Source: Gut  |  Posted 9 years ago

The efficacy of enteral diets used for treatment of Crohn's disease may be dependent on the diet's fat composition.

Gastroenterologists in Germany, Spain and the United Kingdom carried out a double-blind study to see how well two whole protein-based diets containing either polyunsaturated fatty acids or monounsaturated fatty acids induced clinical remission of Crohn's disease compared with steroids.

They enrolled 62 patients with active Crohn's disease to one of three treatment arms for up to four weeks. Twenty patients received a polymeric enteral diet of 35 g of lipids per 1000 kcal which was high in oleate (79 percent) and low in linoleate (6.5 percent). A second group of 23 patients received an identical enteral diet but was low in oleate (28 percent) and high in linoleate (45 percent). Nineteen patients on the conventional ward diet received daily doses of oral prednisone 1.0 mg/kg.

Clinical activity and biological and nutritional parameters were measured and treatment was considered to have failed if remission was not achieved by the end of the fourth week.

Intention to treat analysis found overall remission rates of 20 percent with the high oleate/low linoleate diet, 52 percent with the low oleate/high linoleate diet, and 79 percent with steroids and the conventional diet. When the researchers excluded patients who were non-compliant during the first week, remission rates were 27 percent, 63 percent, and 79 percent, respectively.

The researchers found that, after adjusting for confounding variables, the high oleate/low linoleate diet remained significantly associated with a poor response.