According to a recent study, lower fiber intake was associated with an increased risk of a flare of Crohn’s disease over a 6-month period (CS Brotherton et al. Clin Gastroenterol Hepatol 2016; 1130-36).
This study examined dietary surveys from 1619 participants (Crohn’s disease in 1130, Ulcerative colitis in 489). All participants were considered to be in remission at baseline. The key endpoint was disease flare at 6 months which was defined as a disease activity index score exceeding remission cutoff values.
Key finding: “Compared with those in the lowest quartile of fiber consumption, participants with Crohn’s disease in the highest quartile were less likely to have a flare” (adjusted odds ratio 0.58). There was no significant association with ulcerative colitis.
The associated editorial (1137-39) notes that “among 12 RCTs that enrolled patients with Crohn’s disease, fiber did not influence disease activity in studies of induction (flare to remission) or maintenance (remission to flare)…most RCTs had small sample size.”
My take (borrowed from editorial): “A high fiber diet is likely safe in patients with IBD [in the absence of a known stricture/obstructive symptoms] and may impart a weak benefit.” Overall, dietary approaches are gaining traction and careful evaluation of competing claims will likely be of great benefit.
Related blog posts:
- Fiber intake and Crohn’s Disease
- Top Lecture: Enteral Nutrition for Crohn’s Disease | gutsandgrowth
- Practical Advice on Enteral Nutrition | gutsandgrowth
- Eat your veggies…if you don’t want to get sick
- Specific Carbohydrate Diet | gutsandgrowth