DDW 2022 Nutritional Highlights

Presentations

Role of Diet in IBD Pathogenesis: East vs. West

Presented by: Siew Chien Ng, MD, The Chinese University of Hong Kong

Dr. Ng presented on dietary patterns associated with IBD development, and the differences between eastern and western dietary risk factors for the development of IBD. She shares research showing that western and carnivorous dietary patterns are associated with a greater risk of IBD and highlights the importance of early life events in the development of IBD.

Epidemiological Evidence of Diet and IBD Incidence

Presented by: Ashwin Ananthakrishnan, MD, Massachusetts General Hospital

Dr. Ananthakrishnan reviews the evidence surrounding diet and IBD incidence. He discusses findings from these studies, including that cruciferous vegetable intake may be protective against developing Crohn's disease. He also touches on limitations of the existing studies, including that the cohorts studied have primarily been of White European ancestry and difficulty replicating findings between different cohorts studied.

Interventional Studies in IBD

Presented by: James D. Lewis, MD, University of Pennsylvania

Dr. Lewis presented diet interventions studied for the treatment of IBD, including the Specific Carbohydrate Diet, Mediterranean diet, and Crohn's Disease Exclusion Diet. He discussed considerations for the use of dietary therapy, including selecting the right patient and determining whether to use diet as an adjunctive or primary therapy.

Nationwide Analysis of Malnutrition and Nutritional Support in Hospitalized Patients with Inflammatory Bowel Disease

Presented by: Anoushka Dua, MD, University of California Los Angeles

Dr. Dua presented research looking at the rate of malnutrition and the use of nutrition support in hospitalized patients with IBD. She touched on the multiple mechanisms that predispose IBD patients to become malnourished, including symptoms, malabsorption, surgery, reduction in oral intake, and restrictive diets. She also emphasized that malnutrition happens over a period of time, and may be missed in patients who are overweight or obese.

Machine Learning for Precision Diet and Well Being in IBD

Presented by: Berkeley N. Limketkai, MD, Stanford University School of Medicine

Dr. Limketkai presented on the use of machine learning to improve the quality of care in IBD. He discussed research utilizing machine learning to predict flares in Crohn's disease patients and discussed challenges such as data acquisition, data quality, computational needs, and funding. Machine learning can be a part of using precision nutrition to choose the right dietary pattern for the right patient.

A Retrospective Cohort Study: Pre-operative Oral Enteral Nutritional Optimization for Crohn's Disease in a UK Tertiary IBD Centre

Presented by: Susanna Meade, MD Guy's and St Thomas' NHS Foundation Trust, London, UK

Dr. Meade presents a single-center retrospective observational study comparing postoperative outcomes in patients receiving greater than or equal to two weeks of pre-operative enteral nutrition with those who receive no nutritional optimization. Postoperative complications within 30 days were significantly reduced in patients receiving preoperative enteral nutrition.

Study of Urban and Rural Crohn's Disease Evolution (SOURCE) Indicates that Diet, Exposure to Urban Lifestyle, and Crohn's Disease Are Significant Determinates of the Human Gut Microbiome in China and Israel

Presented by: Yael Haberman, MD, Ph.D. Pediatric Gastroenterology, Hepatology. and Nutrition, Cincinnati Children's Hospital Medical Center

Dr. Haberman presents data from the SOURCE study comparing microbial signatures of rural vs. urban environmental exposures and dietary factors that may worsen or protect disease signaling. Diet was found to be significantly linked with host transcriptomics with signaling for specific dietary components to protect or exacerbate disease signals.

Ultra-Processed Food Consumption and Multi-Year Clinical Trajectories in IBD

Presented by: Susan Jacob, MD, University of Pittsburgh Medical Center

Dr. Jacob presents data from 1536 patients with known IBD who completed the National Cancer Institute 2005 Five-factor Screener during outpatient clinic visits and were followed for two years. Ultra-processed food (UPF) consumption was
divided into quartiles from lowest to highest consumers. Patterns of UPF were associated with multiple proxies of disease severity.

Primary and Food-Induced Secondary Barrier Dysfunction in Patients with Crohn's Disease

Presented by: Jost Langhorst, MD, Dept of Internal and Integrative Medicine, Sozialstiftung Bamberg Klinikum am Bruderwald, Germany

Professor Langhorst describes the use of Confocal Laser Endomicroscopy (CLE) plus food challenge to evaluate functional barrier dysfunction in 29 patients with Crohn's disease. Results show that 73% of CD patients show prevalence of barrier dysfunction in macroscopic uninflamed duodenum (34% are primary - spontaneous and 38% with food-induced barrier dysfunction). He concludes that functional imaging with endomicroscopy for diagnosing "functional food sensitivity" offers great potential as part of standard of care.

Poster Presentations

Inflammatory Bowel Disease Anti-Inflammatory Diet (IBD-AIDTM): An Analysis On The Feasibility Of Dietary Adoption By IBD Patients And Effects On The Gut Microbiome                                  

Presenter: Barbera C. Olendzki    

This trial looked at the IBD-AID diet on the gut microbiome and the feasibility and efficacy of adopting this dietary pattern long term. The researchers found that the IBD-AID reverts dysbiosis with specific foods enhancing bacterial species known to be deficient in patients with IBD. Diet quality was sustained at least 3 months after the intervention.

The Beneficial Effects Of Increasing Dietary Fiber Consumption On Clinical Flare And Inflammatory Markers Among Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study              

Presenter: Phalat Sathirawich    

A prospective cohort of 61 IBD patients in remission were studied with the goal of determining the effect of dietary fiber on clinical relapse rate. The researchers found that increased dietary fiber intake was associated with lower relapse rate and decreased fecal calprotectin over 54 weeks of follow up.

‍

Time Restricted Feeding Is Associated With Improved Patient Reported Outcomes In Patients With Mildly To Moderately Active Crohn's Disease              

‍Presenter: Dana J. Lukin    

A prospective study of 12 patients looked at the impact of time-restricted feeding in patients with mild to moderate Crohn's Disease. The researchers found that a 16 hour daily intermittent fast for 4 weeks was associated with improvement in Harvey Bradshaw Index without impacting weight.