Photo Credit: Happy Lark

The following is a summary of “Mechanistic implications of the Mediterranean diet in patients with newly diagnosed Crohn’s disease- multi-omic results from a prospective cohort,” published in the January 2025 issue of Gastroenterology by Godny et al.

This study investigates the protective mechanisms of the Mediterranean diet (MED) in relation to Crohn’s disease (CD), focusing on its effects on disease progression, inflammatory markers, and gut microbiota composition. A prospective cohort of patients newly diagnosed with CD was established to explore the relationship between MED adherence and various clinical and biological outcomes.

A total of 271 patients (52% male, mean age 31 ± 12 years, with 75% classified as B1 phenotype) were recruited. Dietary adherence to the MED was evaluated through repeated food frequency questionnaires (FFQs) and a predefined IBDMED score. Clinical assessments included the Crohn’s Disease Activity Index (CDAI), C-reactive protein (CRP), fecal calprotectin levels, and microbial composition analyzed via 16S rRNA sequencing. Baseline serum and fecal samples underwent targeted quantitative metabolomics analysis.

Results indicated that adherence to the MED correlated with a non-complicated course of CD and was inversely related to CDAI, fecal calprotectin, CRP levels, and microbial dysbiosis index (all P < .05). Notably, increased adherence over time was associated with reductions in CDAI and inflammatory markers (P < .05). Furthermore, adherence to the MED was linked to a beneficial microbial profile characterized by commensals and short-chain fatty acid producers such as Faecalibacterium, alongside increased levels of plant metabolites, vitamin derivatives, and amino acids. In contrast, lower adherence correlated with higher levels of pathogenic oral genera, including Escherichia coli and Ruminococcus gnavus, as well as elevated tryptophan metabolites, ceramides, and primary bile acids (FDR < .2).

In conclusion, this study demonstrates that adherence to the Mediterranean diet is associated with favorable clinical outcomes in patients with Crohn’s disease, likely due to its role in reducing inflammatory markers and promoting a healthy microbiome. These findings underscore the potential of dietary interventions in managing CD. However, further randomized controlled trials are warranted to establish definitive conclusions regarding the MED’s role in CD treatment strategies.

Source: sciencedirect.com/science/article/abs/pii/S0016508525000381