Dietary microparticles, which are bacteria-sized and non-biological, found in the modern Western diet, have been implicated in both the aetiology and pathogenesis of Crohn's disease.
Dr Lomer and colleagues followed up on the findings of a previous pilot study to confirm whether a reduction in the amount of dietary microparticles facilitates induction of remission in patients with active Crohn's disease.
The researchers conducted a single-blind, randomized, multi-centre, placebo controlled trial.
83 patients with active Crohn's disease were randomly allocated in a 2x2 factorial design to a diet low or normal in microparticles and/or calcium for 16 weeks and received a reducing dose of prednisolone for 6 weeks.
Dietary manipulation provided no added effect to corticosteroid treatment on the outcome measures|
| European Journal of Gastroenterology and Hepatology |
The research team measured several outcomes including Crohn's disease activity index, Van Hees index and quality of life.
In addition, the investigators measured a series of objective measures of inflammation including erythrocyte sedimentation rate, C-reactive protein as well as intestinal permeability and faecal calprotectin.
After 16 weeks patients returned to their normal diet and were followed up for a further 36 weeks by the researchers.
The investigative team found that dietary manipulation provided no added effect to corticosteroid treatment on any of the outcome measures during the dietary trial (16 weeks) or follow-up (to 1 year).
The team applied logistic regression of Crohn's disease activity index based rates of remission and clinical response, in normal versus low microparticle groups.
Dr Lomer concluded, “Our adequately powered and carefully controlled dietary trial found no evidence that reducing microparticle intake aids remission in active Crohn's disease.”