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Moderate Dietary Temperance Effectively Prevents Relapse of Crohn Disease: A Prospective Study of Patients in Remission

Tanaka, Makoto PhD, RN, PHN; Iwao, Yasushi PhD, MD; Sasaki, Satoshi PhD, MD; Okamoto, Susumu PhD, MD; Ogata, Haruhiko PhD, MD; Hibi, Toshifumi PhD, MD; Kazuma, Keiko PhD, RN, PHN

doi: 10.1097/01.SGA.0000278169.35930.f8
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The authors examined the influence of diet (dietary fat intake and dietary temperance) on relapse of patients with Crohn disease. A 1-year prospective study of 76 patients with Crohn disease was conducted. The criterion for eligibility was a Crohn Disease Activity Index score of 150 or lower for at least 1 month. The primary end point was defined as the relapse-free interval from the baseline until the first relapse. Fat intake was assessed using a validated diet history questionnaire. The degree of dietary temperance was assessed using a single-item nominal scale. The Cox proportional hazards model was used to evaluate the influence of diet. Crohn disease relapse was seen in 25 patients (33%), and 47 patients (62%) remained in continuous remission. A decreased ratio of n-6 polyunsaturated fatty acid (PUFA) to n-3PUFA (odds ratio = .38; p = .005) was associated with a poor prognosis. Dietary temperance also was significantly associated with prognosis (p = .014). More moderate dietary temperance decreased the risk of relapse (odds ratio = .22; p = .006). Effective prevention of relapse for Crohn disease patients might be achieved through moderate dietary temperance, particularly when the disease condition is unstable.

Makoto Tanaka, PhD, RN, PHN, is Research Associate, Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Yasushi Iwao, PhD, MD, is Lecturer, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Satoshi Sasaki, PhD, MD, is Project Leader of Scientific Evaluation of Dietary Reference Intakes, National Institute of Health and Nutrition, Tokyo, Japan.

Susumu Okamoto, PhD, MD, is Lecturer, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Haruhiko Ogata, PhD, MD, is Lecturer, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Toshifumi Hibi, PhD, MD, is Professor, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Keiko Kazuma, PhD, RN, PHN, is Professor, Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Correspondence to: Makoto Tanaka, PhD, RN, PHN, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan (e-mail: hmakoto-tky@umin.ac.jp).

Received July 20, 2006; accepted November 6, 2006.

© The Society of Gastroenterology Nurses & Associates 2007. All Rights Reserved.