Scientists have discovered a specific dietary regimen that can significantly alleviate the debilitating symptoms of Crohn's disease and lower bodily inflammation markers. The breakthrough research from Stanford University offers new hope for managing the chronic condition.
Dietary Intervention Shows Striking Results
Researchers at Stanford University conducted a trial involving 97 patients with Crohn's disease between 2019 and 2023. They divided participants into two groups: 65 followed a fasting-mimicking diet (FMD), while 32 continued their typical eating patterns as a control group.
The FMD involved a highly restrictive, low-calorie meal plan for five consecutive days each month over three months. Participants consumed between 725 and 1,090 calories daily from prepackaged soups, meals, and bars provided by researchers, maintaining a specific macronutrient balance.
Significant Clinical Improvements Observed
After three monthly cycles, the results were compelling. Approximately 69% of the FMD group achieved measurable clinical improvement in their Crohn's symptoms, compared to just 44% in the control group. Even more strikingly, 65% of the FMD participants entered clinical remission, versus 38% of those following their usual diet.
Benefits appeared rapidly, with many patients noticing improvement after just one FMD cycle. Participants reported better control of abdominal pain and diarrhoea, enhanced quality of life, and were more likely to personally rate themselves as being in remission.
Reduction in Key Inflammation Markers
The research team, led by senior author and gastroenterologist Dr Sidhartha R Sinha, analysed blood and stool samples for inflammation indicators. While blood markers like C-reactive protein showed little change, they found a significant drop in fecal calprotectin, a crucial stool marker for gut inflammation, in the FMD group.
Further analysis revealed that after the FMD, patients showed reduced pro-inflammatory fatty acids and decreased activity in genes related to inflammation within immune cells. This suggests the diet may work by calming the underlying inflammatory pathways that drive Crohn's disease.
The diet proved effective for people with mild to moderate disease and for those with inflammation in the colon or both the ileum and colon. Notably, it worked particularly well for patients not taking advanced Crohn's medications, with over 75% of this subgroup showing improvement.
A New Approach for a Challenging Condition
Crohn's disease, a chronic inflammatory bowel disease affecting between 780,000 and over 1 million Americans, currently has no cure. Treatment for milder forms presents a significant challenge, often involving powerful immunosuppressants with serious side effects or short-term corticosteroids with long-term risks.
Dr Sinha noted the significance of the findings: 'We have been very limited in what kind of dietary information we can provide patients. We were very pleasantly surprised that the majority of patients seemed to benefit from this diet.'
The FMD's burden is relatively low, requiring only five restrictive days monthly before returning to normal eating—considerably easier than permanent dietary restrictions or lifelong medication. Side effects were mild, mainly temporary fatigue and headaches, with no severe adverse events reported.
Published in Nature Medicine, this study opens new avenues for dietary management of Crohn's disease, though researchers acknowledge more work is needed to fully understand the biological mechanisms behind the diet's effectiveness.
