Dietary fat attenuates the benefits of an elemental diet in active Crohn's disease: a randomized, controlled trial.
OBJECTIVE
Although an elemental diet has been established as the primary treatment for patients with Crohn's disease, the influence of dietary fat on the elemental diet remains unclear. We have designed the first randomized, controlled trial for elemental diets containing different fat percentages in patients with active Crohn's disease.


METHODS
Each patient was randomized to receive one of three dose levels of fat in an elemental diet (Elental) for 4 weeks: 10 patients received low fat (3.06 g/day), 10 patients received medium fat (16.56 g/day) and eight patients received high fat (30.06 g/day). The additional fat was composed of long-chain fatty acids. All patients were evaluated using the International Organization of Inflammatory Bowel Disease rating, plus C-reactive protein level and erythrocyte sedimentation rate, which were measured at weekly intervals.


RESULTS
Although the International Organization of Inflammatory Bowel Disease rating, C-reactive protein level and erythrocyte sedimentation rate in the low-fat group decreased, the values in the medium- and high-fat groups fluctuated during the study. The remission rate after 4 weeks in each group was 80%, 40% and 25% for patients in the low-, medium- and high-fat groups, respectively.


CONCLUSIONS
When the fat consisted of long-chain triglycerides, a high amount of this fat in the elemental diet formula decreased its therapeutic effect against active Crohn's disease.
Bamba
Tadao
T
Second Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa-Seta, Otsu, Shiga, 520-2192 Japan.
Shimoyama
Takashi
T
Sasaki
Masaya
M
Tsujikawa
Tomoyuki
T
Fukuda
Yoshihiro
Y
Koganei
Kazutaka
K
Hibi
Toshifumi
T
Iwao
Yasushi
Y
Munakata
Akihiro
A
Fukuda
Shinsaku
S
Matsumoto
Takayuki
T
Oshitani
Nobuhide
N
Hiwatashi
Nobuo
N
Oriuchi
Tatsuo
T
Kitahora
Tetsuji
T
Utsunomiya
Toshinori
T
Saitoh
Yasushi
Y
Suzuki
Yasuo
Y
Nakajima
Mitsuyoshi
M
D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000378:metabolism / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D012074:Remission Induction
D004041:Dietary Fats; D002097:C-Reactive Protein