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AUSTIN, TEX. – A customized diet developed to relieve inflammatory bowel disease (IBD) symptoms without compromising nutrition has uncovered a novel molecular mechanism of the diet-microbiome immune interaction that may allow gastroenterologists to tailor patient diets to enhance the gut microbiome, according to a poster presented at the annual congress of the Crohn’s & Colitis Foundation and the American Gastroenterological Association.
The study found that P-glycoprotein (P-gp) expression, associated with healthy gut, increased after adoption of the IBD-Anti-Inflammatory Diet (IBD-AID), said poster presenter and study leader Ana Luisa Maldonado-Contreras, PhD, of the University of Massachusetts Medical School, Worcester. The study involved 19 IBD patients placed on the IBD-AID. This is reportedly the first evidence of a whole-dietary recommendation that may help patients with IBD to reduce their symptoms.
“The IBD-AID has been rationally designed to feed a health-promoting, anti-inflammatory microbiome aiming at reducing chronic inflammation” Dr. Maldonado-Contreras said in an interview. The UMass researchers, led by Barbara Olendzki, RD, MPH, director of the Center for Applied Nutrition, derived the IBD-AID diet from a specific carbohydrate diet and modified it based on their research to increase the diversity of bacteria that produce short-chain fatty acids (SCFAs) and modulate the local immune response.
“SCFAs, such as acetate, propionate, and butyrate, are crucial in maintaining intestinal homeostasis by fueling colonocytes, strengthening the gut barrier function, and controlling local mucosal inflammation,” Dr. Maldonado-Contreras said. SCFAs regulate the production of proinflammatory mediators such as cytokines (tumor necrosis factor–alpha and interleukin 2, 6, and 10), eicosanoids, and chemokines, such as MCP-1 and CINC-2, by acting on macrophages and endothelial cells. High levels of SCFAs down-regulate those proinflammatory mediators.
The study found IBD-AID favored a beneficial gut microbiota. Prebiotic foods such as oats, barley, beans, and tempeh correlated with beneficial counts of Bacteroides and Parabacteroides, both capable of producing SCFAs. Probiotic foods like yogurt, fermented cabbage, and kefir correlated with high levels of Clostridium bolteae, a bacterium that plays a critical role in regulatory T-cell induction. Vegetables and nuts correlated with an abundance of Roseburia hominis, Eubacterium rectale, and Faecalibacterium prausnitzii, which tend to be reduced in IBD patients and are potent butyrate-producing Clostridia with known anti-inflammatory activity. Declines in putative pathogenic strains, such as Escherichia, Alistipes, and Eggerthella accompanied the increase of SCFA-producing bacteria.
Among the study patients treated for at least 8 weeks, the 61.3% who achieved at least 50% dietary compliance reported a dramatic decrease of symptoms and disease severity.
Dr. Maldonado-Contreras explained the role P-gp has as a biomarker of gut microbiota. “P-gp is an ABC-transporter located in the apical side of intestinal epithelial cells and is responsible for suppressing neutrophil migration in healthy individuals,” she said. “Loss of P-gp expression, or a reduction in its function, correlates with inflammation in the gastrointestinal tract in both mice and humans.” The study compared P-gp expression before and after patients went on the IBD-AID diet.
Dr. Maldonado-Contreras credited the study’s reported diet compliance of 76% to adoption of the patient-centered counseling model (J Am Diet Assoc. 2001;101:332-41). “With the patient-centered counseling model, we aimed to build self-efficacy, self-management strategies and to provide cooking-skill abilities to promote long-term behavioral habits related to the IBD-AID,” she said. The IBD-AID recipes, menus, and tips are available online (https://www.umassmed.edu/nutrition/).
The Dr. Maldonado-Contreras along with researchers at Icahn School of Medicine at Mount Sinai in New York are further evaluating an adapted version of the IBD-AID diet in pregnancy in the MELODY trial. “We are evaluating whether adherence to the modified IBD-AID during pregnancy in women with Crohn’s disease could beneficially shift the microbiome of mom and their babies, thereby promoting a healthier immune system during a critical time of the baby’s immune system development,” Dr. Maldonado-Contreras said. The trial has recruited 50 patients with Crohn’s disease and healthy controls so far.
Dr. Maldonado-Contreras has no financial relationships to disclose.
