Effect of a vegetable-protein-rich polymeric diet treatment on body composition and energy metabolism in inactive Crohn's disease

Objective Since malnutrition and lactose intolerance are frequently reported in Crohn's disease (CD), we evaluated the differences in terms of compliance-to-treatment and nutritional status in inactive CD patients after two different treatments using either a standard polymeric diet or a vegetable-protein-rich and lactose-free diet. Study design A case-control study. Subjects Forty CD patients with inactive disease were randomly divided into two groups. Group A (10 men; aged 33.9 +/- 7.2 years; BMI, 21.8 +/- 1.7 kg/m(2)) received a conventional polymeric enteral diet, while group B (10 men; aged 35.6 +/- 6.8 years; BMI, 21.4 +/- 1.8 kg/m(2)) was administered a soy-rich and lactose-free polymeric diet, over a 4-week period. Methods All the patients had a clinical and laboratory examination. Body composition was assessed by isotopic dilution and resting metabolic rate (RMR), and substrate oxidation rates were measured by indirect calorimetry. Results Body weight significantly increased after treatment in both groups (A, P < 0.05; and B, P < 0.01), as well as fat-free mass (A, P < 0.05; and B, P < 0.05) and fat mass (A, P < 0.05; and B, P < 0.01). RMR slightly increased, although it did not reach statistical significance. Treatment did not influence substrate oxidation rates. Group B lactose-intolerant patients reported a greater compliance-to-treatment than those in group A. Conclusions This study showed that a polymeric enteral diet rich in vegetable protein and not containing milk protein, eaten at home, with no need for positioning a nasogastric tube, significantly improved body composition in inactive and lactose-intolerant CD patients, with no effect on energy metabolism, suggesting that it could be useful in improving nutritional status in these patients. (C) 2000 Lippincott Williams & Wilkins.