The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn's Disease: A Randomized Diet Controlled Trial.
Study Goal
The researchers aimed to determine the potential efficacy of three versions of the Specific Carbohydrate Diet (SCD) in achieving clinical remission and reducing inflammation in pediatric patients with mild to moderate Crohn's Disease.
Results Summary
All participants who completed the study achieved clinical remission by week 12, with reductions in C-reactive protein levels across all diet groups. Microbiome composition shifted in all patients, with consistent metabolic changes observed, though the specific changes varied by individual.
Population
Pediatric patients (ages 7-18) with mild to moderate Crohn's Disease (PCDAI 15-45).
Effective Dosage
Not specified (dietary intervention only).
Duration
12 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
specific carbohydrate diet (SCD) | increase | clinical remission | patients with mild/moderate CD aged 7 to 18 years | - | achieved clinical remission | #1 |
specific carbohydrate diet (SCD) | decrease | C-reactive protein | patients with mild/moderate CD aged 7 to 18 years | from 1.3 ± 0.7 to 0.9 ± 0.5 | decreased | #2 |
modified SCD (MSCD) | decrease | C-reactive protein | patients with mild/moderate CD aged 7 to 18 years | from 1.6 ± 1.1 to 0.7 ± 0.1 | decreased | #3 |
whole foods (WF) diet | decrease | C-reactive protein | patients with mild/moderate CD aged 7 to 18 years | from 3.9 ± 4.3 to 1.6 ± 1.3 | decreased | #4 |
specific carbohydrate diet (SCD), modified SCD (MSCD), whole foods (WF) diet | change | microbiome composition | patients with mild/moderate CD aged 7 to 18 years | - | shifted | #5 |
specific carbohydrate diet (SCD), modified SCD (MSCD), whole foods (WF) diet | decrease | symptoms and inflammatory burden | patients with mild/moderate CD aged 7 to 18 years | - | had a positive effect | #6 |
more exclusionary diets | decrease | inflammation | patients with mild/moderate CD aged 7 to 18 years | - | associated with a better resolution | #7 |
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.