Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study

ABSTRACT Background and Aim A high‐fiber, low‐animal‐protein, and low‐saturated‐fat diet may modulate gut dysbiosis and benefit inflammatory bowel disease (IBD). This study investigated the effects of this diet on clinical relapses, fecal calprotectin, and gut microbiota in patients with clinically...

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Main Authors: Julajak Limsrivilai, Phalat Sathirawich, Onuma Sattayalertyanyong, Pornpoj Pramyothin, Iyarit Thaipisuttikul, Nonthalee Pausawasdi, Phunchai Charatcharoenwitthaya, Rungnapha Sarasak, Perapon Nitayanon, Phutthaphorn Phaophu, Nichcha Subdee, Sathaporn Manatsathit
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.70219
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author Julajak Limsrivilai
Phalat Sathirawich
Onuma Sattayalertyanyong
Pornpoj Pramyothin
Iyarit Thaipisuttikul
Nonthalee Pausawasdi
Phunchai Charatcharoenwitthaya
Rungnapha Sarasak
Perapon Nitayanon
Phutthaphorn Phaophu
Nichcha Subdee
Sathaporn Manatsathit
author_facet Julajak Limsrivilai
Phalat Sathirawich
Onuma Sattayalertyanyong
Pornpoj Pramyothin
Iyarit Thaipisuttikul
Nonthalee Pausawasdi
Phunchai Charatcharoenwitthaya
Rungnapha Sarasak
Perapon Nitayanon
Phutthaphorn Phaophu
Nichcha Subdee
Sathaporn Manatsathit
author_sort Julajak Limsrivilai
collection DOAJ
description ABSTRACT Background and Aim A high‐fiber, low‐animal‐protein, and low‐saturated‐fat diet may modulate gut dysbiosis and benefit inflammatory bowel disease (IBD). This study investigated the effects of this diet on clinical relapses, fecal calprotectin, and gut microbiota in patients with clinically quiescent IBD. Methods Sixty‐one patients with IBD were enrolled (23 Crohn's disease and 38 ulcerative colitis). All patients were in clinical remission and had maintained unchanged treatment for at least 2 months. They were advised to increase fiber intake and decrease animal protein and saturated fat consumption. Assessments were performed at baseline, week 6, and every 12 weeks until flare or study completion at 54 weeks. Fecal calprotectin and microbiota were analyzed at baseline and upon study completion. The effect of each dietary component on outcomes was analyzed separately. Results The cumulative flare rate was 22.6%. Increased fiber intake was significantly associated with a lower incidence of clinical flares. Flare rates were 12.6%, 20.5%, and 46.5% in the increased, unchanged, and decreased fiber intake groups, respectively, with significant differences between the increased and decreased groups (p = 0.03). Fecal calprotectin, however, was not significantly different in those who increased fiber intake compared to those who did not. Microbiota analysis showed a significant increase in the Clostridia class in the increased fiber intake group. Conclusions Increasing dietary fiber increased Clostridia class bacteria and was associated with a longer time to flare in patients with clinically quiescent IBD.
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spelling doaj-art-995f0b7a69494d1f9190f25ddf749b3c2025-08-20T02:45:50ZengWileyJGH Open2397-90702025-07-0197n/an/a10.1002/jgh3.70219Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal StudyJulajak Limsrivilai0Phalat Sathirawich1Onuma Sattayalertyanyong2Pornpoj Pramyothin3Iyarit Thaipisuttikul4Nonthalee Pausawasdi5Phunchai Charatcharoenwitthaya6Rungnapha Sarasak7Perapon Nitayanon8Phutthaphorn Phaophu9Nichcha Subdee10Sathaporn Manatsathit11Division of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Nutrition, Department of Internal Medicine Siriraj Hospital ThailandDepartment of Microbiology Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Nutrition, Department of Internal Medicine Siriraj Hospital ThailandDepartment of Microbiology Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandDivision of Gastroenterology, Department of Internal Medicine Siriraj Hospital ThailandABSTRACT Background and Aim A high‐fiber, low‐animal‐protein, and low‐saturated‐fat diet may modulate gut dysbiosis and benefit inflammatory bowel disease (IBD). This study investigated the effects of this diet on clinical relapses, fecal calprotectin, and gut microbiota in patients with clinically quiescent IBD. Methods Sixty‐one patients with IBD were enrolled (23 Crohn's disease and 38 ulcerative colitis). All patients were in clinical remission and had maintained unchanged treatment for at least 2 months. They were advised to increase fiber intake and decrease animal protein and saturated fat consumption. Assessments were performed at baseline, week 6, and every 12 weeks until flare or study completion at 54 weeks. Fecal calprotectin and microbiota were analyzed at baseline and upon study completion. The effect of each dietary component on outcomes was analyzed separately. Results The cumulative flare rate was 22.6%. Increased fiber intake was significantly associated with a lower incidence of clinical flares. Flare rates were 12.6%, 20.5%, and 46.5% in the increased, unchanged, and decreased fiber intake groups, respectively, with significant differences between the increased and decreased groups (p = 0.03). Fecal calprotectin, however, was not significantly different in those who increased fiber intake compared to those who did not. Microbiota analysis showed a significant increase in the Clostridia class in the increased fiber intake group. Conclusions Increasing dietary fiber increased Clostridia class bacteria and was associated with a longer time to flare in patients with clinically quiescent IBD.https://doi.org/10.1002/jgh3.70219fibersinflammatory bowel diseasemicrobiota
spellingShingle Julajak Limsrivilai
Phalat Sathirawich
Onuma Sattayalertyanyong
Pornpoj Pramyothin
Iyarit Thaipisuttikul
Nonthalee Pausawasdi
Phunchai Charatcharoenwitthaya
Rungnapha Sarasak
Perapon Nitayanon
Phutthaphorn Phaophu
Nichcha Subdee
Sathaporn Manatsathit
Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
JGH Open
fibers
inflammatory bowel disease
microbiota
title Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
title_full Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
title_fullStr Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
title_full_unstemmed Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
title_short Increased Fiber Intake Enhances Clostridia Bacteria and Reduces Clinical Relapse in Patients With Clinically Quiescent Inflammatory Bowel Disease: A Prospective Longitudinal Study
title_sort increased fiber intake enhances clostridia bacteria and reduces clinical relapse in patients with clinically quiescent inflammatory bowel disease a prospective longitudinal study
topic fibers
inflammatory bowel disease
microbiota
url https://doi.org/10.1002/jgh3.70219
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