Crohn’s disease, a chronic inflammatory condition affecting the digestive tract, has no cure, but dietary interventions can significantly reduce symptoms. Among these is the Crohn’s Disease Exclusion Diet (CDED), a structured eating plan combining whole foods with supplemental liquid nutrition. This diet aims to address both the immediate discomfort and the underlying inflammation that drives the disease.
How the CDED Works
The CDED focuses on removing foods common in Western diets that contribute to gut inflammation. By doing so, it seeks to rebalance the gut microbiome – the vast community of bacteria and other microbes within the digestive system – and strengthen the intestinal barrier. A healthy gut lining is crucial for proper nutrient absorption and immune function.
According to Laura Manning, RD, a clinical nutrition manager at Mount Sinai Hospital, “The CDED combines the benefits of liquid nutrition with anti-inflammatory foods, providing optimal fuel for beneficial gut bacteria. When the microbiome shifts towards a healthier balance, inflammation decreases.”
Who Can Benefit from CDED?
The diet is most often used in children and adults with mild to moderate Crohn’s disease, particularly during active flares. Studies show that when paired with partial enteral nutrition (PEN) – nutritional shakes – CDED can induce remission in 55–77% of participants.
For children, the CDED offers an alternative to harsher medications like steroids or restrictive liquid-only diets. It helps them absorb nutrients for healthy growth and development. Research suggests the CDED with PEN is better tolerated than a purely liquid diet while achieving similar remission rates within six weeks. Importantly, studies indicate the effects can be sustained long-term.
While data on adults are less extensive, preliminary studies show similar efficacy, with remission rates of 68–69% in small trials. Larger, randomized controlled trials are underway to confirm these findings.
Implementing the CDED: Structure and Phases
The CDED follows a three-phase structure:
- Restriction (6 weeks): Eliminating inflammatory foods to reduce gut stress.
- Reintroduction (6 weeks): Gradually adding foods back in to identify triggers.
- Maintenance: A less restrictive long-term plan based on individual tolerance.
Important Considerations
Because of its restrictive nature, the CDED should be implemented under the guidance of a registered dietitian and a gastroenterologist. The diet’s strict structure could, in some cases, contribute to disordered eating behaviors.
Brittany Rogers, RDN, stresses the importance of professional support: “The CDED is structured but allows for flexibility. It’s essential to work with experts and practice self-compassion throughout the process.”
In conclusion, the Crohn’s Disease Exclusion Diet offers a promising nutritional approach for managing mild to moderate Crohn’s disease. By balancing whole foods with liquid nutrition, it addresses inflammation, restores gut health, and may induce remission. However, professional guidance is crucial for safe and effective implementation.
