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Dietary composition of adult eosinophilic esophagitis patients is related to disease severity
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  • Simone Eussen,
  • Sanne Wielders,
  • Willemijn de Rooij,
  • Marleen van Ampting,
  • Betty Van Esch,
  • Jeanne de Vries,
  • Albert J. Bredenoord,
  • Berber Vlieg-Boerstra
Simone Eussen
Danone Nutricia Research
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Sanne Wielders
Wageningen University & Research Division of Human Nutrition and Health
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Willemijn de Rooij
Department of Gastroenterology & Hepatology, Amsterdam University Medical Center
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Marleen van Ampting
Danone Nutricia Research
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Betty Van Esch
Danone Nutricia Research
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Jeanne de Vries
Wageningen University
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Albert J. Bredenoord
Department of Gastroenterology & Hepatology, Amsterdam University Medical Center
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Berber Vlieg-Boerstra
OLVG

Corresponding Author:[email protected]

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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.
20 Oct 2023Submitted to Immunity, Inflammation and Disease
19 Nov 2023Assigned to Editor
19 Nov 2023Submission Checks Completed
19 Nov 2023Review(s) Completed, Editorial Evaluation Pending
21 Nov 2023Reviewer(s) Assigned