Increased Fruit And Vegetable Intake Linked With Improved Biologics Response in Inflammatory Bowel Disease

By Andrew John, MD /alert Contributor
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Eating a diet high in fruits and vegetables may improve responses to biologic induction therapy among patients with inflammatory bowel disease, according to findings presented at the American College of Gastroenterology 2022 annual meeting.

“Several biologics now exist as treatment for inflammatory bowel disease but effective induction of remission still ranges between 20% to 40% for most,” Andres D. Rodriguez, DO, MBA, of the University of Miami, and colleagues wrote in an abstract of their presentation. “Studies suggest that diet may modify intestinal inflammation. In this study, we sought to examine the effect of diet on biochemical response to biologic induction therapies.”

Rodriguez and colleagues performed a retrospective analysis of 105 patients with inflammatory bowel disease who were treated at a tertiary referral center between the years of 2019 and 2021. Patients were asked to fill out the 26-item validated Dietary Screener Questionnaire before each visit to the treatment center. The study included all patients who completed a questionnaire within 3 months of receiving induction therapy with a biologic, and who had data on inflammation markers available both before and after receiving induction therapy. Researchers used linear and average mixed-effects models to examine the possible role of foods mentioned in the questionnaire in reducing C-reactive protein levels. Researchers followed up with patients for 3 months after induction therapy. The models also included such covariates as BMI, current steroid use, previous exposure to biologics, type of inflammatory bowel disease, smoking status, age and gender and class of biologic used in treatment.

Most patients (62.9%) had Crohn’s disease, while 32.4% had ulcerative colitis. More than half of patients (52.4%) were treated with TNF inhibitors.

The researchers reported that before induction therapy, the patients’ mean C-reactive protein value was 13.4 (SD 20.2), whereas after induction, the mean value was 6.63 (SD 12.4). Rodriguez and colleagues wrote that fruit and vegetable intake was linked with reductions in C-reactive protein levels: for each additional unit of daily fruit and vegetable consumption, patients showed a reduction of 1.82 C-reactive protein level after treatment with biologics (P = .04).

The consumption of dairy, red and processed meats and fiber from whole grains were not linked with any reductions in C-reactive protein, according to the abstract.

“In this preliminary analysis, we find that a diet high in fruits and vegetables during induction of biologics may independently improve biochemical response,” Rodriguez and colleagues concluded. “Future clinical drug trials should consider dietary assessment and the influence of diet on response to medication treatment.”

Disclosures: The authors declared no financial ties to drugmakers.

Photo Credit: Getty Images

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