There is ample information about nutritional issues in all media. It is not easy for the medical layperson to find out what is useful or even harmful. There is no shortage of half-truths and fallacies. In a healthy diet, all micro- and macronutrients are actually present. Therefore, in nutritional medicine, based on studies, there is no doubt that the prophylactic use of dietary supplements in healthy people does not offer any benefit. The situation is different when people have chronic inflammatory bowel disease or liver disease.
People with celiac disease also need iron, vitamin D, B12, K, folic acid and micronutrients, for example, which can be prescribed by a doctor. A particularly difficult problem is the distinction between food intolerance and food allergy. These occur in about two to eight percent in Germany. They can be clearly demonstrated by special examinations, since they are immune-mediated. The proof is made possible with a step-by-step diagnosis. About 25 to 30 percent of the population suffers from intolerances. In these cases, careful documentation (food diary) of food intake by the patient is often very helpful. A special “widespread disease” is the so-called irritable bowel syndrome, which affects about eleven percent of people worldwide.
Some patients with irritable bowel syndrome (IBS) suffer from constipation problems, while others struggle more with diarrhea-like symptoms. In recent years, the connection with the bacterial colonization of the gut (microbiome), but also the gut-brain axis, has been the subject of scientific discussion. The treatment is carried out in addition to the nutritional therapy with a treatment in the sense of a microbiome therapy, possibly a drug therapy. In some cases, psychotherapy is required. Research is intensively concerned with the question of whether the microbiome plays a significant role in the development and progression of inflammatory bowel diseases (ulcerative colitis, Crohn’s disease). This represents a completely new therapeutic approach. So far, attempts have been made to treat the inflammation in the intestines with anti-inflammatory preparations and so-called immunosuppressants.
The importance of a high-fiber diet has been confirmed once again. The guideline is 30 grams a day. This value is not reached in most cases (18 to 19 grams/day). A sufficient liquid supply of about 1.5 liters is required for this. With this diet, effects regarding the development of cardiovascular diseases are detectable, but also an influence on high blood pressure, type 2 diabetes and the development of intestinal carcinoma. The diet should contain vegetables, fruits, legumes, nuts and whole grains.