The Mechanisms and Clinical Potential of the Mediterranean Diet in the Management of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), including Crohn’s disease (CD)and ulcerative colitis (UC), is a chronic, relapsing, immune-mediated disorder. With the increasing global incidence of IBD, traditional pharmacological therapies face limitations in both efficacy and safety, prompting growing interest in dietary interventions as adjunctive management strategies. The Mediterranean diet (MD), rich in plant-based foods, olive oil, fish, and natural antioxidants, has been shown to exert anti-inflammatory, immunomodulatory, and gut microbiota-regulating effects. This study explores the nutritional composition and anti-inflammatory mechanisms of the MD, its potential in modulating the gut microbiota, immune responses, and intestinal barrier function, and reviews clinical evidence from observational studies and randomized controlled trials. Although MD demonstrates promising effects in reducing disease activity and improving quality of life, the lack of standardized interventions, marked individual variability, and limited evidence on long-term efficacy remain challenges. Future research should focus on developing culturally adapted dietary protocols, elucidating individualized response mechanisms through multi-omics approaches, and integrating MD with functional nutrients or lifestyle interventions to promote its clinical translation and widespread application in IBD.