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Crohn's Disease Exclusion Diet Well-tolerated in Children
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SAN DIEGO — The Crohn’s Disease Exclusion Diet appeared to be an effective and well-tolerated, first-line therapy for children with mild-to-moderate Crohn’s disease, according to data presented at Digestive Disease Week.
“We have emerging data to show the strong influence of the environment, and in particular the diet, that explains the rising incidence of CD in many western countries,” Johan Emiel Van Limbergen, MD, PhD, of IWK Health Centre in Canada, said in his presentation. “The diet also offers a way of modifying that risk, potentially, and treating the disease by means of altering the diet.”
The CD Exclusion Diet (CDED) is a whole-food diet combined with exclusive enteral nutrition (EEN) designed to reduce dietary exposure to foods that might negatively impact the microbiome, the intestinal barrier and innate immunity.
Researchers conducted a 12-week prospective trial in 78 children with CD, whom they randomly assigned to receive either the CD exclusion diet (n = 40) or EEN alone (n = 38). The primary endpoint of the study was tolerance to the diet, which researchers measured by withdrawals for refusal to continue diet and poor adherence. They also assessed week 6 intention to treat remission defined by PCDAI of 10 or less and the more stringent definition (PCDAI<10), as well as corticosteroid free intention to treat sustained remission week 12.
Investigators included 74 patients in their final analysis.
Van Limbergen and colleagues found that both groups experienced similar outcomes regarding disease activity, decrease in inflammation and sustained steroid-free remission.
However, the CDED was better tolerated by patients with 97.5% tolerance (39/40) compared with 73.7% in the ENN group (28/38; P = .003).
Van Limbergen said their findings show convincing data for the induction of remission in mild-to-moderate CD and show that diet can help reduce inflammation.
“These data support using the Crohn’s disease exclusion diet plus partial enteral nutrition for 12 weeks as a first-line therapy in mild-to-moderate Crohn’s disease,” he concluded. – by Alex Young
Reference:
Van Limbergen JE, et al. Abstract 301. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Van Limbergen reports financial ties to AbbVie, Illumina, Janssen and Nestle Health Sciences. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.