■评估基于饮食因素与袋健康的相互作用而设计的全食物饮食策略(莫纳什袋饮食[MPD])。具体来说,其耐受性和可接受性,它是否达到了饮食和代谢目标,并检查了对症状和炎症的影响。
■在为期6周的开放标签试验中,对接受过MPD的回肠袋患者进行饮食耐受性和接受度评估,食物摄入量(7天食物日记),囊相关症状(临床囊炎疾病活动指数),and,在24小时粪便样本中,钙卫蛋白,发酵生物标志物,和挥发性有机化合物(VOC)。
■在12名患者中,6男,平均(SD)年龄55(5)和袋龄13(2)岁,1例因部分小肠梗阻而退出。9(75%)的耐受性良好,接受度高(81%)。实现了饮食摄入的目标变化。粪便支链脂肪酸与短链脂肪酸的比率增加了中值60[IQR:11-80]%(P=0.02)。3种化合物的粪便VOCs也有所增加,2-甲基-5-丙-2-基环己烷-1,3-二烯(倍数变化[FC]2.08),1,3,3-三甲基-2-氧杂双环[2.2.2]辛烷(FC3.86),丙-2-醇(FC2.10)。所有6例有症状的患者均达到症状缓解(P=0.03)。基线时的粪便钙卫蛋白为292[176-527]μg/g,第5周时为205[148-310]μg/g(P=0.72)。
■良好的耐受性和接受性,MPD实现了碳水化合物相对于蛋白质的摄入和发酵的目标变化。有症状改善的信号。这些结果表明需要进行随机对照试验。(试用注册:ACTRN12621000374864;https://www.anzctr.org.au/ACTRN12621000374864。aspx)。
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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).
UNASSIGNED: 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).