LONG-CHAIN TRIGLYCERIDES REDUCE THE EFFICACY OF ENTERAL FEEDS IN PATIENTS WITH ACTIVE CROHNS-DISEASE

Elemental diets are effective treatments for active Crohn's disease. T o determine which dietary constituents are of therapeutic importance, the effectiveness of four separate feeds was related to their composit ions, and the findings substantiated by meta-analysis of previous diet ary studies. 76 patients with active Crohn's disease were recruited. 1 7 were randomised to an amino-acid based elemental diet (E028), 22 to E028 with added long-chain triglyceride (E028 LCT), 18 to a semi-eleme ntal, peptide based diet (Pepdite 2+) and 19 received E028 with added medium-chain triglyceride (E028 MCT). Disease activity fell in all gro ups and remission rate was negatively correlated with the amount of en ergy derived from LCT (r = -0.97, p = 0.016). Inflammatory indices fel l in the groups (E028 + E028 MCT) containing least LCT. No other dieta ry constituents correlated with remission rate. A meta-analysis of pub lished studies confirmed a negative correlation between remission rate and LCT (r = -0.63, p = 0.006) but not other constituents. The associ ation between dietary LCT and remission rate may have pathogenic signi ficance and allow the development of more effective enteral feeds.