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Dietary adherence to the Mediterranean diet pattern in a randomized clinical trial of patients with quiescent ulcerative colitis (MED)

NTforIBD Comment: Newsletter March 2023

Summary Excerpt: Patients with UC can adhere to and tolerate the Mediterranean Diet Pattern (MDP) and achieve improved diet quality with reduced bowel symptoms compared to Canadian Habitual Diet (CHD). Increased adherence to the MDP can be achieved through appropriate support such as nutrition education and counseling by a Registered Dietitian. Overall, this data supports that the MDP can be recommended as a remission diet to UC patients to help support disease management alongside front-line therapy drugs.

Dietary adherence to the Mediterranean diet pattern in a randomized clinical trial of patients with quiescent ulcerative colitis. Frontiers in Nutrition, 9.
Haskey, N et al.

P499 Exclusive enteral nutrition induces transmural healing in adults with active Crohn’s disease (EEN)

Summary Excerpt: EEN was identified to induce early transmural response and healing in patients with active CD. Further studies are required to evaluate the capacity for EEN to induce transmural healing and the role of IUS as an early assessment tool in monitoring therapeutic response in CD.

Journal of Crohn's and Colitis, Volume 17, Issue Supplement_1, February 2023, Pages i628–i629
Chu M. et al.

Date Title Diets Authors Summary Excerpt Citation
Feb 2022 Clinical and Histologic Remission in an Adult Crohn’s Disease Patient Following the Specific Carbohydrate Diet and Its Impact on Healthcare Costs SCD Arjomand, A This case highlights the rapid and sustainable benefits of the SCD intervention in Crohn’s disease from both a clinical and economic standpoint. Cureus 14(2): e22032. doi:10.7759/cureus.22032
Jun 2006 Polymeric Diet Alone Versus Corticosteroids in the Treatment of Active Pediatric Crohn's Disease: A Randomized Controlled Open-Label Trial EEN Borrelli O et al 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
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.
Feb 2016 Response to Strict and Liberalized Specific Carbohydrate Diet in Pediatric Crohn's Disease SCD Burgis JC et al Disease control may be attainable with the SCD in pediatric CD. Further studies are needed to assess adherence, impact on mucosal healing and growth. World J Gastroenterol. 2016 Feb 14;22(6):2111-7. doi: 10.3748/wjg.v22.i6.2111.
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,
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 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.
May 2010 Lifestyle-related Disease in Crohn’s Disease: Relapse Prevention by a Semi-vegetarian Diet SVD Chiba M et al Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%) in the omnivorous group. Remission rate with SVD was 100% at 1 year and 92% at 2 years. SVD showed significant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003, log rank test). World J Gastroenterol . 2010 May 28;16(20):2484-95. doi: 10.3748/wjg.v16.i20.2484.
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.
Jan 2021 Multidimensional Impact of Mediterranean Diet on IBD Patients MED Chicco F et al A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers. https://pubmed.ncbi.nlm.nih.gov/32440680/
Jan 2023 P499 Exclusive enteral nutrition induces transmural healing in adults with active Crohn’s disease EEN Chu M. et al. EEN was identified to induce early transmural response and healing in patients with active CD. Further studies are required to evaluate the capacity for EEN to induce transmural healing and the role of IUS as an early assessment tool in monitoring therapeutic response in CD. Journal of Crohn's and Colitis, Volume 17, Issue Supplement_1, February 2023, Pages i628–i629
Oct 2017 Effect of the Specific Carbohydrate Diet on Inflammatory Bowel Disease: A 5-Year Longitudinal Study SCD Chutkan R et al Our data confirms that the Specific Carbohydrate Diet is an effective long-term treatment for IBD that can result in improvement of symptoms, mucosal healing, and discontinuation of biologic and immunosuppressive medications. American Journal of Gastroenterology: October 2017 - Volume 112 - Issue - p S1479

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