Personalized Research on Diet in Ulcerative Colitis and Crohn's Disease
NCT ID: NCT03301311
Last Updated: 2022-06-28
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
54 participants
INTERVENTIONAL
2018-04-10
2020-09-08
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
CROSSOVER
TREATMENT
NONE
Study Groups
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Specific Carbohydrate Diet (First)
Participants will be following the Specific Carbohydrate Diet (SCD). Allowed foods include meat/fish/poultry, eggs, some legumes (e.g., lentils and split peas are permitted, chickpeas and soybeans are not), fully fermented yogurt, non-starchy vegetables, ripe fruit, nuts/seeds, honey and nut flours (e.g. almond flour or coconut flour). Restricted foods include all grains, milk products aside from 24-hour fermented SCD yogurt and cheeses aged greater than 30 days, starchy vegetables, processed foods with food additives and sweeteners other than honey.
Specific Carbohydrate Diet (SCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Modified Specific Carbohydrate Diet (MSCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Modified Specific Carbohydrate Diet (First)
Participants will be following a modified Specific Carbohydrate Diet (MSCD). In addition to the foods in the SCD, allowed foods will expand to include organic rice, oats, sweet potatoes, grade A maple syrup and cocoa. Gluten, corn products, milk products (except yogurt and hard cheeses), sweeteners (except honey), and process foods are still restricted.
Specific Carbohydrate Diet (SCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Modified Specific Carbohydrate Diet (MSCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Interventions
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Specific Carbohydrate Diet (SCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Modified Specific Carbohydrate Diet (MSCD)
Patients will be randomized to start with either a strict SCD or modified SCD. Participants will alternate between each diet in 8-week intervals for a total duration of approximately 34 weeks. Participants will complete two 8-week intervention periods on each diet.
Eligibility Criteria
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Inclusion Criteria
* Age 7-18 years
* Enrolled in the ImproveCareNow (ICN2) registry
* Evidence of acute inflammation and/or elevated acute phase reactant as measured by Fecal calprotectin 1.5 times the upper limit of normal, Lactoferrin 1.5 times the upper limit of normal, CRP 1.15 times the upper limit of normal, or ESR 1.15 times the upper limit of normal (based on local reference ranges) obtained within 8 weeks of enrollment.
* Potential participants who are close to meeting one of the acute inflammation and/or elevated acute phase reactant markers and who meet all other study criteria will be considered for study participation on a case by case basis by the investigative study team in consultation with the patient's primary gastroenterologist.
Exclusion Criteria
* Currently or within the past 9 months has had an abscess, fistula, stricturing CD, or ostomy
* Severe disease activity as measured by a short Pediatric Crohn's Disease Activity Index (SPCDAI) score of \>45 or Pediatric Ulcerative Colitis Activity Index (PUCAI) score of \>60 assessed within three weeks of enrollment
* Ever had history of full colectomy
* Hospitalization or surgery planned within 3 months
* Ongoing active gastrointestinal infection
* Severe Malnutrition (BMI less than 5th percentile)
* Recent medication changes including:
* Thiopurines, natalizumab, or methotrexate started within 8 weeks prior to enrollment
* Anti TNF (infliximab, adalimumab) started within 8 weeks prior to enrollment
* Vedolizumab started within 16 weeks prior to enrollment
* Increase in corticosteroids within 4 weeks of screening or have dose \>20 mg prednisone or equivalent
Evidence of Other Complicating Medical Issues:
* Other serious medical conditions, such as neurological, liver, kidney, or systemic disease
* Serious psychological or psychiatric conditions such as eating disorders or self-harm
* Pregnancy
* Tobacco, alcohol, or illicit drug abuse
Inability to Complete the Protocol
* Non-English speaking participants
* On SCD or modified SCD anytime within 8 weeks of enrollment
* If an otherwise eligible patient is on SCD or modified SCD within 8 weeks of enrollment but they are noncompliant per the determination of the patient's dietitian/primary gastroenterologist, then this patient is eligible to participant in the study.
* Participants on a vegan diet
* Lack of smart phone and data plan for participating caregiver
* Participating in another concurrent intervention study
7 Years
18 Years
ALL
No
Sponsors
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University of California, San Francisco
OTHER
Seattle Children's Hospital
OTHER
Dayton Children's Hospital
OTHER
Brown University
OTHER
Children's Hospital Medical Center, Cincinnati
OTHER
Responsible Party
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Principal Investigators
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Heather C Kaplan, MD
Role: PRINCIPAL_INVESTIGATOR
Children's Hospital Medical Center, Cincinnati
Lisa Opipari-Arrigan, PhD
Role: PRINCIPAL_INVESTIGATOR
Children's Hospital Medical Center, Cincinnati
Locations
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Arkansas Children's Hospital
Little Rock, Arkansas, United States
Children's Hospital of Los Angeles
Los Angeles, California, United States
UCSF Benioff Children's Hospital Oakland
Oakland, California, United States
Lucile Packard Children's Hospital
Palo Alto, California, United States
University of California San Francisco Benioff Children's Hospita;
San Francisco, California, United States
Nemours, Alfred I duPont Hospital for Children
Wilmington, Delaware, United States
Nemours Children's Speciality Care
Jacksonville, Florida, United States
Nemours Children's Hospital
Orlando, Florida, United States
GI Care for Kids
Atlanta, Georgia, United States
Riley Hospital for Children
Indianapolis, Indiana, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Children's Mercy Hospital
Kansas City, Missouri, United States
Levine Children's Hospital
Charlotte, North Carolina, United States
Nationwide Children's Hospital
Columbus, Ohio, United States
Oregon Health Sciences University
Portland, Oregon, United States
Dell Children's Medical Center of Central Texas
Austin, Texas, United States
UT Soutwestern Medical Center
Dallas, Texas, United States
Pediatric Specialists of Virginia
Fairfax, Virginia, United States
Children's Hospital of the King's Daughters
Norfolk, Virginia, United States
Seattle Children's
Seattle, Washington, United States
Countries
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References
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Kaplan HC, Opipari-Arrigan L, Yang J, Schmid CH, Schuler CL, Saeed SA, Braly KL, Chang F, Murphy L, Dodds CM, Nuding M, Liu H, Pilley S, Stone J, Woodward G, Yokois N, Goyal A, Lee D, Yeh AM, Lee P, Gold BD, Molle-Rios Z, Zwiener RJ, Ali S, Chavannes M, Linville T, Patel A, Ayers T, Bassett M, Boyle B, Palomo P, Verstraete S, Dorsey J, Kaplan JL, Steiner SJ, Nguyen K, Burgis J, Suskind DL; ImproveCareNow Pediatric IBD Learning Health System. Personalized Research on Diet in Ulcerative Colitis and Crohn's Disease: A Series of N-of-1 Diet Trials. Am J Gastroenterol. 2022 Jun 1;117(6):902-917. doi: 10.14309/ajg.0000000000001800. Epub 2022 Apr 20.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
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CIN001-PRODUCE
Identifier Type: -
Identifier Source: org_study_id
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