Dietary Interventions With Solid Foods in Adults With Crohn Disease: Methodological Insights From a Scoping Review

The role of solid-food diets in managing Crohn disease (CD) is gaining increasing attention in the scientific research community, while current evidence is limited and consists of highly heterogenous methodologies. In this scoping review we aimed to provide a comprehensive analysis of the most important methodological aspects of the available studies on whole-food dietary interventions in adults with CD. Second, this review focuses on describing the nutritional content of the implemented interventions and commenting on their nutritional adequacy. PubMed, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases were searched from inception up to July 2025, to identify all interventional studies in adult patients with CD that examined the effects of solid dietary interventions on various disease outcomes. Studies that targeted adult patients in remission or active CD and involving a well-defined solid diet interventional arm were rigorously considered. In total, 23 studies were eligible for inclusion, including 15 randomized controlled trials (RCTs), 2 pilot RCTs, 5 prospective interventional studies, and a non-randomized clinical trial. Study participants were in active CD (n = 11), in remission (n = 6), or assorted (n = 6) and were followed up for up to 2 years. Nutritional status and adequacy were among the assessed outcomes in 13 out of 23 studies, while adherence to the dietary regimen was described in nearly all of the included studies. The actual nutritional intake of the participants and its adequacy were rarely evaluated. Several methodological challenges in solid-food dietary trials targeting adult CD patients were identified, including study design variability, participant characteristics, criteria for concomitant drug therapies, provided details for the content and adequacy of the dietary regimens, and examined outcomes. This review underscores the methodological challenges and inconsistencies in solid-food dietary intervention studies for adults with Crohn disease, emphasizing that adopting standardized methodologies and outcome measures could strengthen future evidence and clarify the role of diet in multimodal disease management.