Introduction
Recent research has shown that there is considerable interest in studying inflammatory bowel diseases (IBD) due to the potential for dietary interventions to be used as a therapeutic approach for their onset and progression. Evidence suggests that Western-style diets, with high intake of processed foods, food additives, red meat, and animal fat, have been associated with an increased risk of IBD.
Aims & Methods
The purpose of this study is to evaluate the link between an anti-inflammatory exclusion diet and the maintenance of IBD remission, as well as to assess the potential therapeutic advantages of this dietary approach in preserving IBD remission.The inclusion and exclusion criteria were applied to a total of 189 individuals with IBD, with 21 individuals not meeting the criteria. Therefore, 168 eligible patients were enrolled in the study and allocated to either an exclusion diet or a regular diet, based on their personal preference.
Results
A cohort of 84 adult patients with inflammatory bowel disease (IBD) was recruited for the study. The cohort included 47.6% males, with 44 patients having ulcerative colitis (UC) and 40 having Crohn's disease (CD). The intervention group received an exclusion diet consisting of the removal of red and processed meat, fried foods, high-lactose foods, fast food, white bread, sweetened drinks, and vegetable oils rich in omega-6 for a period of 1 year. An equivalent number of IBD patients with similar demographics and disease types formed the control group. The exclusion diet was well tolerated, with 90% of participants adhering to it frequently or always. The study demonstrated that the clinical response was maintained in 80 patients (95.2%) in the intervention group, which was significantly higher than the 72 patients (85.7%) in the control group (p-value=0.036). Although not statistically significant, fecal calprotectin was higher in the control group than in the intervention group at the one-year follow-up interval. Additional information is provided in Table 1.
Parameter
| All patients (168)
| Exclusion diet (n=84)
| Control (n=84)
| p-value*
|
Sex (male)
| 80(47.6)
| 40 (47.6)
| 40 (47.6)
| 1.000
|
Age (years)
| 41.5 (18-77)
| 43.5 (23-77)
| 39.5 (18-72)
| 0.371
|
Immunosuppressive treatment
Azathioprine
Methotrexate
| 30 (17.9)
4 (2.4)
| 10 (11.9)
2 (2.4)
| 20(23.9)
2 (2.4)
| 0.083
|
Biologic treatment
Infliximab
Adalimumab
Vedolizumab
Ustekinumab
Tofacitinib
| 48(28.6)
44 (26.2)
32 (19.1)
8 (4.8)
4 (2.4)
| 22 (26.2)
24 (28.6)
10 (11.9)
4 (4.8)
2 (2.4)
| 26 (31)
20 (23.8)
22 (26.2)
4 (4.8)
2 (2.4)
| 0.033
|
Combo therapy
| 30 (17.9)
| 10 (11.9)
| 20 (23.9)
| 0.069
|
Other IBD treatment
| 28 (16.7)
| 20 (23.8)
| 8 (9.5)
| 0.022
|
Initial fecal calprotectin>300 mcg/g
| 34 (20.2)
| 18 (21.4)
| 16 (19)
| 0.443
|
Fecal calprotectin>300 mcg/g after one year
| 22 (13.1)
| 8 (9.5)
| 14 (16.7)
| 0.171
|
Clinical remission after one year
| 152 (90.5)
| 80 (95.2)
| 72 (85.7)
| 0.036
|
Conclusion
Patients who adhere to an exclusion diet have the chance of a significantly higher rate of maintenance of clinical remission (95% versus 86% in the control group). A trend toward improvement in inflammation tests was observed in the intervention group, confirming once again that Western-style diet is an important etiological factor in IBD. Therefore, it is recommended that the exclusion, anti-inflammatory diet be presented to all patients diagnosed with IBD as a potential intervention.
