A Diet Low in Red and Processed Meat Does Not Reduce Rate of Crohn's Disease Flares

Abstract

Background & aims: Diet may be an important factor in the progression of Crohn's disease (CD). We performed a randomized controlled trial to determine whether reduced consumption of red and processed meats decreases the risk of symptomatic relapse of CD, analyzing results from the Food and Crohn's Disease Exacerbation Study (FACES) trial.

Methods: Adults with CD were recruited into the FACES trial from IBD Partners, an Internet-based cohort of patients with inflammatory bowel disease, from November 2013 through June 2015. Individuals who were in remission (CD activity index [sCDAI] scores of ≤150), had completed a biannual survey, and reported consumption of red meat at least once weekly were randomly assigned to groups that consumed a minimum of 2 servings/week of red or processed meat (high meat, n = 118) or not more than 1 serving per month (low meat, n = 96) for 49 weeks. The primary outcome was relapse of CD, defined as increase in sCDAI score by ≥70 points and to >150 or a need for CD surgery or new CD medication. A secondary outcome, moderate or severe relapse, was based on an increase in sCDAI to >219.

Results: During the trial, the high-meat groups reported consumption of 2 or more servings of red or processed meat during 98.5% of observed weeks compared with 18.8% of weeks for the low-meat group. Any and moderate to severe relapse occurred in 62% of participants in the high-meat group and 42% of participants in the low-meat group. There were no significant differences in time to any (P = .61) or moderate/severe (P = .50) relapse.

Conclusions: In an analysis of data from the FACES trial, we found that among patients with CD in remission, level of red and processed meat consumption was not associated with time to symptomatic relapse. ClinicalTrials.gov, Number: NCT0192673.

Trial registration: ClinicalTrials.gov NCT00192673.

Keywords: IBD; Inflammatory Bowel Disease; Prevention; Quiescent Disease.

Figure 1

FACES CONSORT diagram

Figure 2

Dietary pattern before and after the intervention a. Principle component analysis of baseline dietary patterns using nutrient variables b. Principle component analysis of baseline dietary patterns using whole foods variables

Figure 3

Comparison of time to symptomatic relapse by arm a. Time to any symptomatic relapse b. Time to moderate to severe symptomatic relapse c. Time to persistent symptomatic relapse

Figure 4

a. Comparison of adherence to the diet by treatment arm. The high meat group consumed 2+ servings of red or processed meat in 98.5% of weeks. The low meat group consumed 0 servings red or processed meat in 57.3% of weeks. b. Percent of weeks that participants in each treatment group reported consuming two or more portions of red or processed meats c. Change in consumption of red meat from baseline to week 20 by treatment arm