Coconut water beneficial in ulcerative colitis

The study included 95 participants (mean age 37.2 years, 54.1 percent men) with a Simple Clinical Colitis Activity Index (SCCAI) score of 3–9 and an Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score of greater than 1. These participants were randomly assigned to intervention groups receiving 400 mL of coconut water (n=49) or placebo (n=46) for 8 weeks. The interventions were administered in addition to standard medical therapy.

The median disease duration of the cohort was 48, and 26.1 percent of the participants had pancolitis. The median SCCAI and UCEIS scores at baseline were 5 and 4, respectively.

Over 8 weeks of treatment, significantly more participants in the coconut water group than in the placebo group achieved the primary endpoint of clinical remission (SCCAI ≤2; 53.1 percent vs 28.3 percent; odds ratio [OR], 2.9, 95 percent confidence interval [CI], 1.2–6.7; p=0.02).

Likewise, participants in the coconut water group were more likely to show clinical response (SCCAI decline of ≥3; 57.1 percent vs 28.3 percent; OR, 3.4, 95 percent CI, 1.4–7.9; p=0.01) as well as a faecal calprotectin (FCP) <150 μg/g (30.6 percent vs 6.5 percent; OR, 6.3, 95 percent CI, 1.7–23.6; p=0.003).

On microbiome analysis, the relative abundance of bacterial taxa increased at week 8, which had a significant negative correlation with SCCAI, UCEIS, or FCP. This effect was independent of disease activity and dietary fibre.

In terms of safety, adverse events were comparable in the coconut water and placebo groups. None of the participants had hyperkalaemia.