1*Division of Gastroenterology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; †Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ‡Division of Gastroenterology, Hepatology, and Nutrition, Seattle Children's Hospital, University of Washington, Seattle, Washington; §Public Health Sciences Division, Departments of Epidemiology and Medicine, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington; ‖George Washington University, Washington, DC; ¶Division of Gastroenterology and Hepatology, McMaster University, Hamilton, Ontario, Canada; and **Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Inflammatory bowel disease is believed to be caused by a combination of genetic and environmental stimuli such as our diet. Diets high in meat and fats and low in fruits and vegetables have been associated with new-onset inflammatory bowel disease. This has triggered interest in using dietary modification as a treatment. The 3 principle models of dietary intervention are supplementation with selected dietary components, exclusion of selected dietary components, or use of dietary formulas in place of a normal diet. Despite the high level of interest in dietary interventions as a treatment for inflammatory bowel disease, few well-designed clinical trials have been conducted to firmly establish the optimal diet to induce or maintain remission. This may be in part related to the challenges of conducting dietary intervention trials. This review examines these challenges and potential approaches to be used in dietary intervention trials.