Dietary composition of adult eosinophilic esophagitis patients is
related to disease severity
Abstract
Background: In addition to the elimination diet, dietary composition may
influence disease severity in patients with Eosinophilic Esophagitis
(EoE) through modulation of the immune response. Aim: To explore the
immunomodulatory role of nutrition before and during elimination diet in
adult EoE patients. Methods: Nutritional intake was assessed in 39 Dutch
adult EoE patients participating in the Supplemental Elemental Trial
(SET) using 3-day food diaries. In this randomized controlled trial,
diagnosed patients received either a four-food elimination diet alone
(FFED) or FFED with addition of an amino acid-based formula for six
weeks. Multiple linear regression analyses were performed to assess
associations between the intake of nutrients and food groups per 1000
kCal and peak eosinophil count/High Power Field (PEC), both at baseline
and after six weeks. Results: At baseline, we found a statistically
significant negative (thus favorable) relationship between the intake of
protein, total fat, phosphorus, zinc, vitamin B12, folate and milk
products and PEC (p<0.05), while calcium (p=0.058) and full
fat cheese/curd (p=0.056) were borderline (favorably) significant. In
contrast, total carbohydrates, prepacked fruit juice and white bread
were significantly positively related to PEC (p<0.05)
(unfavorable), while ultra-processed meals (p=0.059) were borderline
(unfavorably) significant. After dietary intervention, coffee/tea were
significantly negatively (favorably) related to PEC, hummus/legumes were
significantly positively (unfavorably) related with PEC, while peanuts
were borderline significantly positively related (p=0.058). Conclusion:
Dietary composition may be related to inflammation in adult EoE
patients. High quality and anti-inflammatory diets may be a promising
adjuvant therapy in the dietary management of EoE.