SAD diet vs Low Fat Diet for Ulcerative Colitis

J Fritsch et al. Clin Gastroenterol Hepatol 2021; 19: 1189-1199. Full text: Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis

Background: “A high-fat diet has been associated with an increased risk of ulcerative colitis (UC). We studied the effects of a low-fat, high-fiber diet (LFD) vs an improved standard American diet (iSAD, included higher quantities of fruits, vegetables, and fiber than a typical SAD)”

Key findings:

  • Compared with baseline, the iSAD and LFD each increased quality of life, based on the short IBD questionnaire and Short-Form 36 health survey scores (baseline short IBD questionnaire score, 4.98; iSAD, 5.55; LFD, 5.77; baseline vs iSAD, P = .02; baseline vs LFD, P = .001)
  • Fecal levels of acetate (an anti-inflammatory metabolite) increased from a relative abundance of 40.37 at baseline to 42.52 on the iSAD and 53.98 on the LFD (baseline vs LFD, P = .05; iSAD vs LFD, P = .09)
  • Overall, in this small cross-over study (cross-over study) of 17 patients with UC in remission, a catered LFD or a iSAD were each well tolerated and increased quality of life. However, the LFD decreased markers of inflammation and reduced intestinal dysbiosis in fecal samples

My take: While dietary intervention is recognized as a more effective intervention in Crohn’s disease, this study shows that a low-fat high fiber diet for patients with ulcerative colitis may be beneficial.