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Title: The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial

Abstract

Background: Crohn’s disease (CD) is a chronic inflammatory intestinal disorder associated with intestinal dysbiosis. Diet modulates the intestinal microbiome and therefore has a therapeutic potential. The aim of this study is to determine the potential efficacy of three versions of the specific carbohydrate diet (SCD) in active Crohn’s Disease. Methods: 18 patients with mild/moderate CD (PCDAI 15–45) aged 7 to 18 years were enrolled. Patients were randomized to either SCD, modified SCD(MSCD) or whole foods (WF) diet. Patients were evaluated at baseline, 2, 4, 8 and 12 weeks. PCDAI, inflammatory labs and multi-omics evaluations were assessed. Results: Mean age was 14.3 ± 2.9 years. At week 12, all participants (n = 10) who completed the study achieved clinical remission. The C-reactive protein decreased from 1.3 ± 0.7 at enrollment to 0.9 ± 0.5 at 12 weeks in the SCD group. In the MSCD group, the CRP decreased from 1.6 ± 1.1 at enrollment to 0.7 ± 0.1 at 12 weeks. In the WF group, the CRP decreased from 3.9 ± 4.3 at enrollment to 1.6 ± 1.3 at 12 weeks. In addition, the microbiome composition shifted in all patients across the study period. While the nature of the changes wasmore » largely patient specific, the predicted metabolic mode of the organisms increasing and decreasing in activity was consistent across patients. Conclusions: This study emphasizes the impact of diet in CD. Each diet had a positive effect on symptoms and inflammatory burden; the more exclusionary diets were associated with a better resolution of inflammation.« less

Authors:
ORCiD logo [1];  [1]; ORCiD logo [2];  [1];  [1];  [1];  [1]; ORCiD logo [2]; ORCiD logo [2];  [2];  [2]; ORCiD logo [2]
  1. Seattle Children's Hospital, WA (United States); Univ. of Washington, Seattle, WA (United States)
  2. Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
Publication Date:
Research Org.:
Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
Sponsoring Org.:
USDOE Office of Science (SC), Biological and Environmental Research (BER)
OSTI Identifier:
1737561
Report Number(s):
PNNL-SA-152828
Journal ID: ISSN 2072-6643
Grant/Contract Number:  
AC05-76RL01830
Resource Type:
Accepted Manuscript
Journal Name:
Nutrients
Additional Journal Information:
Journal Volume: 12; Journal Issue: 12; Journal ID: ISSN 2072-6643
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; inflammatory bowel disease; Crohn's disease; specific carbohydrate diet; microbiome; multi-omics application

Citation Formats

Suskind, David, Lee, Dale, Kim, Young-Mo, Wahbeh, Ghassan, Singh, Namita, Braly, Kimberly, Nuding, Mason, Nicora, Carrie D., Purvine, Samuel O., Lipton, Mary S., Jansson, Janet K., and Nelson, William C.. The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial. United States: N. p., 2020. Web. https://doi.org/10.3390/nu12123749.
Suskind, David, Lee, Dale, Kim, Young-Mo, Wahbeh, Ghassan, Singh, Namita, Braly, Kimberly, Nuding, Mason, Nicora, Carrie D., Purvine, Samuel O., Lipton, Mary S., Jansson, Janet K., & Nelson, William C.. The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial. United States. https://doi.org/10.3390/nu12123749
Suskind, David, Lee, Dale, Kim, Young-Mo, Wahbeh, Ghassan, Singh, Namita, Braly, Kimberly, Nuding, Mason, Nicora, Carrie D., Purvine, Samuel O., Lipton, Mary S., Jansson, Janet K., and Nelson, William C.. Sun . "The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial". United States. https://doi.org/10.3390/nu12123749. https://www.osti.gov/servlets/purl/1737561.
@article{osti_1737561,
title = {The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial},
author = {Suskind, David and Lee, Dale and Kim, Young-Mo and Wahbeh, Ghassan and Singh, Namita and Braly, Kimberly and Nuding, Mason and Nicora, Carrie D. and Purvine, Samuel O. and Lipton, Mary S. and Jansson, Janet K. and Nelson, William C.},
abstractNote = {Background: Crohn’s disease (CD) is a chronic inflammatory intestinal disorder associated with intestinal dysbiosis. Diet modulates the intestinal microbiome and therefore has a therapeutic potential. The aim of this study is to determine the potential efficacy of three versions of the specific carbohydrate diet (SCD) in active Crohn’s Disease. Methods: 18 patients with mild/moderate CD (PCDAI 15–45) aged 7 to 18 years were enrolled. Patients were randomized to either SCD, modified SCD(MSCD) or whole foods (WF) diet. Patients were evaluated at baseline, 2, 4, 8 and 12 weeks. PCDAI, inflammatory labs and multi-omics evaluations were assessed. Results: Mean age was 14.3 ± 2.9 years. At week 12, all participants (n = 10) who completed the study achieved clinical remission. The C-reactive protein decreased from 1.3 ± 0.7 at enrollment to 0.9 ± 0.5 at 12 weeks in the SCD group. In the MSCD group, the CRP decreased from 1.6 ± 1.1 at enrollment to 0.7 ± 0.1 at 12 weeks. In the WF group, the CRP decreased from 3.9 ± 4.3 at enrollment to 1.6 ± 1.3 at 12 weeks. In addition, the microbiome composition shifted in all patients across the study period. While the nature of the changes was largely patient specific, the predicted metabolic mode of the organisms increasing and decreasing in activity was consistent across patients. Conclusions: This study emphasizes the impact of diet in CD. Each diet had a positive effect on symptoms and inflammatory burden; the more exclusionary diets were associated with a better resolution of inflammation.},
doi = {10.3390/nu12123749},
journal = {Nutrients},
number = 12,
volume = 12,
place = {United States},
year = {2020},
month = {12}
}

