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Dietary fat attenuates the benefits of an elemental diet in active Crohn's disease

2003; Lippincott Williams & Wilkins; Volume: 15; Issue: 2 Linguagem: Inglês

10.1097/00042737-200302000-00008

1473-5687

Tadao Bamba, Takashi Shimoyama, Masaya Sasaki, Tomoyuki Tsujikawa, Yoshihiro Fukuda, Kazutaka Koganei, Toshifumi Hibi∥, Yasushi Iwao, Akihiro Munakata, Shinsaku Fukuda, Takayuki Matsumoto, Nobuhide Oshitani, Nobuo Hiwatashi, Tatsuo Oriuchi, Tetsuji Kitahora, Toshinori Utsunomiya, Yasushi Saitoh, Yasuo Suzuki, Nakajima Mitsuyoshi,

IL-33, ST2, and ILC Pathways

Objectives Although an elemental diet has been established as the primary treatment for patients with Crohn's disease, the influence of dietary fat on the elemental diet remains unclear. We have designed the first randomized, controlled trial for elemental diets containing different fat percentages in patients with active Crohn's disease. Methods Each patient was randomized to receive one of three dose levels of fat in an elemental diet (Elental) for 4 weeks: 10 patients received low fat (3.06 g/day), 10 patients received medium fat (16.56 g/day) and eight patients received high fat (30.06 g/day). The additional fat was composed of long-chain fatty acids. All patients were evaluated using the International Organization of Inflammatory Bowel Disease rating, plus C-reactive protein level and erythrocyte sedimentation rate, which were measured at weekly intervals. Results Although the International Organization of Inflammatory Bowel Disease rating, C-reactive protein level and erythrocyte sedimentation rate in the low-fat group decreased, the values in the medium- and high-fat groups fluctuated during the study. The remission rate after 4 weeks in each group was 80%, 40% and 25% for patients in the low-, medium- and high-fat groups, respectively. Conclusions When the fat consisted of long-chain triglycerides, a high amount of this fat in the elemental diet formula decreased its therapeutic effect against active Crohn's disease.