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. 2024 Sep 20;16(18):3184.
doi: 10.3390/nu16183184.

Cultural Perspectives on the Efficacy and Adoption of the Crohn's Disease Exclusion Diet across Diverse Ethnicities: A Case-Based Overview

Rotem Sigall Boneh  1   2   3 , Sowon Park  4 , Maria Soledad Arcucci  5   6 , Marta Herrador-López  7 , Chen Sarbagili-Shabat  1   8 , Nitzan Kolonimos  9 , Nicolette Wierdsma  10   11 , Min Chen  12 , Einat Hershkovitz  9 , Eytan Wine  12 , Johan Van Limbergen  2   3   13
Affiliations

Cultural Perspectives on the Efficacy and Adoption of the Crohn's Disease Exclusion Diet across Diverse Ethnicities: A Case-Based Overview

Rotem Sigall Boneh et al. Nutrients. .

Abstract

Background: The Crohn's Disease Exclusion Diet (CDED) is a whole-foods regimen that has demonstrated efficacy in inducing remission among children and adults with mild-to-moderate disease. While initial studies predominantly originated from Israel, recent years have witnessed the expansion of experiences to diverse cultures, culminating in the recognition of CDED in the latest ESPEN guidelines. However, implementing dietary therapy poses significant challenges across various cultures, necessitating adaptations.

Aim and methods: This case-based study aims to present the collective experience from different cultures, shedding light on the encountered challenges and the corresponding solutions devised to surmount them by convening healthcare providers (dietitians and physicians across six countries and eight cultural settings) with extensive experience in utilizing the CDED.

Results and conclusions: Our findings underscore the efficacy of CDED across diverse cultural contexts and emphasize the pivotal role of dietitians in tailoring the diet to accommodate patients' cultural behaviors and traditions. We highlight challenges encountered and delineate strategies for overcoming them by customizing the diet and offering tailored guidance. Additionally, we provide insights into implementing CDED in various regions through adjusted recipes and personalized counseling from dietitians. This study contributes to the growing body of literature on CDED, and offers practical guidance for its effective adoption in diverse cultural settings.

Keywords: Crohn’s Disease (CD); Crohn’s Disease Exclusion Diet (CDED); culture; dietary therapy; dietitians; ethnicity.

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Conflict of interest statement

R.S.B. received funds for consulting or speaking from Nestlé Health Science, Takeda, Megapharm and Janssen, and serves on the advisory board for Evinature. J.V.L. received Nestlé Health Sciences consulting/research support/travel/speaker fees, as well as contributions from Nutricia (speaker fee) and Pfizer (advisory board). E.W. is on the advisory board for AbbVie, Nestlé Health Science, Pfizer and BioJamp, and received speaker fees from AbbVie, Nestlé Health Science, Janssen, and Mead Johnson Nutrition. C.S.-S. received Wolfson medical center IP for Nestle Health Science, and speaking fees from Nestle, Takeda, and Ferring. N.W. received Nestlé Health Sciences research support and a speaker fee from Janssen. M.H.-L. received a consultation fee, research grant, royalties, and honorarium from Nestlé Health Science. N.K., M.C., M.S.A., E.H. and S.P. declare no conflicts of interest.

Figures

Figure 1
Figure 1
Multifaceted challenges in adapting the Crohn’s Disease Exclusion Diet across diverse cultural contexts.
See this image and copyright information in PMC

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