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Works referenced in this record:

The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions
journal, May 2016

  • Vindigni, Stephen M.; Zisman, Timothy L.; Suskind, David L.
  • Therapeutic Advances in Gastroenterology, Vol. 9, Issue 4
  • DOI: 10.1177/1756283X16644242

Combinatorial Effects of Diet and Genetics on Inflammatory Bowel Disease Pathogenesis
journal, January 2015


The microbiota in inflammatory bowel disease: current and therapeutic insights
journal, January 2017

  • Lane, Erin R.; Zisman, Timothy; Suskind, David
  • Journal of Inflammation Research, Vol. Volume 10
  • DOI: 10.2147/JIR.S116088

Structural Biology of Pectin Degradation by Enterobacteriaceae
journal, June 2008

  • Abbott, D. Wade; Boraston, Alisdair B.
  • Microbiology and Molecular Biology Reviews, Vol. 72, Issue 2
  • DOI: 10.1128/MMBR.00038-07

Bacterial Community Variation in Human Body Habitats Across Space and Time
journal, November 2009


Polymeric Diet Alone Versus Corticosteroids in the Treatment of Active Pediatric Crohn’s Disease: A Randomized Controlled Open-Label Trial
journal, June 2006

  • Borrelli, Osvaldo; Cordischi, Letizia; Cirulli, Manuela
  • Clinical Gastroenterology and Hepatology, Vol. 4, Issue 6
  • DOI: 10.1016/j.cgh.2006.03.010

Deregulation of intestinal anti-microbial defense by the dietary additive, maltodextrin
journal, January 2015


Diel metabolomics analysis of a hot spring chlorophototrophic microbial mat leads to new hypotheses of community member metabolisms
journal, April 2015


A Pyrosequencing Study in Twins Shows That Gastrointestinal Microbial Profiles Vary With Inflammatory Bowel Disease Phenotypes
journal, December 2010


MPLEx: a Robust and Universal Protocol for Single-Sample Integrative Proteomic, Metabolomic, and Lipidomic Analyses
journal, May 2016


MEGAHIT: an ultra-fast single-node solution for large and complex metagenomics assembly via succinct de Bruijn graph
journal, January 2015


Low counts of Faecalibacterium prausnitzii in colitis microbiota
journal, January 2009

  • Sokol, H.; Seksik, P.; Furet, J. P.
  • Inflammatory Bowel Diseases, Vol. 15, Issue 8
  • DOI: 10.1002/ibd.20903

Mosdepth: quick coverage calculation for genomes and exomes
journal, October 2017


Ecological and Evolutionary Forces Shaping Microbial Diversity in the Human Intestine
journal, February 2006


Twin studies reveal specific imbalances in the mucosa-associated microbiota of patients with ileal Crohnʼs disease
journal, January 2009

  • Willing, Ben; Halfvarson, Jonas; Dicksved, Johan
  • Inflammatory Bowel Diseases, Vol. 15, Issue 5
  • DOI: 10.1002/ibd.20783

Prodigal: prokaryotic gene recognition and translation initiation site identification
journal, March 2010


Faecalibacterium prausnitzii and human intestinal health
journal, June 2013


Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease
journal, January 2018

  • Suskind, David L.; Cohen, Stanley A.; Brittnacher, Mitchell J.
  • Journal of Clinical Gastroenterology, Vol. 52, Issue 2
  • DOI: 10.1097/MCG.0000000000000772

A cross-platform toolkit for mass spectrometry and proteomics
journal, October 2012

  • Chambers, Matthew C.; Maclean, Brendan; Burke, Robert
  • Nature Biotechnology, Vol. 30, Issue 10
  • DOI: 10.1038/nbt.2377

Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases
journal, August 2007

  • Frank, D. N.; St. Amand, A. L.; Feldman, R. A.
  • Proceedings of the National Academy of Sciences, Vol. 104, Issue 34, p. 13780-13785
  • DOI: 10.1073/pnas.0706625104

Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome
journal, February 2015

  • Chassaing, Benoit; Koren, Omry; Goodrich, Julia K.
  • Nature, Vol. 519, Issue 7541
  • DOI: 10.1038/nature14232

