Specific Carbohydrate not superior to Mediterranean diet for Crohn’s disease

02 Jun 2021
Specific Carbohydrate not superior to Mediterranean diet for Crohn’s disease

When it comes to considering a special diet in the management of patients with Crohn’s disease (CD), the Specific Carbohydrate Diet (SCD) does not appear to lead to significantly greater remission or lower inflammation levels compared with the Mediterranean diet (MD), a study has found.

The study randomized 194 CD patients with mild-to-moderate symptoms to follow MD or SCD for 12 weeks. All patients received prepared meals and snacks according to their assigned diet for the first 6 weeks. Thereafter, the participants had to prepare their foods independently.

A total of 191 patients completed the trial. The primary outcome of symptomatic remission at week 6 with SCD, while slightly higher, did not achieve superiority as compared with MD (46.5 percent vs 43.5 percent, respectively; p=0.77).

The same was true for other outcomes. Faecal calprotectin (FC) response (FC <250 μg/g and >50-percent reduction among those with baseline FC >250 μg/g) occurred in eight out of 23 patients (34.8 percent) in the SCD arm and four out of 13 patients (30.8 percent) in the MD arm (p=0.83).

Likewise, there was no significant between-group difference noted in the number of patients who exhibited C-reactive protein (CRP) response (high-sensitivity CRP [hsCRP] <5 mg/L and >50-percent decrease from baseline among those with hsCRP >5 mg/L): two out of 37 (5.4 percent) in the SCD arm and one out of 28 (3.6 percent) in the MD arm (p=0.68).

In light of the present data, the greater ease of following the MD, along with other health benefits associated with this dietary pattern, MD may be preferable to SCD for most CD patients with mild to moderate symptoms.

Gastroenterology 2021;doi:10.1053/j.gastro.2021.05.047