Journal Article

Anti-Inflammatory Diet Prevents Subclinical Colonic Inflammation and Alters Metabolomic Profile of Ulcerative Colitis Patients in Clinical Remission

Halloran, Brendan, Park, Heekuk, Wishart, David, Valcheva, Rosica, Dieleman, Levinus, Keshteli, Ammar, van Diepen, Kendall, Nickurak, Cheryl, van Zanten, Sander, Madsen, Karen, Mandal, Rupasri, Kroeker, Karen

2022

Overview

A relationship between ulcerative colitis (UC) and diet has been shown in epidemiological and experimental studies. In a 6-month, open-label, randomized, placebo-controlled trial, adult UC patients in clinical remission were randomized to either an “Anti-inflammatory Diet (AID)” or “Canada’s Food Guide (CFG)”. Menu plans in the AID were designed to increase the dietary intake of dietary fiber, probiotics, antioxidants, and omega-3 fatty acids and to decrease the intake of red meat, processed meat, and added sugar. Stool was collected for fecal calprotectin (FCP) and microbial analysis. Metabolomic analysis was performed on urine, serum, and stool samples at the baseline and study endpoint. In this study, 53 patients were randomized. Five (19.2%) patients in the AID and 8 (29.6%) patients in the CFG experienced a clinical relapse. The subclinical response to the intervention (defined as FCP < 150 µg/g at the endpoint) was significantly higher in the AID group (69.2 vs. 37.0%, p = 0.02). The patients in the AID group had an increased intake of zinc, phosphorus, selenium, yogurt, and seafood versus the control group. Adherence to the AID was associated with significant changes in the metabolome, with decreased fecal acetone and xanthine levels along with increased fecal taurine and urinary carnosine and p-hydroxybenzoic acid levels. The AID subjects also had increases in fecal Bifidobacteriaceae, Lachnospiraceae, and Ruminococcaceae. In this study, we found thatdietary modifications involving the increased intake of anti-inflammatory foods combined with a decreased intake of pro-inflammatory foods were associated with metabolic and microbial changes in UC patients in clinical remission and were effective in preventing subclinical inflammation.

• Publisher: MDPI AG,MDPI
• Subject: 4-hydroxybenzoic acid / acetone / added sugars / Adult / adults / Anti-inflammatory diet / Anti-inflammatory drugs / Antioxidants / Bifidobacteriaceae / blood serum / Canada / Cancer / carnosine / Chromatography / Colitis, Ulcerative - diet therapy / Colitis, Ulcerative - metabolism / Counseling / Diabetes / Diet / Diet - methods / Diet therapy / dietary fiber / Dietitians / Epidemiology / Fatty acids / Feces - chemistry / food intake / Humans / Inflammation / Inflammation - diet therapy / Inflammation - prevention & control / Inflammatory bowel disease / Laboratories / Lachnospiraceae / Leukocyte L1 Antigen Complex - analysis / Medical research / Medicine, Experimental / metabolome / metabolomics / NMR / Nuclear magnetic resonance / Nutrition research / Omega-3 fatty acids / phosphorus / Prevention / Probiotics / Quality of life / Recipes / red meat / relapse / remission / Remission (Medicine) / Ruminococcaceae / seafoods / selenium / taurine / Tumor necrosis factor-TNF / Type 2 diabetes / Ulcerative colitis / Urine / xanthine / yogurt / zinc