Specific carbohydrate diet for pediatric inflammatory bowel disease in clinical practice within an academic IBD center
journal, April 2016


Kraken: ultrafast metagenomic sequence classification using exact alignments
journal, January 2014


Meta-analysis: enteral nutrition in active Crohn’s disease in children: META-ANALYSIS: ENTERAL NUTRITION IN CROHN’S DISEASE IN CHILDREN
journal, July 2007


Temporal variability is a personalized feature of the human microbiome
journal, December 2014

  • Flores, Gilberto E.; Caporaso, J. Gregory; Henley, Jessica B.
  • Genome Biology, Vol. 15, Issue 12
  • DOI: 10.1186/s13059-014-0531-y

Diet Dominates Host Genotype in Shaping the Murine Gut Microbiota
journal, January 2015

  • Carmody, Rachel N.; Gerber, Georg K.; Luevano, Jesus M.
  • Cell Host & Microbe, Vol. 17, Issue 1
  • DOI: 10.1016/j.chom.2014.11.010

Short- and long-term therapeutic efficacy of nutritional therapy and corticosteroids in paediatric Crohn's disease
journal, June 2006


Prokka: rapid prokaryotic genome annotation
journal, March 2014


Exclusive enteral feeding as primary therapy for Crohn's disease in Australian children and adolescents: A feasible and effective approach
journal, October 2006


Western diet induces dysbiosis with increased E coli in CEABAC10 mice , alters host barrier function favouring AIEC colonisation
journal, April 2013


The ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents
journal, November 2013


Evaluation of the Pediatric Crohn Disease Activity Index: A Prospective Multicenter Experience
journal, January 2005


Controlled trial of bowel rest and nutritional support in the management of Crohn's disease.
journal, October 1988


Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease
journal, January 2012

  • DʼHaens, Geert; Ferrante, Marc; Vermeire, Severine
  • Inflammatory Bowel Diseases, Vol. 18, Issue 12
  • DOI: 10.1002/ibd.22917

Crohn’s Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial
journal, August 2019


Imbalance in intestinal microflora constitution could be involved in the pathogenesis of inflammatory bowel disease
journal, July 2008

  • Takaishi, Hiromasa; Matsuki, Takahiro; Nakazawa, Atsushi
  • International Journal of Medical Microbiology, Vol. 298, Issue 5-6
  • DOI: 10.1016/j.ijmm.2007.07.016

Nutritional Therapy in Pediatric Crohn Disease: The Specific Carbohydrate Diet
journal, January 2014

  • Suskind, David L.; Wahbeh, Ghassan; Gregory, Nila
  • Journal of Pediatric Gastroenterology and Nutrition, Vol. 58, Issue 1
  • DOI: 10.1097/MPG.0000000000000103

Bacterial Metabolism During Biofilm Growth Investigated by 13C Tracing
journal, November 2018


Decreased abundance of Faecalibacterium prausnitzii in the gut microbiota of Crohn's disease: Abundance of Faecalibacterium prausnitzii
journal, March 2013

  • Fujimoto, Takehide; Imaeda, Hirotsugu; Takahashi, Kenichiro
  • Journal of Gastroenterology and Hepatology, Vol. 28, Issue 4
  • DOI: 10.1111/jgh.12073

Increased Proportions of Bifidobacterium and the Lactobacillus Group and Loss of Butyrate-Producing Bacteria in Inflammatory Bowel Disease
journal, November 2013

  • Wang, W.; Chen, L.; Zhou, R.
  • Journal of Clinical Microbiology, Vol. 52, Issue 2
  • DOI: 10.1128/JCM.01500-13

A Review of Dietary Therapy for IBD and a Vision for the Future
journal, April 2019

  • Green, Nicole; Miller, Talya; Suskind, David
  • Nutrients, Vol. 11, Issue 5
  • DOI: 10.3390/nu11050947

Inflammation, Antibiotics, and Diet as Environmental Stressors of the Gut Microbiome in Pediatric Crohn’s Disease
journal, October 2015


The Sequence Alignment/Map format and SAMtools
journal, June 2009


Dynamics of the human gut microbiome in inflammatory bowel disease
journal, February 2017

  • Halfvarson, Jonas; Brislawn, Colin J.; Lamendella, Regina
  • Nature Microbiology, Vol. 2, Issue 5
  • DOI: 10.1038/nmicrobiol.2017.4

MS-GF+ makes progress towards a universal database search tool for proteomics
journal, October 2014

  • Kim, Sangtae; Pevzner, Pavel A.
  • Nature Communications, Vol. 5, Issue 1
  • DOI: 10.1038/ncomms6277

Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes
journal, September 2011


Environment dominates over host genetics in shaping human gut microbiota
journal, February 2018

  • Rothschild, Daphna; Weissbrod, Omer; Barkan, Elad
  • Nature, Vol. 555, Issue 7695
  • DOI: 10.1038/nature25973