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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
May 2021 A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults with Crohn's Disease SCD, MD Lewis JD et al This study compares the SCD and MD on symptoms, fecal calprotectin and CRP at 6 and 12 weeks finding no statistical significance in these endpoints. Gastroenterology. 2021;S0016-5085(21)03069-9. doi:10.1053/j.gastro.2021.05.047
Oct 2020 Adherence to the Mediterranean Diet Is Associated with Decreased Fecal Calprotectin in Patients with Ulcerative Colitis after Pouch Surgery MD Godny L et al In patients with UC after pouch surgery, adherence to MED is associated with decreased calprotectin levels. Thus, MED may have a role in modifying intestinal inflammation in IBD. Eur J Nutr . 2020 Oct;59(7):3183-3190. doi: 10.1007/s00394-019-02158-3. Epub 2019 Dec 7.
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
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,
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.
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
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.
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.
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.
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
Oct 2017 Diet to the Rescue: Cessation of Pharmacotherapy After Initiation of Exclusive Enteral Nutrition (EEN) Followed by Strict and Liberalized Specific Carbohydrate Diet (SCD) in Crohn's Disease EEN, SCD Nakayuenyongsuk W et al NA Dig Dis Sci. 2017 Oct;62(10):2686-2689. doi: 10.1007/s10620-016-4446-1.
Apr 2020 Dietary Therapies Induce Rapid Response and Remission in Pediatric Patients With Active Crohn's Disease CDED, EEN Sigall Boneh R et al For pediatric patients with active CD, dietary therapies (CDED and EEN) induce a rapid clinical response (by week 3). Identification of patients with and without a rapid response to diet might help identify those who, with compliance, will be in clinical remission by week 6 of the diet. Clin Gastroenterol Hepatol . 2020 Apr 14;S1542-3565(20)30487-0. doi: 10.1016/j.cgh.2020.04.006.

Nutritional Therapy for IBD

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

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