P805 Adherence to Mediterranean diet is associated with decreased faecal calprotectin in patients after pouch surgery. (16th January 2018) - Godny, L
Abstract: Background: Mediterranean diet (MED) is associated with health benefits in several chronic diseases, yet scarce data exist regarding the role of MED in inflammatory bowel diseases (IBD). Here we aimed to evaluate the association between MED and clinical, inflammatory and microbial parameters in patients with IBD after pouch surgery. Methods: Consecutive patients after pouch surgery were recruited at a comprehensive pouch clinic. Diet was assessed using validated food frequency questionnaires. Adherence to MED was calculated according to MED score, ranging from 0 (low adherence) to 9 (high adherence). Pouch behaviour was assessed clinically and defined as normal pouch or pouchitis based on Pouchitis Disease Activity Index (PDAI). Blood and fecal samples were collected and assessed for C- reactive protein (CRP), fecal calprotectin and microbial composition using 16S rRNA pyro-sequencing. Results: We recruited 153 patients (male gender: 47%; mean age: 45.9 ± 14 years; mean pouch age:9.5 ± 7 years). Of those 54 (35.3%) had a normal pouch and 99 (64.7%) had pouchitis. There was no significant difference in MED score in patients with normal pouch compared with patients with pouchitis (4.56 ± 1.8 vs. 4.41 ± 1.7, p = 0.63). MED score was comparable in patients with CRP <5 mg/l compared with patients with elevated CRP (4.6 ± 1.8 vs.4.4 ± 1.6, p = 0.28). However, patients with fecal calprotectin < 200 μg/g had significantly higher MED score compared with patients with elevated fecal calprotectin (4.8 ± 1.8 vs. 4.07 ± 1.7, p = 0.02). Microbial analysis indicated that patients who highly adhered to MED (MED score >5) had higher abundance of the genera: Streptococcus, Clostridium and SMB53 . Conclusions: Adherence to MED is associated with decreased fecal calprotectin and with changes in microbial composition in patients with IBD after pouch surgery, thus MED may have a role in modifying inflammation in IBD. Interventional studies testing this hypothesis are ongoing.