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Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial (CDED, PEN)

Summary Excerpt: CDED plus PEN was better tolerated than EEN in children with mild to moderate CD. Both diets were effective in inducing remission by week 6. The combination CDED plus PEN induced sustained remission in a significantly higher proportion of patients than EEN, and produced changes in the fecal microbiome associated with remission. These data support use of CDED plus PEN to induce remission in children with CD.

Gastroenterology. 2019 Aug;157(2):440-450.e8. doi: 10.1053/j.gastro.2019.04.021. Epub 2019 Jun 4
Levine A et al

Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease (AIP)

Summary Excerpt: Dietary elimination can improve symptoms and endoscopic inflammation in patients with IBD. Randomized controlled trials are warranted.

Inflamm Bowel Dis , 23 (11), 2054-2060 Nov 2017
Konijeti GG et al

An Anti-Inflammatory Diet as Treatment for Inflammatory Bowel Disease: a Case Series Report (IBD-AID)

Summary Excerpt: This case series indicates potential for the IBD-AID as an adjunct dietary therapy for the treatment of IBD. A randomized clinical trial is warranted.

Nutr J. 2014 Jan 16;13:5. doi: 10.1186/1475-2891-13-5
Olendzki B et al

Nutritional Therapy in Pediatric Crohn Disease: the Specific Carbohydrate Diet. (SCD)

Summary Excerpt: This chart review suggests that the SCD and other low complex carbohydrate diets may be possible therapeutic options for pediatric Crohn disease. Further prospective studies are required to fully assess the safety and efficacy of the SCD, or any other low complex SCDs in pediatric patients with Crohn disease.

J Pediatr Gastroenterol Nutr. 2014 Jan;58(1):87-91. doi: 10.1097/MPG.0000000000000103.
Suskind DL et al

Exclusive Enteral Nutrition Provides an Effective Bridge to Safer Interval Elective Surgery for Adults With Crohn's Disease (EEN)

Summary Excerpt: Exclusive enteral nutrition frequently down-stages the need for surgery in patients presenting with stricturing or penetrating complications of Crohn's disease; it is associated with a reduction in systemic inflammation, operative times and the incidence of post-operative abscess or anastomotic leak.

Aliment Pharmacol Ther , 45 (5), 660-669 Mar 2017
Heerasing N et al

Dietary Therapy With the Crohn's Disease Exclusion Diet Is a Successful Strategy for Induction of Remission in Children and Adults Failing Biological Therapy (CDED)

Summary Excerpt: Dietary treatment combining PEN with the CDED may be a useful salvage regimen for patients failing biological therapy despite dose escalation.

J Crohns Colitis , 11 (10), 1205-1212 2017 Oct 1
Sigall-Boneh RS et al

Exclusive Enteral Nutrition Therapy in Paediatric Crohn's Disease Results in Long-term Avoidance of Corticosteroids: Results of a Propensity-score Matched Cohort Analysis (EEN)

Summary Excerpt: These findings suggest that EEN induction therapy is more effective in achieving early remission and is associated with long-term steroid avoidance without increased use of biologics or need for surgery.

J Crohns Colitis , 11 (9), 1063-1070 2017 Sep 1
Connors J et al

Polymeric Diet Alone Versus Corticosteroids in the Treatment of Active Pediatric Crohn's Disease: A Randomized Controlled Open-Label Trial (EEN)

Summary Excerpt: In children with active and recently diagnosed CD, a short course of polymeric diet is more effective than corticosteroids in inducing healing of gut inflammatory lesions.

Clin Gastroenterol Hepatol , 4 (6), 744-53 Jun 2006
Borrelli O et al

The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series (SCD)

Summary Excerpt: Our survey results suggest that SCD can potentially be an effective tool in the management of some patients with IBD and specifically in patients with colonic and ileocolonic CD who made up the majority of our study group. A highly educated group of patients follow the SCD; all but one of the adults in our study had a college or graduate degree. Our results also suggest that in some patients with moderate to severe disease who follow this diet, discontinuation of immunosuppressive agents has been feasible.