AUSTIN, TEX. – A customized diet developed to relieve inflammatory bowel disease (IBD) symptoms without compromising nutrition has uncovered a novel molecular mechanism of the diet-microbiome immune interaction that may allow gastroenterologists to tailor patient diets to enhance the gut microbiome, according to a poster presented at the annual congress of the Crohn’s & Colitis Foundation and the American Gastroenterological Association.
The study found that P-glycoprotein (P-gp) expression, associated with healthy gut, increased after adoption of the IBD-Anti-Inflammatory Diet (IBD-AID), said poster presenter and study leader Ana Luisa Maldonado-Contreras, PhD, of the University of Massachusetts Medical School, Worcester. The study involved 19 IBD patients placed on the IBD-AID. This is reportedly the first evidence of a whole-dietary recommendation that may help patients with IBD to reduce their symptoms.
“The IBD-AID has been rationally designed to feed a health-promoting, anti-inflammatory microbiome aiming at reducing chronic inflammation” Dr. Maldonado-Contreras said in an interview. The UMass researchers, led by Barbara Olendzki, RD, MPH, director of the Center for Applied Nutrition, derived the IBD-AID diet from a specific carbohydrate diet and modified it based on their research to increase the diversity of bacteria that produce short-chain fatty acids (SCFAs) and modulate the local immune response.
“SCFAs, such as acetate, propionate, and butyrate, are crucial in maintaining intestinal homeostasis by fueling colonocytes, strengthening the gut barrier function, and controlling local mucosal inflammation,” Dr. Maldonado-Contreras said. SCFAs regulate the production of proinflammatory mediators such as cytokines (tumor necrosis factor–alpha and interleukin 2, 6, and 10), eicosanoids, and chemokines, such as MCP-1 and CINC-2, by acting on macrophages and endothelial cells. High levels of SCFAs down-regulate those proinflammatory mediators.
The study found IBD-AID favored a beneficial gut microbiota. Prebiotic foods such as oats, barley, beans, and tempeh correlated with beneficial counts of Bacteroides and Parabacteroides, both capable of producing SCFAs. Probiotic foods like yogurt, fermented cabbage, and kefir correlated with high levels of Clostridium bolteae, a bacterium that plays a critical role in regulatory T-cell induction. Vegetables and nuts correlated with an abundance of Roseburia hominis, Eubacterium rectale, and Faecalibacterium prausnitzii, which tend to be reduced in IBD patients and are potent butyrate-producing Clostridia with known anti-inflammatory activity. Declines in putative pathogenic strains, such as Escherichia, Alistipes, and Eggerthella accompanied the increase of SCFA-producing bacteria.
Among the study patients treated for at least 8 weeks, the 61.3% who achieved at least 50% dietary compliance reported a dramatic decrease of symptoms and disease severity.
Dr. Maldonado-Contreras explained the role P-gp has as a biomarker of gut microbiota. “P-gp is an ABC-transporter located in the apical side of intestinal epithelial cells and is responsible for suppressing neutrophil migration in healthy individuals,” she said. “Loss of P-gp expression, or a reduction in its function, correlates with inflammation in the gastrointestinal tract in both mice and humans.” The study compared P-gp expression before and after patients went on the IBD-AID diet.
Dr. Maldonado-Contreras credited the study’s reported diet compliance of 76% to adoption of the patient-centered counseling model (J Am Diet Assoc. 2001;101:332-41). “With the patient-centered counseling model, we aimed to build self-efficacy, self-management strategies and to provide cooking-skill abilities to promote long-term behavioral habits related to the IBD-AID,” she said. The IBD-AID recipes, menus, and tips are available online (https://www.umassmed.edu/nutrition/).
The Dr. Maldonado-Contreras along with researchers at Icahn School of Medicine at Mount Sinai in New York are further evaluating an adapted version of the IBD-AID diet in pregnancy in the MELODY trial. “We are evaluating whether adherence to the modified IBD-AID during pregnancy in women with Crohn’s disease could beneficially shift the microbiome of mom and their babies, thereby promoting a healthier immune system during a critical time of the baby’s immune system development,” Dr. Maldonado-Contreras said. The trial has recruited 50 patients with Crohn’s disease and healthy controls so far.
Dr. Maldonado-Contreras has no financial relationships to disclose.
