Journal Article

The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial

Suskind, David L., Braly, Kimberly, Lee, Dale, Kim, Young-Mo, Nicora, Carrie D., Wahbeh, Ghassan, Singh, Namita, Lipton, Mary S., Jansson, Janet K., Nelson, William C., Purvine, Samuel O., Nuding, Mason

2020

Overview

Background: Crohn’s disease (CD) is a chronic inflammatory intestinal disorder associated with intestinal dysbiosis. Diet modulates the intestinal microbiome and therefore has a therapeutic potential. The aim of this study is to determine the potential efficacy of three versions of the specific carbohydrate diet (SCD) in active Crohn’s Disease. Methods: 18 patients with mild/moderate CD (PCDAI 15–45) aged 7 to 18 years were enrolled. Patients were randomized to either SCD, modified SCD(MSCD) or whole foods (WF) diet. Patients were evaluated at baseline, 2, 4, 8 and 12 weeks. PCDAI, inflammatory labs and multi-omics evaluations were assessed. Results: Mean age was 14.3 ± 2.9 years. At week 12, all participants (n = 10) who completed the study achieved clinical remission. The C-reactive protein decreased from 1.3 ± 0.7 at enrollment to 0.9 ± 0.5 at 12 weeks in the SCD group. In the MSCD group, the CRP decreased from 1.6 ± 1.1 at enrollment to 0.7 ± 0.1 at 12 weeks. In the WF group, the CRP decreased from 3.9 ± 4.3 at enrollment to 1.6 ± 1.3 at 12 weeks. In addition, the microbiome composition shifted in all patients across the study period. While the nature of the changes was largely patient specific, the predicted metabolic mode of the organisms increasing and decreasing in activity was consistent across patients. Conclusions: This study emphasizes the impact of diet in CD. Each diet had a positive effect on symptoms and inflammatory burden; the more exclusionary diets were associated with a better resolution of inflammation.

• Publisher: MDPI AG,MDPI
• Subject: 60 APPLIED LIFE SCIENCES / Abscesses / Adolescent / age / C-Reactive Protein / Carbohydrates / Child / Crohn Disease - diet therapy / Crohn Disease - therapy / Crohn's disease / Diet / Dietary Carbohydrates / Dietitians / Double-Blind Method / Drug therapy / dysbiosis / Dysbiosis - drug therapy / Female / Fistula / Food / Gastroenterology / Humans / Immune system / Induction Chemotherapy / Induction therapy / inflammation / Inflammatory bowel disease / Inflammatory Bowel Diseases / intestinal microorganisms / intestines / Laboratories / Male / Metabolites / Metabolomics / Metagenomics / microbiome / Microbiota / multi-omics application / multiomics / Nutrition research / Patients / Pediatrics / Permeability / Proteins / Proteomics / remission / specific carbohydrate diet / therapeutics