European investigators assessed whether the fat content of protein-based diets effects remission in active Crohn's disease.
Two whole protein-based diets with different fat compositions (n6 polyunsaturated fatty acids versus monounsaturated fatty acids) were compared with steroids.
A total of 62 patients with active Crohn's disease were included in the study.
They were randomized to receive, for not more than 4 weeks, 1 of 3 regimens.
The first comprised of a polymeric enteral diet containing 35 g of lipids per 1000 kcal, high in oleate (79%) and low in linoleate (6.5%) (PEN1, n = 20).
The second regimen consisted of an identical enteral diet except for the type of fat, which was high in linoleate (45%) and low in oleate (28%) (PEN2, n = 23).
|Crohn's remission rates:|
High oleate: 27%
High linoleate: 63%
The third was oral prednisone (1 mg/kg/day, n = 19), and these patients received a conventional ward diet.
The treatment was considered to be a failure when remission was not achieved at week 4.
The researchers found that overall remission rates (by intention to treat) were 20% for PEN1, 52% for PEN2, and 79% for steroids.
After excluding those patients who were non-compliant during the first week (per protocol analysis), remission rates were 27%, 63%, and 79%, respectively.
After adjusting for confounding variables, PEN1 remained significantly associated with a poor response.
Dr M. A. Gassull, of the Hospital University Germans Trias i Pujol, Badalona, Spain, concluded on behalf of fellow authors, "The type of dietary fat may be of importance for the primary therapeutic effect of enteral nutrition in active Crohn's disease."