A Mediterranean Diet Pattern Improves Intestinal Inflammation Concomitant with Reshaping of the Bacteriome in Ulcerative Colitis: A Randomised Controlled Trial

J Crohns Colitis. 2023 Nov 8;17(10):1569-1578.doi: 10.1093/ecco-jcc/jjad073.


Natasha Haskey 1Mehrbod Estaki 2Jiayu Ye 3Rachel K Shim 4Sunny Singh 5Levinus A Dieleman 6Kevan Jacobson 7Deanna L Gibson 1 8


Author information

1Department of Biology, Irving K Barber Faculty of Science, University of British Columbia-Okanagan, Kelowna, BC, Canada.

2Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

3Diabetes Center, University of California San Francisco, San Francisco, CA, USA.

4Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

5Division of Gastroenterology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

6Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

7Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition and British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.

8Department of Medicine, Faculty of Medicine, University of British Columbia, BC, Canada.


Background and aims: Dietary patterns are important in managing ulcerative colitis [UC], given their influence on gut microbiome-host symbiosis and inflammation. We investigated whether the Mediterranean Diet Pattern [MDP] vs the Canadian Habitual Diet Pattern [CHD] would affect disease activity, inflammation, and the gut microbiome in patients with quiescent UC.

Methods: We performed a prospective, randomised, controlled trial in adults [65% female; median age 47 years] with quiescent UC in an outpatient setting from 2017 to 2021. Participants were randomised to an MDP [n = 15] or CHD [n = 13] for 12 weeks. Disease activity [Simple Clinical Colitis Activity Index] and faecal calprotectin [FC] were measured at baseline and week 12. Stool samples were analysed by 16S rRNA gene amplicon sequencing.

Results: The diet was well tolerated by the MDP group. At week 12, 75% [9/12] of participants in the CHD had an FC >100 μg/g, vs 20% [3/15] of participants in the MDP group. The MDP group had higher levels of total faecal short chain fatty acids [SCFAs] [p = 0.01], acetic acid [p = 0.03], and butyric acid [p = 0.03] compared with the CHD. Furthermore, the MDP induced alterations in microbial species associated with a protective role in colitis [Alistipes finegoldii and Flavonifractor plautii], as well as the production of SCFAs [Ruminococcus bromii].

Conclusions: An MDP induces gut microbiome alterations associated with the maintenance of clinical remission and reduced FC in patients with quiescent UC. The data support that the MDP is a sustainable diet pattern that could be recommended as a maintenance diet and adjunctive therapy for UC patients in clinical remission. ClinicalTrials.gov no: NCT0305371.

© Copyright 2013-2024 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.