Yanai H, wait. Lancet gastrointestinal heparin. 2021; doi:10.1016/S2468-1253(21)00299-5.
Yanai H, wait. Lancet gastrointestinal heparin. 2021; doi:10.1016/S2468-1253(21)00299-5.
Crohn’s disease exclusion diet with or without enteral nutrition induces and maintains remission in adults with mild to moderate CD, and may lead to complete endoscopic remission.
"The goal of current drug therapy is to reduce inflammation and induce mucosal healing, which can be achieved by changing the immune pathway; however, many drugs used to treat Crohn's disease involve immunosuppression and have additional side effects," Israel Petati Henit Yanai, MD, of Kwarabin Medical Center and his colleagues wrote in "The Lancet Gastroenterology and Hepatology". "There is an unmet need for safer therapies, especially for patients with mild disease activity and low risk of complex diseases, or those with immunosuppressive diseases. Dietary factors are the strongest environmental factors that can cause inflammation. One of the candidates."
Using whole foods and partial enteral nutrition, CD Exclusion Diet (CDED) is a new type of diet therapy aimed at relieving and reducing inflammation in patients with CD. The children studied showed that this method may be as effective as pure enteral nutrition, but with better compliance; there are no data in the adult cohort.
In an open-label, pilot randomized trial, researchers analyzed 44 CD patients (median age 30 years) to 24 weeks to assess the feasibility and effectiveness of CDED in inducing and maintaining remission and compliance. And compare the improvement results between the two CDED plus partial enteral nutrition (n = 20) and CDED alone (n = 24).
According to the results of the study, 63% (n = 25) of patients achieved clinical remission after dietary intervention in the 6th week. At week 6, there was no significant difference between 68% (n = 13) of the CDED group with partial enteral nutrition and 57% (n = 12) of the CDED group alone. Among the patients who responded at week 6, 88% (n = 22) continued to respond at week 12, and 80% (n = 20) continued to respond at week 24. Among these patients, there was no significant difference between the two groups at week 1212 (63% and 48%, respectively) or 24 (63% and 38%).
Further analysis showed that 35% (n = 14) of the patients had remission under endoscopy at week 24. The difference between groups—8 patients in the CDED partial enteral nutrition group and 6 patients in the CDED alone group—is not significant.
The researchers noted that there were no serious or treatment-related adverse events.
"This diet can be used for adults with mild to moderate Crohn's disease without complications at the time of diagnosis, and may be a treatment option for patients who cannot receive medication due to underlying health conditions," Yanai and colleagues concluded road. "Our findings indicate that CDED alone or CDED and partial enteral nutrition should be further explored in strong randomized controlled trials."
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