title: Potential Impact of Diet on Treatment Effect from Anti-TNF Drugs in Inflammatory Bowel Disease.
abstract: We wanted to investigate the current knowledge on the impact of diet on anti-TNF response in inflammatory bowel diseases (IBD), to identify dietary factors that warrant further investigations in relation to anti-TNF treatment response, and, finally, to discuss potential strategies for such investigations. PubMed was searched using specified search terms. One small prospective study on diet and anti-TNF treatment in 56 patients with CD found similar remission rates after 56 weeks among 32 patients with good compliance that received concomitant enteral nutrition and 24 with poor compliance that had no dietary restrictions (78% versus 67%, p = 0.51). A meta-analysis of 295 patients found higher odds of achieving clinical remission and remaining in clinical remission among patients on combination therapy with specialised enteral nutrition and Infliximab (IFX) compared with IFX monotherapy (OR 2.73; 95% CI: 1.73-4.31, p < 0.01, OR 2.93; 95% CI: 1.66-5.17, p < 0.01, respectively). In conclusion, evidence-based knowledge on impact of diet on anti-TNF treatment response for clinical use is scarce. Here we propose a mechanism by which Western style diet high in meat and low in fibre may promote colonic inflammation and potentially impact treatment response to anti-TNF drugs. Further studies using hypothesis-driven and data-driven strategies in prospective observational, animal and interventional studies are warranted.
authors.affiliation: Focused Research Unit for Molecular Diagnostic and Clinical Research, IRS-Centre Sonderjylland, Hospital of Southern Jutland, Åbenrå 6200, Denmark. vandersen@health.sdu.dk.|Institute of Molecular Medicine, University of Southern Denmark, Odense 5000, Denmark. vandersen@health.sdu.dk.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Andersen
authors.affiliation: Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg 1871, Denmark. akh@sund.ku.dk.
authors.forename: Axel Kornerup
authors.initials: AK
authors.lastname: Hansen
authors.affiliation: Research Unit for Dietary Studies, Parker Institute, Frederiksberg 2000, Denmark. berit.lilienthal.heitmann@regionh.dk.|Section for General Medicine, Department of Public Health, University of Copenhagen, Copenhagen 1353, Denmark. berit.lilienthal.heitmann@regionh.dk.|National Institute of Public Health, University of Southern Denmark, Odense 5000, Denmark. berit.lilienthal.heitmann@regionh.dk.
authors.forename: Berit Lilienthal
authors.initials: BL
authors.lastname: Heitmann
mesh_terms: D000818:Animals; D016208:Databases, Factual; D066273:Diet, Western; D004043:Dietary Fiber / Q000008:administration & dosage; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D019317:Evidence-Based Medicine; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000627:therapeutic use; D008019:Life Style; D008460:Meat; D015201:Meta-Analysis as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D004043:Dietary Fiber; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Western style diet; anti-TNF; chronic inflammatory diseases; diet; dietary pattern; epithelium-associated bacteria; fibre intake; food; lifestyle factors; meat intake; microbiome; mucin-degrading bacteria; mucosa associated bacteria; mucus; personalized medicine; sulphate-reducing bacteria; treatment response; treatment result