Work

Randomized controlled trial of a natural whole food diet versus habitual diet for Crohn's disease: Is diet quality the key?

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND & AIMS: Diets can help induce remission in patients with Crohn's disease (CD). However, given inconsistent recommendations across purportedly beneficial anti-inflammatory diets and prior studies highlighting benefits of plant-based diet patterns, we hypothesized that the benefit of diet therapy stems from the overall "healthfulness" of diet patterns. METHODS: In a randomized controlled trial, adults with mild-to-moderate CD were assigned to receive guidance on a natural whole food diet that comprised principles of a healthful diet versus continuation of one's habitual diet. Primary outcomes included clinical remission and change in calprotectin in weeks 4 and 8. Secondary outcomes included nutritional parameters (nutrient and energy intake, body composition, metabolic rate) and adverse events. Healthy Eating Index (HEI) served as a surrogate of diet quality and adherence. RESULTS: Twenty-eight participants with active CD were randomized. In intention-to-treat analysis, whole food diet led to overall greater clinical remission (odds ratio [OR] 1.41; 95 % CI 1.03-1.93; P = 0.03) and similar change in calprotectin. In per protocol analysis, adherence to a healthful diet was associated with clinical remission (OR 1.18; 95 % CI 1.02-1.38; P = 0.03) and change in calprotectin (-234; 95 % CI -465 to -3; P = 0.047). There was no increased risk of nutritional deficiency or reported adverse events. CONCLUSION: Following a natural whole food diet based on principles of a "healthful" diet was safe and effective for inducing clinical remission and reducing fecal calprotectin concentrations in mild-to-moderate CD. Further investigation is needed to confirm these findings and to identify mechanisms to improve adherence to healthy anti-inflammatory diets. GOV REGISTRATION: NCT04431700.

Source: Clinical Nutrition ESPEN

DOI: 10.1016/j.clnesp.2025.08.015

Authors: Berkeley N. Limketkai, Jieping Yang, Lydia Chau, Shaya Noorian, Zhaoping Li

Institution: University of California, Los Angeles

Language: English

Topic: Inflammatory Bowel Disease

Subfield: Genetics

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDGs: Good health and well-being, Zero hunger

Open Access status: hybrid

Estimated APC paid: $2,750