Lifestyle-related disease in Crohn's disease: relapse prevention by a semi-vegetarian diet.
OBJECTIVE
To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn's disease (CD) in patients who have achieved remission, who are a high-risk group for relapse.


METHODS
A prospective, single center, 2-year clinical trial was conducted. Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease. The primary endpoint was clinical relapse defined as the appearance of active symptoms of CD. Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse. A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.


RESULTS
SVD was continued by 16 patients (compliance 73%). Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%) in the omnivorous group. Remission rate with SVD was 100% at 1 year and 92% at 2 years. SVD showed significant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003, log rank test). The concentration of C-reactive protein was normal at the final visit in more than half of the patients in remission who were taking an SVD, who maintained remission during the study (9/15; 60%), who terminated follow-up (8/12; 67%), and who completed 2 years follow-up (7/10; 70%). There was no untoward effect of SVD.


CONCLUSIONS
SVD was highly effective in preventing relapse in CD.
Chiba
Mitsuro
M
Division of Gastroenterology, Nakadori General Hospital, 3-15, Misono-cho, Minami-dori, Akita 010-8577, Japan. mchiba@meiwakai.or.jp
Abe
Toru
T
Tsuda
Hidehiko
H
Sugawara
Takeshi
T
Tsuda
Satoko
S
Tozawa
Haruhiko
H
Fujiwara
Katsuhiko
K
Imai
Hideo
H
D000328:Adult; D000368:Aged; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003424:Crohn Disease / Q000178:diet therapy* / Q000188:drug therapy / Q000517:prevention & control*; D014676:Diet, Vegetarian; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D055502:Secondary Prevention; D012460:Sulfasalazine / Q000627:therapeutic use; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D019804:Mesalamine