Special issue of Gastroenterology highlights how food impacts health and disease

Patients are always interested in understanding what they should eat and how it will impact their health. Physicians are just as interested in advancing their understanding of the major health effects of foods and food-related diseases. To satisfy this need, the editors of Gastroenterology, the official journal of the American Gastroenterological Association, are pleased to announce the publication of this year's highly anticipated special 13th issue on food, the immune system and the gastrointestinal tract.

"This special issue provides a tour de force of biological and clinical data regarding how food impacts health and disease," said Douglas A. Corley, MD, PhD, MPH, and Detlef Schuppan, MD, PhD, guest editors for this special issue. "We hope this will inform future research by identifying gaps in knowledge, while providing patients and clinicians with evidence-based summaries to guide clinical recommendations."

In the last two decades, we have witnessed a marked expansion of research into how food and nutritional elements influence health and disease. Food and its interactions with the immune system are a critical topic for gastroenterology to address, changing our view of digestion and resorption of food as the principal role of the gastrointestinal tract. Articles in this special issue of Gastroenterology evaluate immunology, biological mechanisms and clinical studies of foods and food-related diseases for all the major topic areas, including food allergies, celiac disease, non-celiac wheat sensitivity, carbohydrate (FODMAP) intolerance in relation to irritable bowel syndrome, cancer, obesity and brain-gut interactions.

The specific topics covered in this special 13th issue of Gastroenterology are outlined below.

Food and the Microbiome

• Diet in the Pathogenesis and Treatment of Inflammatory Bowel Diseases; by Dale Lee, et al.
  • The question of what to eat is among the most commonly asked by patients, and among the most difficult to answer for clinicians.

• Food, Immunity, and the Microbiome; by Herbert Tilg and Alexander R. Moschen
  • By increasing our understanding of interactions between diet, immunity and the microbiota, we might develop food-based approaches to prevent or treat many diseases.

  Food Allergies
• Food Allergies: The Basics; by Rudolf Valenta, et al.
  • Learning about the structure of disease-causing food allergens has allowed researchers to engineer synthetic and recombinant vaccines.

• Diagnosis, Management, and Investigational Therapies for Food Allergies; by Mike Kulis, et al.
  • Although there are no therapies currently available for routine clinical care [of food allergies], recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective.

  Eosinophilic Esophagitis

• Molecular, Genetic, and Cellular Bases for Treating Eosinophilic Esophagitis (EoE); by Marc E. Rothenberg
  • We propose that EoE is a unique disease characterized by food hypersensitivity; strong hereditability influenced by early life exposures and esophageal-specific genetic risk variants; and allergic inflammation and that the disease is remitted by disrupting inflammatory and T-helper type 2 cytokine?mediated responses and through dietary elimination therapy.

  Food and Functional Bowel Disease

• Food Components and Irritable Bowel Syndrome; by Peter R. Gibson, et al.
  • The concepts behind, and delivery of, specialized diets differ from those of pharmacologic agents.

  Celiac Disease: Clinical Spectrum and Management

• Advances in Diagnosis and Management of Celiac Disease; by Ciarán P. Kelly, et al.
  • There is increasing interest in developing nondietary therapies.

• Local Communication Among Mucosal Immune Cells in Patients with Celiac Disease; by Jeroen van Berge, et al.
  • We review the immune processes that occur in the lamina propria and their potential effects on epithelial pathology in celiac disease.

  Nonceliac Gluten and Wheat Sensitivity

• Nonceliac Gluten Sensitivity; by Alessio Fasano, et al.
  • Although there is clearly a fad component to the popularity of the gluten free diet, there is also undisputable and increasing evidence for nonceliac gluten sensitivity.

  Food and the Brain: How the Brain Responds to Nutrients

• Neural Responses to Macronutrients: Hedonic and Homeostatic Mechanisms; by Alastair J. Tulloch, et al.
  • A greater understanding of the neural circuits affected by the consumption of specific macronutrients, and by obesity, might lead to new treatments and strategies for preventing unhealthy weight gain.

• Peripheral Mechanisms in Appetite Stimulation; by Michael Camilleri
  • Understanding these mechanisms is key to the physiological control of feeding and the derangements that occur in obesity and their restoration with treatment (as shown by the effects of bariatric surgery).

  Nutrients and Gastrointestinal Malignancies

• Diet and Upper Gastrointestinal Malignancies; by Christian C. Abnet, et al.
  • Public health recommendations for normal-risk individuals regarding diet and gastrointestinal cancer should probably emphasize the importance of eating for overall health rather than eating specific foods to reduce risk for specific cancers.

• Nutrients, Foods, and Colorectal Cancer Prevention; by Mingyang Song, et al.
  • Diet likely influences colorectal carcinogenesis through several interacting mechanisms. These include the direct effects on immune responsiveness and inflammation, and the indirect effects of overnutrition and obesity -- risk factors for colorectal cancer.