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一项探索抗炎饮食模式对炎症性肠病成年患者疾病活动度、症状及微生物群特征影响的前瞻性随机对照试验。

A pilot randomized controlled trial investigating the effects of an anti-inflammatory dietary pattern on disease activity, symptoms and microbiota profile in adults with inflammatory bowel disease.

作者信息

Marsh Abigail, Chachay Veronique, Banks Merrilyn, Okano Satomi, Hartel Gunter, Radford-Smith Graham

机构信息

The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia.

Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.

出版信息

Eur J Clin Nutr. 2024 Dec;78(12):1072-1081. doi: 10.1038/s41430-024-01487-9. Epub 2024 Aug 10.

Abstract

BACKGROUND/OBJECTIVES: There is a lack of certainty in dietary prescription for individuals with inflammatory bowel disease (IBD) due to heterogeneity in studies to date. The aim of this study was to investigate the efficacy on disease activity of a modified anti-inflammatory dietary pattern purposely designed to reduce intake of food additives (IBD-MAID), compared to standard care, in adults with IBD.

SUBJECT/METHODS: Adults with IBD were randomised to IBD-MAID (meals provided) [n = 29] or general healthy eating (GHE) [n = 29] for 8 weeks. Disease activity, faecal calprotectin (FC), C-reactive protein (CRP), symptoms, and quality of life (S&QOL) were assessed using validated tools.

RESULTS

The IBD-MAID was well tolerated and adhered to (92% adherence). At week 8, there was no statistically significant difference in change from baseline in outcome measures between groups. However, baseline to week 8 analysis indicated: (1) statistically significant improvements in S (p = 0.001) & QOL (p = 0.004), FC (p = 0.007), and Crohn's disease activity (p = 0.03) but not ulcerative colitis, in individuals following the IBD-MAID and (2) statistically significant improvement in QOL in individuals receiving GHE (p = 0.015). Correlation analysis on change from baseline to week 8 revealed a greater decrease in food additives intake was associated with statistically significant improvements in FC, S & QOL and alignment of anti-inflammatory dietary principles with improvements in QOL.

CONCLUSION

The IBD-MAID was well tolerated. The most novel finding pertains to the correlation between reduced food additives intake and improvements in inflammatory markers, S&QOL. Further research is needed to explore the effects of food additives exposure on IBD course.

TRIAL REGISTRATION

12619001500145.

摘要

背景/目的:由于迄今为止研究的异质性,炎症性肠病(IBD)患者的饮食处方缺乏确定性。本研究的目的是调查与标准护理相比,专门设计用于减少食品添加剂摄入量的改良抗炎饮食模式(IBD-MAID)对IBD成年患者疾病活动的疗效。

受试者/方法:IBD成年患者被随机分为IBD-MAID组(提供膳食)[n = 29]或一般健康饮食(GHE)组[n = 29],为期8周。使用经过验证的工具评估疾病活动、粪便钙卫蛋白(FC)、C反应蛋白(CRP)、症状和生活质量(S&QOL)。

结果

IBD-MAID耐受性良好且依从性高(依从率92%)。在第8周时,两组间结局指标相对于基线的变化无统计学显著差异。然而,基线至第8周的分析表明:(1)遵循IBD-MAID的个体在症状(p = 0.001)、生活质量(p = 0.004)、FC(p = 0.007)和克罗恩病活动(p = 0.03)方面有统计学显著改善,但溃疡性结肠炎无改善;(2)接受GHE的个体在生活质量方面有统计学显著改善(p = 0.015)。对基线至第8周变化的相关分析显示,食品添加剂摄入量的更大减少与FC、症状和生活质量的统计学显著改善相关,且抗炎饮食原则与生活质量改善一致。

结论

IBD-MAID耐受性良好。最新颖的发现是食品添加剂摄入量减少与炎症标志物、症状和生活质量改善之间的相关性。需要进一步研究以探讨食品添加剂暴露对IBD病程的影响。

试验注册

12619001500145。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9f3/11611722/7fe9abae61ee/41430_2024_1487_Fig1_HTML.jpg

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