J Acad Nutr Diet. 2015 Aug;115(8):1226-32. doi: 10.1016/j.jand.2015.04.016
Kakodkar S et al

Date Title Diets Authors Summary Excerpt Citation
Oct 2019 The Autoimmune Protocol Diet Modifies Intestinal RNA Expression in Inflammatory Bowel Disease AIP Chandrasekaran A et al Results from this RNA substudy would suggest dietary elimination, along with emphasis on a nutrient-dense diet, has the potential to positively modify inflammation and reduce symptoms in UC. Our substudy, though very small, included a well-defined subgroup of participants with UC on mesalamine only, avoiding effects that might be attributable to systemic or targeted immunosuppression. Crohn's & Colitis 360, Volume 1, Issue 3, October 2019, otz016
Oct 2019 An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease AIP Chandrasekaran A et al Dietary modification can improve quality of life as early as week 3 in patients with active IBD. Larger randomized controlled trials are needed to examine dietary interventions in IBD. Crohn's & Colitis 360, Volume 1, Issue 3, October 2019, otz019,
Aug 2019 Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial CDED, PEN Levine A et al CDED plus PEN was better tolerated than EEN in children with mild to moderate CD. Both diets were effective in inducing remission by week 6. The combination CDED plus PEN induced sustained remission in a significantly higher proportion of patients than EEN, and produced changes in the fecal microbiome associated with remission. These data support use of CDED plus PEN to induce remission in children with CD. Gastroenterology. 2019 Aug;157(2):440-450.e8. doi: 10.1053/j.gastro.2019.04.021. Epub 2019 Jun 4
Jun 2019 Clinical Course and Dietary Patterns Among Patients Incorporating the Autoimmune Protocol for Management of Inflammatory Bowel Disease AIP Lee J et al Patients utilizing AIP for management of IBD report clinical benefit of AIP, reduction of steroid use, and successful food group reintroduction. Dietary interventions could be another form of treatment in patients with IBD to improve symptoms and maintain remission. Current Developments in Nutrition, Volume 3, Issue Supplement_1, June 2019, nzz035.P12-010-19
Apr 2019 Relapse Prevention by Plant-Based Diet Incorporated into Induction Therapy for Ulcerative Colitis: A Single-Group Trial SVD Chiba M et al Relapse rates in UC after induction therapy with PBD were far lower than those previously reported with conventional therapy. Adherence to PBD was significantly higher than baseline even at 6-year follow-up. We conclude PBD is effective for preventing UC relapse. Perm J . 2019;23:18-220. doi: 10.7812/TPP/18-220.
Apr 2019 Treatment of Active Crohn's Disease With an Ordinary Food-based Diet That Replicates Exclusive Enteral Nutrition CD-TREAT Svolos V et al CD-TREAT replicates EEN changes in the microbiome, decreases gut inflammation, is well tolerated, and is potentially effective in patients with active CD. Gastroenterology . 2019 Apr;156(5):1354-1367.e6. doi: 10.1053/j.gastro.2018.12.002. Epub 2018 Dec 11.
Feb 2018 Effect of the Specific Carbohydrate Diet on the Microbiome of a Primary Sclerosing Cholangitis and Ulcerative Colitis Patient SCD Dubrovsky A and Kitts CL Not only were substantial changes in the fecal bacterial composition detectable within two weeks, but all UC symptoms were also controlled as early as one week following the start of the diet. Cureus. 2018 Feb 9;10(2):e2177. doi: 10.7759/cureus.2177.
Feb 2018 Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease SCD Suskind DL et al SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD. J Clin Gastroenterol. 2018 Feb;52(2):155-163. doi: 10.1097/MCG.0000000000000772.
Dec 2017 Exclusive Enteral Nutrition versus Infliximab in Inducing Therapy of Pediatric Crohn’s Disease EEN Lou Y et al EEN provided similar improvements as IFX in clinical symptoms, mucosal healing, and BMI. EEN therapy has less adverse effects when compared with IFX. Gastroenterol Res Pract , 2017, 6595048 2017
Nov 2017 Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease AIP Konijeti GG et al Dietary elimination can improve symptoms and endoscopic inflammation in patients with IBD. Randomized controlled trials are warranted. Inflamm Bowel Dis , 23 (11), 2054-2060 Nov 2017
Nov 2017 Nutritional Adequacy of the Specific Carbohydrate Diet in Pediatric Inflammatory Bowel Disease SCD Braly K et al Nutrient intake of pediatric inflammatory bowel disease patients on the SCD was adequate when compared with a healthy peer reference population, but adequacy was variable when compared with the dietary recommended intakes. Close monitoring with a multidisciplinary team for patients using the SCD as an alternative or adjunct therapy is recommend to ensure positive outcomes for overall patient health. J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):533-538. doi: 10.1097/MPG.0000000000001613.
Oct 2017 Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial SVD Chiba M et al IPF therapy can induce remission in most patients with CD who are naïve to biologics regardless of age or whether they have a new diagnosis or relapse. Perm J . 2017;21:17-009. doi: 10.7812/TPP/17-009.

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Improving the Care of Patients with Crohn’s Disease and Ulcerative Colitis through Nutrition

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