AJG

INSIDE THE JOURNALS WEIGHING THE BENEFITS OF

THE MEDITERRANEAN DIET

The American Journal of Gastroenterology published two studies in the second half of 2017 which explore the potential health benefits of adherence to a Mediterranean diet (Med-diet).

Prior to the first-published study, while diet and lifestyle were known factors in gallstone disease, there was no prospective study that analyzed diet and cholecystectomy risk. In a populationbased, prospective study of more than 64,000 French women and nearly 2,800 cholecystectomy cases, adhering to a diet rich in olive oil, legumes, fruits and vegetables was associated with reduced cholecystectomy risk.

 READ MORE Diet and Risk of Cholecystectomy: A Prospective Study Based on the French E3N Cohort Barré, et al.

Am J Gastroenterol 2017;112:1448–1456. doi: 10.1038/ajg.2017.216.

Read the full article: bit.ly/Med-Diet1

The second paper, published online October 24, looked into the relationship between the Med-diet and non-alcoholic fatty liver disease (NAFLD). As with cardiometabolic disorders more broadly, the prevalence of NAFLD is increasing in Western countries. Although the Meddiet is effective in preventing certain cardiometabolic disorders, investigation was needed to determine the Meddiet’s relationship with NAFLD. The study determined that “adherence to [Mediterranean diet] is associated with a lower prevalence of NALFD in patients with cardiometabolic disorders,” among other findings.

 READ MORE Adherence to Mediterranean Diet and Non-Alcoholic Fatty Liver Disease: Effect on Insulin Resistance Baratta, et al.

Am J Gastroenterol 2017;112(12):1832–1839. doi:10.1038/ajg.2017.371.

TABLE 4

TABLE 6

TABLE 3

LIVING ON LIQUIDS

GI dietitian Kelly Issokson says the primary question patients ask her is “How can I use diet to help my IBD?” To answer that question, Issokson often recommends Exclusive Enteral Nutrition (EEN), a formula-based diet, to patients with Crohn’s disease.

While Issokson does not have IBD, she underwent a 30-day EEN trial to increase awareness of EEN and to gain greater perspective on patients’ challenges with the diet.

In the October 2017 Red Journal, Issokson reflects on her EEN trial: the foreseen and unforeseen emotional and physical challenges, the acclimation process, and even the perks of the diet. She makes the following recommendations in “Living on Liquids: Surviving and Thriving on Exclusive Enteral Nutrition.”  READ MORE Read the full article: bit.ly/LivingOnLiquids Kelly Issokson MS, RD, CNSC, Cedars-Sinai Medical Center, Los Angeles, CA

ESTABLISH CLEAR EXPECTATIONS

Discuss the duration of therapy, time frames for remission, expected symptoms, and what to do in case of weight loss or lack of response to EEN—these are all key to shared decision-making.

PROVIDE SUPPORT

A drastic diet change is scary, and support can make the difference between EEN success and failure. Dietitians help support patients through their EEN and ensure they are getting enough nutrition for healing and weight maintenance.

BE ENTHUSIASTIC Using EEN to induce remission is a low-risk and safe therapy that allows patients more control over their disease. This is cool!

REINTRODUCE FOOD SLOWLY Remind your patients that solids require more digestive effort than liquids and the body needs time to acclimate. Lower-fiber and lower-fat foods may be tolerated best initially.

CELEBRATE ACHIEVEMENTS Every day on EEN is an accomplishment. At the end of the EEN trial, splurge on something fun with all the money saved from not buying food.

LISTEN TO THE PODCAST Listen to Kelly Issokson’s conversation with AJG Co-Editor-in-Chief Brennan M. R. Spiegel, MD, MSHS, FACG.

LISTEN HERE: gi.org/ajgpodcasts