A Randomized Trial Comparing The Specific Carbohydrate Diet To A Mediterranean Diet In Adults With Crohn's Disease
Notes for this study:
||Patient-Reported Outcomes Measurement Information System (PROMIS) scores reflected significant reductions in fatigue (SCD mean change (SD) -5.37 (7.10) vs MD -5.24 (8.35), P<.0001) and sleep disturbance (SCD -3.28 (7.76) vs MD -3.82 (7.72), P<.001) in both groups from week 1 to week 6, with no differences between groups at weeks 6 or 12.
|Number of Subjects
||18-29, 30-44, 45-64
In this 12-week randomized trial, 194 participants with mild to moderate CD followed the MD or SCD for 12 weeks to compare their effects on symptoms and inflammation
Funding issues for this study:
The primary and secondary outcomes included symptomatic remission,
fecal calprotectin response (indicating reduced intestinal inflammation), and C-reactive protein_(CRP) response (indicating reduced systemic inflammation).
Disease-specific questionnaires were used to assess disease-specific symptoms, body weight, extraintestinal manifestations of CD, stool quality, fatigue, social isolation, pain, and sleep quality.
The researchers also analyzed the fecal calprotectin response and CRP response in combination with symptomatic remission.
Stool microbiome analysis was performed at baseline and at weeks 6 and 12 of the trial to determine effects on alpha and beta diversity (microbiome measurements).
Both groups reported similar adherence to both diets and significantly increased their consumption of fruits and vegetables. Both groups also experienced similar rates of remission and improvements in fatigue, pain, sleep interference, social isolation, and symptoms as assessed by disease-specific questionnaires. However, CRP did not improve in either group, indicating that the diets may influence symptoms more than inflammation.
During interviews before the trial, the participants indicated that they would be unlikely to continue a restrictive diet for longer than 6 weeks unless they experienced improvements in their symptoms. Therefore, the authors recommended the MD (rather than the SCD), given its numerous health benefits and less restrictive guidelines.
Over the course of the study, 70 participants withdrew, and this could have influenced the results. Although the authors noted that the subgroup of participants with high dietary adherence demonstrated improvements similar to those of the entire group, the withdrawal of participants reduced their sample size enough to affect their statistical analysis. Additionally, improvements in symptoms and remission could be explained by the increased dietary quality rather than exclusion of specific foods.
Of the 31 authors listed on this study, 13 reported one or more potential conflicts of interest.