A Diet Low in Red and Processed Meat Does Not Reduce Rate of Crohn’s Disease Flares

Abstract

BACKGROUND & AIMS: Diet may be an important factor in the progression of Crohn's disease (CD). We performed a randomized controlled trial to determine whether reduced consumption of red and processed meats decreases the risk of symptomatic relapse of CD, analyzing results from the Food and Crohn's Disease Exacerbation Study (FACES) trial. METHODS: Adults with CD were recruited into the FACES trial from IBD Partners, an Internet-based cohort of patients with inflammatory bowel disease, from November 2013 through June 2015. Individuals who were in remission (CD activity index [sCDAI] scores of 150), had completed a biannual survey, and reported consumption of red meat at least once weekly were randomly assigned to groups that consumed a minimum of 2 servings/week of red or processed meat (high meat, n ¼ 118) or not more than 1 serving per month (low meat, n ¼ 96) for 49 weeks. The primary outcome was relapse of CD, defined as increase in sCDAI score by 70 points and to >150 or a need for CD surgery or new CD medication. A secondary outcome, moderate or severe relapse, was based on an increase in sCDAI to >219. RESULTS: During the trial, the high-meat groups reported consumption of 2 or more servings of red or processed meat during 98.5% of observed weeks compared with 18.8% of weeks for the low-meat group. Any and moderate to severe relapse occurred in 62% of participants in the high-meat group and 42% of participants in the low-meat group. There were no significant differences in time to any (P ¼ .61) or moderate/ severe (P ¼ .50) relapse. CONCLUSIONS: In an analysis of data from the FACES trial, we found that among patients with CD in remission, level of red and processed meat consumption was not associated with time to symptomatic relapse. ClinicalTrials. gov, Number: NCT0192673.

Microbial genes and pathways in inflammatory bowel disease

“…In addition, interactions between the gut microbiota and dietary concentrations of proteins and fiber can change intestinal permeability and severity of intestinal inflammation in mice 124 . Reduced consumption of red and processed meat, however, did not decrease the rate of CD flares in a separate study 125 . In the future, engineered diets that restrict deleterious components but supplement beneficial nutrients may be used alone or in combination with other therapies to maintain or prevent disease.…”

The microbiome and inflammatory bowel disease

“…63 There is insufficient evidence to support the use of this strategy in adults. [146][147][148][149][150] Albenberg et al 151 assessed the effect of a diet low in red and processed meat in preventing symptomatic relapse of CD. There was no difference in relapse (defined as increase in short Crohn disease activity index score by > _70 points or a total score >150 points, initiation or increase of IBD medications, or surgery) or fecal calprotectin levels among patients with CD on diets high or low in red and processed meats.…”

Analysis of 61 exclusive enteral nutrition formulas used in the management of active Crohn’s disease—new insights into dietary disease triggers

“…Likewise, there are no intervention studies to prove that exclusion of food additives, sugars or milk fat mitigates colonic inflammation in IBD patients or that their introduction to the diet of patients with disease in remission initiates disease flare. On the contrary, data from a dietary intervention showed that among patients with Crohn's disease in remission, the levels of red and processed meat consumption were not associated with time to symptomatic relapse 11 …”