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Crohn’s Disease Exclusion Diet
The Crohn’s Disease Exclusion Diet (CDED) is a new generation of nutritional therapy—in its initial stages, aimed at inducing remission, it involves a combination of partial enteral nutrition (PEN) with selected natural diet products. The primary mechanism of action is to exclude or limit exposure to dietary factors with potentially deleterious effects on the pathogenesis and course of CD.
by influencing the activity of immune cells and their migration to the site of inflammation, they exhibit anti-inflammatory effects;
by nourishing colonocytes, providing them with a primary source of energy;
by reducing the pH in the intestine, positively influencing the composition of the intestinal microbiota (stimulating the growth of beneficial strains of bacteria and inhibiting the growth of pathogenic bacteria).
2. CDED—Protocol and Mechanism of Action
|Natural Products—Exclusion or Controlled Exposure||Food Additives—Exclusion|
|Mandatory Foods (Stages 1 and 2)|
|A balanced diet—source of complete protein with low taurine content||Additional benefits—sources of water-soluble dietary fibre (pectins) and resistant starch|
|Group of foods||allowed in stage 1
|Additionally allowed in stage 1 (weeks 1—6) ***|
|Cereals||white rice, rice flour and rice pasta (in unlimited amounts)||- quinoa (in unlimited amounts)
- sweet potato (½ can replace 1 potato, once a day)
- oatmeal—½ cup 1—2 times a week (can be used to make oatmeal or oatmeal cookies)
- one slice of whole-grain bread/day (without yeast)
|Meat/fish/eggs||instead of chicken breast, a serving of lean white fish once a week.||- fresh lean beef (lean meat i.e., sirloin) can be eaten once a week instead of chicken breast
- a serving of tuna in canola oil or olive oil once a week
|Vegetables||- 2 tomatoes or 6 cherry tomatoes
- 2 peeled cucumbers
- 1 young carrot
- fresh spinach (a cup once a day)
- lettuce leaves (3 per day)
- avocado (1 a day; max. ½/meal)
|gradual introduction of new vegetables:
- initially those containing lower amounts of dietary fibre (e.g., 1 small zucchini, 2 broccoli or cauliflower florets)
- starting from week 10 other vegetables can br introduced (except for cabbage, leak, asparagus, artichoke and celery)—e.g., ½ of sweet red bell pepper, beet
|Fruits||- strawberries (several a day)
- a slice of melon
|gradual introduction of new fruit:
in weeks 7–9 1 pear, peach or kiwi/a day can be eaten—instead of a serving of strawberries, 10 bilberries (or a cup) can be eaten
- form week 10 other fruits can be introduced (which contain more fibre), but in limited quantities—i.e.,
½ cup of mango, pineapple cubes or orange slices (except for passion fruit, pomegranate, cactus, kaki)
|Fats||- olive oil
- canola oil
|- honey (3 teaspoons a day) or
- sugar (4 teaspoons a day)
|other||- legumes (lentils, chickpeas, beans, peas)—½ cup dry seeds a day)
- almonds or walnuts (unsalted, unroasted, unprocessed)—8 pieces a day
- tahini (without emulsifying agents and sulphites)—2 spoons a day
|fluids||- water (slices of lemon, lime, orange or mint leaves can be added to taste)
- herbal teas (preferable from fresh leaves)
- 1 glass of freshly squeezed orange juice
|Spices||-salt, pepper, paprika, cinnamon, cumin, turmeric
- fresh herbs i.e.: mint, oregano, cilantro, rosemary, sage, basil, thyme, dill, parsley
- other spices: onion, garlic, ginger, fresh lemon juice
mandatory, i.e., recommended for daily consumption. Their role is to provide adequate nutritional value of the diet as well as substrates for the production of SCFA;
neutral, which are supposed to add variety to the daily menu, but do not necessarily have to be consumed.
|Foods Allowed 5 Days a Week *||Examples of Products Allowed 2 Days a Week **|
|Examples of Foods That Can Be Consumed for Breakfast:||Examples of Foods That Can Be Consumed for Lunch (Dinner):|
|- other parts of chicken (except for skin or giblets)
- fresh seafood, salmon (once a week)—1 serving of unprocessed, full-fat natural yoghurt (without additives) a day
- 2 slices of whole-grain bread (without yeast), or 1 serving of pasta a day
- all vegetables except for leak, celery stalks and large amounts of kale
- all fruits (including dried fruits, without sulphites) except for passion fruit, pomegranate, cactus, kaki
- 1 cup of black coffee (not instant) or tea
|- any kind of bread
- milk, cheese
- 1 bowl of cereal with milk
|- steaks, burgers, pork, seafood, fish, i.e., salmon and tuna,
- any type of pasta
- dairy products, including cheese
- 1 serving of home-made dessert (e.g., cake) or one scoop of ice-cream
- cocoa/dark chocolate
|- or 1 meal eaten out instead of unrestricted meals prepared at home|
The entry is from 10.3390/jcm10143027
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