| Summary: | The incidence of inflammatory bowel diseases (IBD), including Crohn’s disease (CD) is increasing worldwide, especially in young children and adolescents. Although hospitalised patients are usually provided with enteral or parenteral support, continuing care typically requires a trial and error approach to suppressing symptoms and maintaining disease remission. Current nutritional advice does not differ from general population guidelines. International collaborative studies have revealed 163 distinct genetic loci affecting susceptibility to IBD, in some of which host-microbe interactions can be seen to play an important role. The nature of these loci enables a rationale for predicting nutritional requirements that may not be evident through standard therapeutic approaches. Certain recognised nutrients, such as vitamin D and long chain omega-3 polyunsaturated fatty acids, may be required at higher than anticipated levels. Various phytochemicals, not usually considered in the same class as classic nutrients, could play an important role. Prebiotics and probiotics may also be beneficial. Genomic approaches enable proof of principle of nutrient optimisation, rather than waiting for disease symptoms to appear and/or progress. We suggest a paradigm shift in diagnostic tools and nutritional therapy for Crohn’s disease, involving a systems biology approach for implementation.
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