P698 Role of an exclusion diet (reduced disaccharides, saturated fats, emulsifiers, red and ultraprocessed meats) in maintaining the remission of chronic inflammatory bowel diseases in adults
Preda, C.M.(1)*;Istratescu, D.(2);Manuc, T.(2);Nitescu, M.(3);Louis, E.(4);Manuc, M.(2);Stroie, T.(2);Diculescu, M.(2);
(1)Clinical Institute Fundeni, Department of Gastroenterology and Hepatology, Bucharest, Romania;(2)Clinical Fundeni Institute, Department of Gastroenterology and Hepatology, Bucharest, Romania;(3)UMF „Carol Davila” National Institute for Infectious Diseases Prof. Dr. MateiBals-, Department of Infectious Diseases, Bucharest, Romania;(4)CHU de Liege, Department of Gastroenterology, Liege, Belgium;
Inflammatory bowel diseases (IBD) are a main focus in current research with diet being an emerging therapeutic line due to its links both in onset and progression. A Western-style diet high in processed foods, food additives, red meat, and animal fat has been linked to a higher risk of developing IBD. The aim of this study was to establish an association between an anti-inflammatory exclusion diet and maintenance of remission in IBD. Also, we assessed the efficacy and safety of this diet compared to a non-dietary group and the possible therapeutic effect of this diet in the maintenance of IBD remission.
One hundred seventeen adult IBD patients in remission (64 patients with Crohn’s disease- CD and 53 patients with ulcerative colitis- UC) were randomized at their own will to a 6-months exclusion diet (n=32) or a habitual diet (n=85). Dietary patterns, clinical activity of the disease and inflammatory markers were assessed at baseline and at the end of dietary intervention.
The acceptance rate of the exclusion diet in our cohort was 27.35% (30% in UC and 20% in CD). The exclusion diet and control populations were similar, except for immunosuppressive treatment (only 30% of patients in the exclusion diet group had an immunomodullator compared to 70% in the control group (p-value <0.001)).
The clinical remission after six months was maintained in the exclusion diet arm (100%). In the control arm, 3 patients had clinically active disease (1 patient with UC and 2 patients with CD) and 80 patients maintained the clinical remission state (96.4%) (p-value = 0.278). Figure 1 is depicting the remission rates in different patient groups. Regarding biochemical markers, erythrocyte sedimentation rate (ESR) at baseline was higher in the exclusion diet arm: 31 (5-62) than in the control arm 14.5 (4-48) (p-value=0.011), but six months after, the groups were similar (p-value = 0.440). Fecal calprotectin at baseline was higher than 300 micrograms/gram in 30% of cases in the exclusion diet arm and in 25.8% of cases in the control arm (p-value = 0.774). Six months after, 50% of cases had a higher fecal calprotectin (>300 micrograms/gram) in the intervention arm and only 20.5% in the control arm (p-value = 0.033).
Figure 1. Maintenance of clinical remission 6 months after intervention
We found a better trend of sustained clinical remission in patients who follow an exclusion diet.
However, the threshold for statistical significance was not achieved.
The clinical study continues, these are preliminary data.
There is also a trend of improvement in ESR in the intervention group, but the levels of fecal calprotectin did not improved.