AUSTIN, TEX. – A customized diet developed to relieve inflammatory bowel disease (IBD) symptoms without compromising nutrition has uncovered a novel molecular mechanism of the diet-microbiome immune interaction that may allow gastroenterologists to tailor patient diets to enhance the gut microbiome, according to a poster presented at the annual congress of the Crohn’s & Colitis Foundation and the American Gastroenterological Association.
The study found that P-glycoprotein (P-gp) expression, associated with healthy gut, increased after adoption of the IBD-Anti-Inflammatory Diet (IBD-AID), said poster presenter and study leader Ana Luisa Maldonado-Contreras, PhD, of the University of Massachusetts Medical School, Worcester. The study involved 19 IBD patients placed on the IBD-AID. This is reportedly the first evidence of a whole-dietary recommendation that may help patients with IBD to reduce their symptoms.
“The IBD-AID has been rationally designed to feed a health-promoting, anti-inflammatory microbiome aiming at reducing chronic inflammation” Dr. Maldonado-Contreras said in an interview. The UMass researchers, led by Barbara Olendzki, RD, MPH, director of the Center for Applied Nutrition, derived the IBD-AID diet from a specific carbohydrate diet and modified it based on their research to increase the diversity of bacteria that produce short-chain fatty acids (SCFAs) and modulate the local immune response.
“SCFAs, such as acetate, propionate, and butyrate, are crucial in maintaining intestinal homeostasis by fueling colonocytes, strengthening the gut barrier function, and controlling local mucosal inflammation,” Dr. Maldonado-Contreras said. SCFAs regulate the production of proinflammatory mediators such as cytokines (tumor necrosis factor–alpha and interleukin 2, 6, and 10), eicosanoids, and chemokines, such as MCP-1 and CINC-2, by acting on macrophages and endothelial cells. High levels of SCFAs down-regulate those proinflammatory mediators.
The study found IBD-AID favored a beneficial gut microbiota. Prebiotic foods such as oats, barley, beans, and tempeh correlated with beneficial counts of Bacteroides and Parabacteroides, both capable of producing SCFAs. Probiotic foods like yogurt, fermented cabbage, and kefir correlated with high levels of Clostridium bolteae, a bacterium that plays a critical role in regulatory T-cell induction. Vegetables and nuts correlated with an abundance of Roseburia hominis, Eubacterium rectale, and Faecalibacterium prausnitzii, which tend to be reduced in IBD patients and are potent butyrate-producing Clostridia with known anti-inflammatory activity. Declines in putative pathogenic strains, such as Escherichia, Alistipes, and Eggerthella accompanied the increase of SCFA-producing bacteria.
Among the study patients treated for at least 8 weeks, the 61.3% who achieved at least 50% dietary compliance reported a dramatic decrease of symptoms and disease severity.
Dr. Maldonado-Contreras explained the role P-gp has as a biomarker of gut microbiota. “P-gp is an ABC-transporter located in the apical side of intestinal epithelial cells and is responsible for suppressing neutrophil migration in healthy individuals,” she said. “Loss of P-gp expression, or a reduction in its function, correlates with inflammation in the gastrointestinal tract in both mice and humans.” The study compared P-gp expression before and after patients went on the IBD-AID diet.
Dr. Maldonado-Contreras credited the study’s reported diet compliance of 76% to adoption of the patient-centered counseling model (J Am Diet Assoc. 2001;101:332-41). “With the patient-centered counseling model, we aimed to build self-efficacy, self-management strategies and to provide cooking-skill abilities to promote long-term behavioral habits related to the IBD-AID,” she said. The IBD-AID recipes, menus, and tips are available online (https://www.umassmed.edu/nutrition/).
The Dr. Maldonado-Contreras along with researchers at Icahn School of Medicine at Mount Sinai in New York are further evaluating an adapted version of the IBD-AID diet in pregnancy in the MELODY trial. “We are evaluating whether adherence to the modified IBD-AID during pregnancy in women with Crohn’s disease could beneficially shift the microbiome of mom and their babies, thereby promoting a healthier immune system during a critical time of the baby’s immune system development,” Dr. Maldonado-Contreras said. The trial has recruited 50 patients with Crohn’s disease and healthy controls so far.
Dr. Maldonado-Contreras has no financial relationships to disclose.
REPORTING FROM CROHN’S & COLITIS CONGRESS
