Table 2.
Dietary randomized control trials to treat Inflammatory bowel disease.
| Diet | Study design | Patient cohort | No. | Duration | Primary endpoint | Secondary endpoints | Ref. |
|---|---|---|---|---|---|---|---|
| Crohn’s disease exclusion diet | Observational | CD patients unresponsive to biologics | 21 (11 Adult, 10 children) | 12 weeks | Clinical response (remission ≤3 HBI) 19/21 (90.4%) | Clinical remission 13/21 (62%) ↓ HBI (P < 0.001) ↓ CRP (P=0.02) |
(254) |
| Observational | Paediatric + young adult CD patients with active disease | 47 | 6 weeks | Remission (≤3 HBI): 70.2% | ↓ PCDAI (P < 0.001), ↓ HBI (P < 0.001) ↓ CRP (P < 0.001) |
(255) | |
| RCT | Paediatric CD patients | 74 | 12 weeks | ↑ Tolerance: CDED+PEN vs. EEN (P < 0.01) | ↑ Corticosteroid-free remission: CDED+PEN vs. EEN (P=0.01) ↔ Faecal calprotectin CDED+PEN vs. EEN (P=0.43) |
(256) | |
| RCT | Adult CD patients with mild/moderate disease | 40 | 24 weeks | ↔ Remission ( < 5 HBI) at wk 6: CDED+PEN vs. CDED (P=0.46) | ↔ Clinical remission at Wk24 (P=0.11) ↔ endoscopic remission at Wk24 (P=0.74) ↔ CRP (P=0.79), Faecal calprotectin (P=0.60) |
(257) | |
| Specific carbohydrate diet | Observational | Paediatric CD and UC patients with active disease | 12 (10 analysed) | 12 weeks | Remission (PCDAI/PUCAI < 10): 80% | ↓ PCDAI (-23.5)
a
↓ PUDAI (-21.6) a ↓ CRP a , Faecal calprotectin a |
(258) |
| Low FODMAP diet | RCT | Quiescent CD and UC patients | 52 (43 analysed) | 4 weeks | ↔ IBS symptom score: Low FODMAP: -67 vs. Control: -34 (P=0.075) | ↔ disease activity (P=0.8) ↑ IBD control score (P=0.03) ↔ CRP (P=0.25), Faecal calprotectin (P=0.98), peripheral blood T cells |
(259) |
| RCT | Quiescent/mild CD and UC patients | 55 | 6 weeks | ↔ disease activity (HBI/mayo score): Low FODMAP vs. control diet (CD patients, P=0.28, UC patients, P= 0.84): | ↔ faecal calprotectin (P=0.13) ↔ CRP (P=0.64) ↔ IBD control score (P=0.89) |
(260) | |
| Mediterranean diet | Observational | CD patients | 58 | 6 months | ↓ BMI: -0.48, P=0.032 | ↑ QoL (P < 0.001) ↓ CRP (P=0.04) ↓ Faecal Calprotectin (P=0.04) |
(261) |
| Observational | UC patients | 84 | 6 months | ↓ BMI: -0.42, P=0.002 | ↑ QoL (P < 0.001) ↓ CRP (P=0.01) ↓ Faecal Calprotectin (P=0.049) |
(261) | |
| RCT | CD patients with mild/moderate disease | 191 | 12 weeks | ↔ Symptomatic remission (sCDAI < 150 at week 6): Mediterranean diet vs. SCD (P=0.77) | ↔ clinical remission (P=0.28) ↔ CRP (P=ns) ↔ Faecal Calprotectin (P=0.44) ↔ QoL (P>0.3) |
(262) | |
| Low Fat, High fibre | RCT | Quiescent UC patients | 18 (17 analysed) | 4 weeks | ↑ QoL: Low fat/high fibre vs. control diet (P=0.04) | ↔ CRP, Faecal Calprotectin (P=ns) ↓ serum amyloid A (P=0.07) |
(263) |
RCT, randomised control trial; HBI, Harvey-Bradshaw index; CRP, C-reactive protein; CDED, Crohn’s disease exclusion diet; PEN, partial enteral nutrition; QoL, Quality of life; PCDAI, Paediatric Crohn’s disease activity index; PUCAI, Paediatric ulcerative colitis activity index. UC, ulcerative colitis.
a
no p-value reported.
↑, increased; ↓, decreased; ↔, unchanged; NS, not significant.