Table 1.
Suggested dietary approaches for CD treatment with explanation of mechanisms of action and effects.
| Dietary Treatment | Putative Action | Clinical Impact | ||
|---|---|---|---|---|
| Enteral nutrition (EN) | Promotes gut health [29] | EN promotes CD remission [33] | ||
| Parenteral nutrition (PN) | Promotes gut health [63] | PN favors CD remission. This diet is particularly indicated for malnourished patients during an acute inflammatory phase or post-operative complications affecting gastrointestinal function [61,62] | ||
| Specific carbohydrate diet (SCD) | Promotes gut health. “Forbidden” foods are sucrose, maltose, isomaltose, lactose, potatoes, okra, corn, fluid milk, soy, cheeses with a high amount of lactose such as fresh cheese, food additives, and preservatives [79] |
SCD improves symptoms and quality of life and, in some cases, maintains remission with no need of medications [79]. In children, SCD promotes mucosal healing [81]. SCD normalizes inflammatory markers, e.g., CRP and fecal calprotectin, and serum albumin [82,83,84] | ||
| Low FODMAP diet | Promotes gut health. “Forbidden” foods are fermentables, oligosaccharides, disaccharides, monosaccharides, and polyols [86] |
Improved gastrointestinal symptoms [1,86]; no evidence that calpotectin levels or luminal inflammation ameliorate [87] | ||
| Flexitarian or semi-vegetarian diet (SVD) | It promotes gut health. Limited amounts of meat and fish are allowed [93] |
SVD is effective in preventing CD relapse [93] | ||
| Low fat/fiber limited exclusion diet (LOFFLEX) | Elemental formula followed by an exclusion diet in a well-structured protocol [79] | Possible induction of CD remission although its efficacy is not yet fully demonstrated [79] | ||
| Paleolithic diet | Maker’s diet | Vegan diet | Elimination diets [79] | Efficacy not demonstrated yet [79] |
| Gluten free diet | Absence of gluten intake [79] | Contrasting data [79] | ||
Abbreviations: EN, Enteral Nutrition; PN, Parenteral Nutrition; CD, Crohn’s Disease; SCD, Specific Carbohydrate Diet; FODMAP, fermentable, oligosaccharides, disaccharides, monosaccharides and polyols; SVD, Flexitarian or Semi-Vegetarian Diet; LOFFLEX, Low Fat/Fiber Limited Exclusion Diet.