title: High amount of dietary fiber not harmful but favorable for Crohn disease.
abstract: Current chronic diseases are a reflection of the westernized diet that features a decreased consumption of dietary fiber. Indigestible dietary fiber is metabolized by gut bacteria, including Faecalibacterium prausnitzii, to butyrate, which has a critical role in colonic homeostasis owing to a variety of functions. Dietary fiber intake has been significantly inversely associated with the risk of chronic diseases. Crohn disease (CD) is not an exception. However, even authors who reported the inverse association between dietary fiber and a risk of CD made no recommendation of dietary fiber intake to CD patients. Some correspondence was against advocating high fiber intake in CD. We initiated a semivegetarian diet (SVD), namely a lacto-ovo-vegetarian diet, for patients with inflammatory bowel disease. Our SVD contains 32.4 g of dietary fiber in 2000 kcal. There was no untoward effect of the SVD. The remission rate with combined infliximab and SVD for newly diagnosed CD patients was 100%. Maintenance of remission on SVD without scheduled maintenance therapy with biologic drugs was 92% at 2 years. These excellent short- and long-term results can be explained partly by SVD. The fecal bacterial count of F prausnitzii in patients with CD is significantly lower than in healthy controls. Diet reviews recommend plant-based diets to treat and to prevent a variety of chronic diseases. SVD belongs to plant-based diets that inevitably contain considerable amounts of dietary fiber. Our clinical experience and available data provide a rationale to recommend a high fiber intake to treat CD.
authors: Chief of the Inflammatory Bowel Disease Section at Akita City Hospital in Japan. mchiba@m2.gyao.ne.jp.
authors: Mitsuro
authors: M
authors: Chiba
authors: Chief of the Gastrointestinal Endoscopy Section at Akita City Hospital in Japan. ac070289@akita-city-hp.jp.
authors: Tsuyotoshi
authors: T
authors: Tsuji
authors: Chief of the Gastroenterology Division at Akita City Hospital in Japan. ac060950@akita-city-hp.jp.
authors: Kunio
authors: K
authors: Nakane
authors: Gastroenterologist and the Director of Akita City Hospital in Japan. ac990892@akita-city-hp.jp.
authors: Masafumi
authors: M
authors: Komatsu
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy / Q000628:therapy*; D004035:Diet Therapy / Q000379:methods*; D014676:Diet, Vegetarian; D004043:Dietary Fiber / Q000008:administration & dosage*; D005243:Feces / Q000382:microbiology; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D004043:Dietary Fiber; D005765:Gastrointestinal Agents; D000069285:Infliximab