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Tasty&Healthy Whole-Food Diet in Asymptomatic Children and Young Adults With Biologically Active Crohn's Disease: The
Luba Plotkin1, Yonat Aharoni-Frutkoff2, Daniel Pollak3
1The Juliet Keidan Institute of Pediatric Gastroenterology, Hepatology, and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel; The Institute of Pediatric Gastroenterology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Background & Aims:
Tasty&Healthy is an exclusive whole food diet designed to reduce inflammation in Crohn's disease without the need for formula. This TASTI-E randomized-controlled trial compared the effect of Tasty&Healthy versus habitual diet on subclinical inflammation in Crohn's disease.
Methods:
Clinically quiescent patients with Crohn's disease, 6 to 40 years of age, with Mucosal Inflammation Noninvasive Index >8 reflecting bowel inflammation, were randomized to an 8-week Tasty&Healthy intervention or to continue their regular diet. Thereafter, the habitual group was offered an 8-week open-label Tasty&Healthy intervention. The primary outcome was >50% decline in calprotectin. The study was terminated early due to COVID-19-related challenges.
Results:
Of the 46 randomized patients (mean age, 18.2 ± 7.6 years; median disease duration, 9.01 months [interquartile range, 2.9-17.1 months]), 19 were allocated to Tasty&Healthy and 27 to habitual diet. Calprotectin response was greater in the Tasty&Healthy (53%) versus habitual arm (7%; relative risk, 3.23; 95% confidence interval, 1.15-9.01; P = .028). Among 15 patients who crossed over to Tasty&Healthy, the rates of calprotectin <250 μg/g (53% vs 7%, respectively; P = .045) and Mucosal Inflammation Noninvasive Index <8 (93% versus 20%; P = .002) were higher at week 16 versus week 8. Adherence to Tasty&Healthy was 77% based on self-reported questionnaires and 71% by fecal gluten. Micronutrient and macronutrient consumption was similar between the groups, except for higher fiber intake with Tasty&Healthy. The Tasty&Healthy intervention resulted in a unique serum metabolic signature.
Conclusions:
The Tasty&Healthy diet may reduce calprotectin levels in patients with Crohn's disease with subclinical inflammation. Its flexible structure, free of formula, likely explains the high adherence among asymptomatic individuals.
Clinicaltrials:
gov, Number: NCT04239248.
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