Which dietary interventions benefit IBD patients?

In dietary trials for inflammatory bowel disease (IBD), there appears to be some evidence of a benefit with partial enteral nutrition for induction and maintenance of remission in Crohn’s disease (CD), according to a study. However, lowering intake of red meat and refined carbohydrates does not exert any effect in terms of reducing the risk of CD relapse.

Researchers conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluated the effect of solid food diets for the induction or maintenance of remission in IBD. They searched multiple online databases for relevant studies. The comprehensive literature search yielded 8,332 records, of which 27 were included in the meta-analysis.

Pooled data showed that for induction of remission in CD, low refined carbohydrate diet (relative risk [RR], 7.35, 95 percent confidence interval [CI], 1.14–47.47; two RCTs; n=16) and symptoms-guided diet (RR, 20.00, 95 percent CI, 1.27–315.40; one RCT; n=51) were superior to controls. However, the studies had very low certainty of evidence.

Meanwhile, there was no significant difference between Mediterranean diet and the Specific Carbohydrate Diet (RR, 0.86, 95 percent CI, 0.63–1.19; low certainty of evidence) and between partial enteral nutrition and exclusive enteral nutrition (RR, 0.75, 95 percent CI, 0.21–2.71; very low certainty of evidence).

In terms of reducing the risk of 48-week clinical relapse in CD, there was no difference seen between low (<1 serving/month) and high (≥2 servings/week) consumption of red or processed meats (RR, 0.99, 95 percent CI, 0.80–1.23).

For induction and maintenance of remission in ulcerative colitis, diets were similar to controls. The overall certainty of evidence was either very low or low in all analysed outcomes.