Plant-based fasting-mimicking diet does not boost medication response in UC

The low-calorie, plant-based fasting-mimicking (LC-PB) diet does little to improve clinical response to medications in patients with active ulcerative colitis (UC), according to a study. However, LC-PB diet helps with steroid tapering and reduce serum amyloid A.

For the study, researchers enrolled 32 adult patients initiating advanced therapies for active UC. They were randomly assigned to LC-PB or a control diet intervention as an adjunct to therapy. The LC-PB diet provided 1,090 kcal on day 1 and 725 kcal on days 2-5.

The primary endpoint was clinical response at week 8, defined as at least a 3-point decrease in the Simple Clinical Colitis Activity Index (SCCAI) score. Secondary outcomes included clinical improvement (change in SCCAI from baseline), steroid tapering, C-reactive protein (CRP), serum amyloid A, and faecal calprotectin (FC).

A total of 23 patients completed the study. In the intention-to-treat (ITT) analysis, clinical response by week 8 occurred in 57 percent of patients in the LC-PB arm and in 35 percent of those in the control arm. The difference was not statistically significant (p=0.11).

However, the LC-PB group showed greater clinical improvement, measured as continuous SCCAI, compared with the control group (p=0.039). Additionally, the LC-PB group was more likely to have better SCCAI sub-scores (ie, urgency, well-being), greater reductions in serum amyloid A, and be tapered off steroids. Mean CRP and FC decreased more in the LC-PB group than in the control group, although the difference was not significant.

In terms of safety, none of the patients lost weight and experienced serious adverse events relating to the diet.

Additional research is warranted, given the limited sample size in the present study.