Diabetes and Nutritional Sciences Division, King's College London (KCL), London, UK; Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust (GSTFT), London, UK.
J Hum Nutr Diet. 2013 Dec;26(6):527-37. doi: 10.1111/jhn.12046. Epub 2013 Apr 10.
Orofacial granulomatosis (OFG) is a rare disease of unknown cause. A cinnamon- and benzoate-free diet is successful in up to 72% of patients. Phenolic acids are among the chemical constituents restricted in this diet, which avoids some but not all of these structurally similar compounds. The present study aimed to: (i) develop a novel diet low in phenolic acids; (ii) implement this in a small clinical trial; and (iii) assess its nutritional adequacy.
A literature review identified 10 papers quantifying phenolic acids from which 91 10-mg phenolic acid exchanges were devised. A phenolic acid exclusion diet with precautionary micronutrient supplementation was designed and implemented in 10 patients. Phenolic acids were excluded for 6 weeks and were reintroduced at a rate of one exchange every second day for 6 weeks. Wilcoxon matched pairs tests analysed disease outcomes measured by an oral disease severity scoring tool at weeks 0, 6 and 12. Nutritional adequacy was assessed, excluding micronutrient supplementation, at weeks 0 and 6, and compared intakes with dietary reference values.
The diet was nutritionally inadequate for a range of micronutrients. Seven of 10 patients responded. Mean [standard deviation (SD)] severity scores improved from week 0-6 [20.8 (9.39) and 10.1 (5.72); P = 0.009] and were maintained in five patients who completed the reintroduction [6.6 (3.13) and 7.2 (5.54); P = 0.713].
A low phenolic acid diet with micronutrient supplementation holds promise of a novel dietary treatment for OFG. Further work is required in larger studies to determine long-term outcomes.
口面肉芽肿病（OFG）是一种病因不明的罕见疾病。72%的患者采用不含肉桂和苯甲酸的饮食治疗可取得成功。这种饮食限制了酚酸等化学成分，避免了一些但并非所有结构相似的化合物。本研究旨在：（i）制定一种新的低酚酸饮食；（ii）在小临床试验中实施；并（iii）评估其营养充足性。
文献综述确定了 10 篇定量酚酸的论文，从中设计了 91 个 10mg 酚酸交换物。设计并实施了一种含酚酸排除饮食和预防性微量营养素补充的方案，纳入 10 例患者。酚酸排除治疗 6 周，然后以每两天 1 次交换的速度重新引入，持续 6 周。在第 0、6 和 12 周使用口腔疾病严重程度评分工具评估疾病结局，采用 Wilcoxon 配对检验分析。排除微量营养素补充后，在第 0 和 6 周评估营养充足性，并将摄入量与膳食参考值进行比较。
该饮食在多种微量营养素方面营养不足。10 例患者中有 7 例出现反应。严重程度评分从第 0 周到第 6 周的均值[标准差（SD）]改善[20.8（9.39）和 10.1（5.72）；P=0.009]，完成重新引入的 5 例患者评分保持稳定[6.6（3.13）和 7.2（5.54）；P=0.713]。
含微量营养素补充的低酚酸饮食有望成为 OFG 的新型饮食治疗方法。需要在更大的研究中进一步确定长期结局。
