A catered low-fat, high-fiber diet ‘new, hopeful option’ to manage Crohn’s disease
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Key takeaways:
- Patients with Crohn’s disease who ate the catered Mi-IBD diet for 8 weeks had “a high dietary adherence.”
- They also had a decrease in proinflammatory marker levels, as well as improvement in quality of life.
WASHINGTON — Patients with Crohn’s disease who ate a catered low-fat, high-fiber diet for 8 weeks experienced improvements in symptoms, inflammation and quality of life vs. those offered counseling alone, researchers reported.
“We know that most patients with Crohn’s disease seek dietary counseling and ask their physicians about the foods they should consume,” Hajar Hazime, PhD, who trained at the Abreu Lab at the University of Miami Health System Sylvester Comprehensive Cancer Center, told Healio. “However, it is still unclear which diets are the most helpful for patients with inflammatory bowel disease, leading to confusion and reduced enjoyment of food. Some IBD patients even develop overly restrictive diets similar to the avoidant and restrictive food intake disorder. Additionally, patients who receive dietary counseling rarely follow this advice, with previous studies reporting low dietary adherence.”
Hazime added: “We aimed to determine whether providing participants with a catered low-fat, high-fiber diet makes it easier for them to adhere to dietary recommendations and whether this diet can improve CD symptoms, inflammation and microbiome function.”
Under the guidance of their mentor, Maria T. Abreu, MD, director of the Crohn’s and Colitis Center and professor at the Miller School of Medicine, Hazime and colleagues developed the Mi-IBD diet, which consisted of 20% of total calories from fat, an omega-6/omega-3 fatty acid ratio of approximately 1:1 and 25 g to 35 g of fiber per day — corresponding to 14 g of fiber per 1,000 calories consumed.
In a study presented at Digestive Disease Week, researchers enrolled 73 patients with CD and 24 healthy household controls who chose between diet counseling alone, 8 weeks of catered food with the Mi-IBD diet or catered food with dyadic psychosocial support.
They collected data on demographics, clinical parameters, quality of life and food knowledge, as well as fecal and serum samples at baseline and week 8, and performed proteomic, metabolomics, biologic pathway and network analyses.
“We found that providing CD patients with a catered diet led to a high dietary adherence — over 95%,” Hazime said. “This diet was well-tolerated, improved CD symptoms and reduced levels of proinflammatory markers.”
She added, “Notably, we found significant improvements even in the short term, indicating that patients did not need to adhere to the diet for an extended period to see positive effects. However, it is important to acknowledge that adherence and changing dietary behaviors can be challenging for many patients.”
Those on the Mi-IBD diet also reported significant improvements in food-related quality of life and symptoms, as measured by the short Crohn’s Disease Activity Index. In addition, the Mi-IBD diet modified the fecal metabolome profile in patients with CD.
“The Mi-IBD diet, which we previously tested in ulcerative colitis patients, shows promising results and can be added to the list of diets recommended for patients with IBD,” Hazime told Healio. “The diet is relatively easy to follow and emphasizes consuming fruits, vegetables and other sources of soluble and insoluble fiber while avoiding fried foods and excessive animal fat.”
She continued, “Overall, this diet offers a new, hopeful option for managing IBD symptoms and improving patients’ quality of life.”
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Hazime H, et al. A low-fat, high-fiber dietary intervention in Crohn’s disease patients improves serum proteomic and metabolomic patterns reflecting improvements in systemic inflammation and mucosal healing. Presented at: Digestive Disease Week; May 18-21, 2024; Washington (hybrid).
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