A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects
Abstract Aims To evaluate a whole‐food diet strategy (the Monash Pouch diet [MPD]) designed based on the interacting roles dietary factors play with pouch health. Specifically, its tolerability and acceptability, whether it achieved its dietary and metabolic goals, and the effects on symptoms and in...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.13008 |
| _version_ | 1827394974802509824 |
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| author | Zaid S Ardalan Chu K Yao Kraig Green Chris Probert Paul A Gill Sam Rosella Jane G Muir Miles P Sparrow Peter R Gibson |
| author_facet | Zaid S Ardalan Chu K Yao Kraig Green Chris Probert Paul A Gill Sam Rosella Jane G Muir Miles P Sparrow Peter R Gibson |
| author_sort | Zaid S Ardalan |
| collection | DOAJ |
| description | Abstract Aims To evaluate a whole‐food diet strategy (the Monash Pouch diet [MPD]) designed based on the interacting roles dietary factors play with pouch health. Specifically, its tolerability and acceptability, whether it achieved its dietary and metabolic goals, and the effects on symptoms and inflammation were examined. Methods In a 6‐week open‐label trial, patients with ileoanal pouches educated on the MPD were assessed regarding diet tolerability and acceptance, food intake (7‐day food diaries), pouch‐related symptoms (clinical pouchitis disease activity index), and, in 24‐h fecal samples, calprotectin, fermentative biomarkers, and volatile organic compounds (VOC). Results Of 12 patients, 6 male, mean (SD) age 55 (5) and pouch age 13 (2) years, one withdrew with partial small bowel obstruction. Tolerability was excellent in 9 (75%) and acceptance was high (81%). Targeted changes in dietary intake were achieved. Fecal branched‐ to short‐chain fatty acid ratio increased by median 60 [IQR: 11–80]% (P = 0.02). Fecal VOCs for 3 compounds were also increased, 2‐methyl‐5‐propan‐2‐ylcyclohexa‐1,3‐diene (Fold‐change [FC] 2.08), 1,3,3‐trimethyl‐2‐oxabicyclo[2.2.2]octane (FC 3.86), propan‐2‐ol (FC 2.10). All six symptomatic patients achieved symptomatic remission (P = 0.03). Fecal calprotectin at baseline was 292 [176–527] μg/g and at week 5 was 205 [148–310] μg/g (P = 0.72). Conclusion Well tolerated and accepted, the MPD achieved targeted changes in intakes and fermentation of carbohydrates relative to that of protein. There were signals of improvement in symptoms. These results indicate the need for a randomized‐controlled trial. (Trial registration: ACTRN12621000374864; https://www.anzctr.org.au/ACTRN12621000374864.aspx). |
| first_indexed | 2024-03-08T18:25:08Z |
| format | Article |
| id | doaj.art-db3313d7aafb47c8866c56dde8c66637 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-03-08T18:25:08Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-db3313d7aafb47c8866c56dde8c666372023-12-30T16:05:16ZengWileyJGH Open2397-90702023-12-0171294295210.1002/jgh3.13008A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effectsZaid S Ardalan0Chu K Yao1Kraig Green2Chris Probert3Paul A Gill4Sam Rosella5Jane G Muir6Miles P Sparrow7Peter R Gibson8Department of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UKDepartment of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UKDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaDepartment of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria AustraliaAbstract Aims To evaluate a whole‐food diet strategy (the Monash Pouch diet [MPD]) designed based on the interacting roles dietary factors play with pouch health. Specifically, its tolerability and acceptability, whether it achieved its dietary and metabolic goals, and the effects on symptoms and inflammation were examined. Methods In a 6‐week open‐label trial, patients with ileoanal pouches educated on the MPD were assessed regarding diet tolerability and acceptance, food intake (7‐day food diaries), pouch‐related symptoms (clinical pouchitis disease activity index), and, in 24‐h fecal samples, calprotectin, fermentative biomarkers, and volatile organic compounds (VOC). Results Of 12 patients, 6 male, mean (SD) age 55 (5) and pouch age 13 (2) years, one withdrew with partial small bowel obstruction. Tolerability was excellent in 9 (75%) and acceptance was high (81%). Targeted changes in dietary intake were achieved. Fecal branched‐ to short‐chain fatty acid ratio increased by median 60 [IQR: 11–80]% (P = 0.02). Fecal VOCs for 3 compounds were also increased, 2‐methyl‐5‐propan‐2‐ylcyclohexa‐1,3‐diene (Fold‐change [FC] 2.08), 1,3,3‐trimethyl‐2‐oxabicyclo[2.2.2]octane (FC 3.86), propan‐2‐ol (FC 2.10). All six symptomatic patients achieved symptomatic remission (P = 0.03). Fecal calprotectin at baseline was 292 [176–527] μg/g and at week 5 was 205 [148–310] μg/g (P = 0.72). Conclusion Well tolerated and accepted, the MPD achieved targeted changes in intakes and fermentation of carbohydrates relative to that of protein. There were signals of improvement in symptoms. These results indicate the need for a randomized‐controlled trial. (Trial registration: ACTRN12621000374864; https://www.anzctr.org.au/ACTRN12621000374864.aspx).https://doi.org/10.1002/jgh3.13008dietfermentable oligo‐, di‐ and monosaccharides and polyolspouchpouchitisprotein fermentationulcerative colitis |
| spellingShingle | Zaid S Ardalan Chu K Yao Kraig Green Chris Probert Paul A Gill Sam Rosella Jane G Muir Miles P Sparrow Peter R Gibson A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects JGH Open diet fermentable oligo‐, di‐ and monosaccharides and polyols pouch pouchitis protein fermentation ulcerative colitis |
| title | A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| title_full | A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| title_fullStr | A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| title_full_unstemmed | A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| title_short | A novel Monash Pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| title_sort | novel monash pouch diet in patients with an ileoanal pouch is tolerable and has favorable metabolic luminal effects |
| topic | diet fermentable oligo‐, di‐ and monosaccharides and polyols pouch pouchitis protein fermentation ulcerative colitis |
| url | https://doi.org/10.1002/jgh3.13008 |
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