For patients with mild or remittances ulcerative colitis, a low-fat, high-fiber diet improved the quality of life and stool markers of dysbiosis and inflammation, according to the results of a small crossover trial.
Patients with inflammatory bowel disease they often ask what they should eat, but few studies have addressed this issue, wrote Julia Fritsch, of the University of Miami and its associates. Clinical gastroenterology and hepatology. Continuing previous findings that a high-fat diet may contribute to inflammatory bowel disease, 38 adults with ulceration were randomly assigned colitis was in remission or mild (with an outbreak in the last 18 months) to receive a low-fat diet (with 10% daily fat calories and a lot of fruits and vegetables) or an “improved American standard diet” ( with 35% to 40% of daily calories from fat, but more fruits and vegetables than Americans usually eat). Each diet was attended to, delivered to the patients ’home, and lasted 4 weeks, followed by a 2-week wash period, after which each participant switched to the other diet.
Of the 38 patients, 17 completed the study. 24-hour food recall surveys showed that both diets were healthier than those eaten by early participants and web-based daily food diaries (such as www.nutrihand.com/Static/index.html) confirmed that more than 94% of patients adhered to the amount of fat in each diet. Although participants in both groups ate only about half of the fruits and vegetables provided, the main outcome of quality of life based on the short-term inflammatory bowel disease (SIBDQ) questionnaire improved significantly from a median of 4.98 (interquartile range, 4.1–6.0) at baseline to 5.77 (IQR, 5–6.4) with the low-fat diet, and 5.55 (IQR, 4, 75-6.25) with the improved American standard diet. Both diets also produced significant improvements in the quality of life measured by the 36-item short-term survey and in disease activity as measured by the Mayo partial score.
It should be noted, however, that only the low-fat diet significantly reduced serum amyloid A, which is a marker of mucosal inflammation and intestinal dysbiosis, which was quantified by 16S ribosomal RNA sequencing. “It should be noted that there were several variables that were associated with changes in the composition of the microbiota,” the researchers wrote. These include SIBDQ, C-reactive protein, interleukin-6, interleukin-1 beta, and 32 dietary components such as protein, potassium, iron, and zinc.
“These data suggest that even patients in remission [from ulcerative colitis] The researchers concluded that “they could benefit from a healthier diet.” Similarly, neither diet aggravated the symptoms, which is notable given the higher amount of fiber in the two diets. ‘administren. ” They called the restoration “a feasible way to conduct a dietary intervention study with adherence,” noting that “dieting for a patient with IBD for a year costs between $ 19,000 and $ 21,000 per patient. The cost of a patient with biological products such as ustekinumab is approximately $ 130,752 to $ 261,504. “
The study was supported by the Crohn and Colitis Foundation’s extensive medical research program, the Micky and Madeleine Arison Family Foundation Discovery Laboratory, Crohn’s and Colitis, and the Martin Kalser Chair. The lead author revealed links to Boehringer Ingelheim, Gilead, AbbVie, Seres Therapeutics, Shire, Landos, Pfizer and several other pharmaceutical companies. The other investigators reported that they had no conflicts of interest.
This article originally appeared on MDedge.com, which is part of the Medscape professional network.