P0951 An Exclusive Whole-Food Tasty&Healthy Diet Induces Endoscopic and Radiological Healing in Crohn’s Disease When Used as Maintenance Treatment: Results from the MyTasty Clinical Trial

Background

Tasty&Healthy (T&H) is a whole food diet shown to induce clinical and biological remission in Crohn’s disease (CD)(1). It eliminates processed foods, gluten, red meat, and dairy (except plain yogurt); no formula or mandatory components are needed. Here we aimed to evaluate whether T&H diet maintenance treatment induces radiologic and endoscopic remission while gradually reintroducing gluten and dairy.

Methods

Patients, aged 4–37 years, achieving deep remission (MINI index<8 and wPCDAI<12.5/CDAI<150) in the previous TASTI-MM (T&H vs. EEN) and TASTI-E (T&H vs. regular diet) induction RCTs, were enrolled in this open-label maintenance trial and completed 24 weeks on the diet. Gluten and dairy were reintroduced monthly; >30% increase in fecal calprotectin prompted re-elimination of the specific ingredient. Intestinal Ultrasound with Segmental Activity Scoring (IUS-SAS) was performed at weeks 0, 8 and 24 and, in a subset who consented, video capsule-endoscopy (VCE) or ileocolonoscopy at week 24.

Results

Forty-three patients were enrolled: age 16±5.8 years, 33 children/adolescents; 91% not receiving any therapy besides T&H. Clinical remission at 24 weeks was maintained in 37/43 (86%) participants; 53% successfully re-introduced gluten and dairy. All IUS parameters improved from baseline to weeks 8 and 24 ( including the maximal bowel score (IBUS-SAS 44.9 [IQR 2.1-64.9], 14 [0-48.5], 13.6 [0-34,6]; p = 0.0068) and in the terminal ileum (43 [IQR 0-64.8], 14 [0- 47.5], 5 [0-31], respectively; p = 0.0069). Among 29 patients with paired IUS assessments at baseline and week 24, 86% showed improvement or normalization of the ileal IBUS-SAS score, and 83% (24/29) demonstrated improvement in both the maximal and panenteric cumulative scores. Of the 23 patients who underwent VCE/ileocolonoscopy, 14 (61%) exhibited complete endoscopic healing or had only a few aphthous ulcers.

Conclusion

The T&H diet, combined with structured, calprotectin-guided reintroduction of gluten and dairy, maintained clinical remission and improved radiological and endoscopic inflammation in patients up to 24 weeks.

‍

‍