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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
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
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.
Jan 2014 Nutritional Therapy in Pediatric Crohn Disease: the Specific Carbohydrate Diet. SCD Suskind DL et al 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.
Jan 2014 An Anti-Inflammatory Diet as Treatment for Inflammatory Bowel Disease: a Case Series Report IBD-AID Olendzki B et al 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
Jun 2014 Analysis of Gut Microbiome and Diet Modification in Patients with Crohn's Disease SCD Walters SS et al Changes in the composition and complexity of the gut microbiome were identified in response to specialized carbohydrate diet. The SCD was associated with restructuring of the gut microbial communities. SOJ Microbiol Infect Dis. 2014;2(3):1-13. doi: 10.15226/sojmid/2/3/00122. Epub 2014 Jun 27.
Aug 2014 Partial Enteral Nutrition With a Crohn's Disease Exclusion Diet Is Effective for Induction of Remission in Children and Young Adults With Crohn's Disease CDED, PEN Sigall-Boneh R et al Dietary therapy involving PEN with an exclusion diet seems to lead to high remission rates in early mild-to-moderate luminal Crohn's disease in children and young adults. Inflamm Bowel Dis , 20 (8), 1353-60 Aug 2014
Oct 2014 Clinical and Mucosal Improvement with Specific Carbohydrate Diet in Pediatric Crohn Disease SCD Cohen SA et al Clinical and mucosal improvements were seen in children with CD, who used SCD for 12 and 52 weeks. In addition, CE can monitor mucosal improvement in treatment trials for pediatric CD. Further studies are critically needed to understand the mechanisms underlying SCD's effectiveness in children with CD. J Pediatr Gastroenterol Nutr. 2014 Oct;59(4):516-21. doi: 10.1097/MPG.0000000000000449.
May 2015 Efficacy of Concomitant Elemental Diet Therapy in Scheduled Infliximab Therapy in Patients With Crohn's Disease to Prevent Loss of Response EEN Kamata N et al Concomitant ED therapy is effective in maintaining scheduled IFX maintenance therapy in patients with luminal CD in order to prevent LOR. Dig Dis Sci , 60 (5), 1382-8 May 2015
Aug 2015 Resolution of Severe Ulcerative Colitis with the Specific Carbohydrate Diet SCD Khandalavala BN and Nirmalraj MC Successful use of the SCD in children with UC has been documented. We describe previously unreported, highly beneficial results with both symptomatic and clinical improvement and complete remission of UC in an adult female with the SCD. Case Rep Gastroenterol. 2015 Aug 7;9(2):291-5. doi: 10.1159/000438745. eCollection 2015 May-Aug
Aug 2015 The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series SCD Kakodkar S et al 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
Aug 2015 Comparative Effectiveness of Nutritional and Biological Therapy in North American Children with Active Crohn's Disease PEN Lee D et al Although PEN improved clinical symptoms, EEN and anti-TNF were more effective for decreasing mucosal inflammation and improving specific aspects of QOL. Inflamm Bowel Dis . 2015 Aug;21(8):1786-93. doi: 10.1097/MIB.0000000000000426.
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.

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