cohort, suggest a modest, dose-dependent association with risk, although data are limited and the diagnostic criteria have recently changed with Rome V. Mechanistically, both disorders may converge on the intestinal microenvironment: in experimental models, emulsifiers alter microbial composition and metabolism, the mucus layer, epithelial barrier integrity and mucosal immune activation, and non-nutritive sweeteners alter microbial composition and epithelial barrier function, although human data are limited and causality has not been established. We also discuss IBS-like symptoms in quiescent IBD, dietary management in both conditions, and the main knowledge gaps, including exposure assessment, residual confounding and the need for adequately powered intervention trials.

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Journal
Microorganisms
Published
2026-10-30
DOI
https://doi.org/10.3390/microorganisms14112477
Primary Topic
Consumer Attitudes and Food Labeling
Type
article
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article

Ultra-Processed Foods in Inflammatory Bowel Disease and Irritable Bowel Syndrome: Epidemiology, the Intestinal Microenvironment and Implications for Dietary Management

Giovanni Sarnelli, Luisa Bertin, Javier Chahuán A., Andrea Pasta et al.
3 links
Microorganisms
Consumer Attitudes and Food Labeling
article

Ultra-Processed Foods in Inflammatory Bowel Disease and Irritable Bowel Syndrome: Epidemiology, the Intestinal Microenvironment and Implications for Dietary Management

Giovanni Sarnelli, Luisa Bertin, Javier Chahuán A., Andrea Pasta, Elena Formisano, Fabiana Zingone, Federico Caldart, Salvatore Crucillà, Karen Routhiaux, Elisa Marabotto, Marcella Pesce, Enrico Tettoni, Cedric Van de Bruaene, Hugo Monrroy, Edoardo Vincenzo Savarino, Tarek Arraf, Pietro Pirro, Daniele Salvi, Francesco Calabrese
article en

Abstract

Ultra-processed foods (UPFs) provide more than half of daily energy intake in several high-income countries, and their consumption is increasing worldwide. Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic gastrointestinal conditions whose burden has grown alongside industrialized dietary patterns. Here, we summarize the epidemiological, mechanistic and clinical evidence linking UPF consumption to both conditions. Most prospective cohorts and meta-analyses associate higher UPF intake with incident Crohn’s disease, whereas associations with ulcerative colitis are weaker and inconsistent. In IBS, observational studies, including a large prospective cohort, suggest a modest, dose-dependent association with risk, although data are limited and the diagnostic criteria have recently changed with Rome V. Mechanistically, both disorders may converge on the intestinal microenvironment: in experimental models, emulsifiers alter microbial composition and metabolism, the mucus layer, epithelial barrier integrity and mucosal immune activation, and non-nutritive sweeteners alter microbial composition and epithelial barrier function, although human data are limited and causality has not been established. We also discuss IBS-like symptoms in quiescent IBD, dietary management in both conditions, and the main knowledge gaps, including exposure assessment, residual confounding and the need for adequately powered intervention trials.

MicroorganismsVol. 14(11)
University of Verona (IT), University of Padua (IT), Pontificia Universidad Católica de Chile (CL), Technion – Israel Institute of Technology (IL), Rambam Health Care Campus (IL), Federico II University Hospital (IT), Ospedale Policlinico San Martino (IT), Azienda Ospedale - Università Padova (IT), Fondazione Poliambulanza Istituto Ospedaliero (IT), IRCCS Azienda Ospedaliera Metropolitana (IT), University of Naples Federico II (IT), University of Genoa (IT), KU Leuven (BE)
Good health and well-being
Openalex Percentile: Top 10%
Consumer Attitudes and Food Labeling
DOIOpen Access PDFOpenAlex
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