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Food Exclusion Based on IgG Antibodies Alleviates Symptoms in Ulcerative Colitis: A Prospective Study.
Jian, L, Anqi, H, Gang, L, Litian, W, Yanyan, X, Mengdi, W, Tong, L
Inflammatory bowel diseases. 2018;24(9):1918-1925
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Plain language summary
Ulcerative Colitis (UC) is a chronic debilitating inflammatory bowel disease that may need lifetime management. Dietary management of UC by eliminating food antigens that may be causing a delayed immune response is one of the approaches used widely to manage the disease. Food intolerance, mediated by immunoglobulin G antibodies in response to food antigens that are otherwise harmless, could be one cause of UC. Low levels of digestive enzymes may result in poor digestion of glucose, amino acids, and glycerol, followed by an immune reaction that leads to food sensitivities. Ninety-seven UC patients were enrolled in this open-label, stratified, prospective, randomised controlled trial to evaluate the effect of an elimination diet versus a sham diet (a normal healthy diet). Following an IgG-specific exclusion diet for six months resulted in the alleviation of UC symptoms and an improvement in health-related quality of life. Further studies are needed to confirm the effectiveness of the exclusion diet since the intervention group did not show a significant reduction in IgG antibody levels. These results can be used by healthcare professionals to understand the potential role of exclusion diets in the management of UC.
Abstract
BACKGROUND Most patients with ulcerative colitis (UC) rely predominantly on medication for disease control. Diet interventions can reduce pharmaceutical expenditures and prolong remission. We designed a prospective study to evaluate whether an immunoglobulin G (IgG)-guided exclusion diet would improve symptoms and quality of life (QoL) in patients with UC. METHODS The 6-month diet intervention included 97 patients with UC, who were randomly divided into an intervention group (n = 49) and a control (n = 48) group. Individual diet plans were created for the intervention group according to IgG titers; the control group ate a healthy diet as normal. Observational indices included disease activity, extraintestinal manifestations, nutritional status, and QoL. Relationships between food-specific IgG antibodies and these indices were also analyzed. RESULTS At baseline, there were no significant differences between the groups. Food-specific IgG antibodies were detected in 70.10% of participants. After intervention, the Mayo score was significantly lower in the intervention group than in the control group (2.41 ± 0.89 vs 3.52 ± 1.15, P < 0.05). The number of patients with extraintestinal manifestations decreased from 7 to 2 in the intervention group and from 6 to 5 in the control group. As for nutritive indices, the intervention group had higher mean body mass index and albumin than the control group (23.88 ± 3.31 vs 21.50 ± 6.24 kg/m2, respectively, P < 0.05; 48.05 ± 6.39 vs 45.72 ± 5.48 g/L, respectively, P < 0.05), whereas prealbumin and transferrin were not significantly different between the groups. QoL improved after food exclusion (P < 0.05). CONCLUSIONS An IgG-guided exclusion diet ameliorated UC symptoms and improved QoL. Interactions between IgG-based food intolerance and UC warrant further study.
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Effects of Quinoa (Chenopodium quinoa Willd.) Consumption on Markers of CVD Risk.
Li, L, Lietz, G, Bal, W, Watson, A, Morfey, B, Seal, C
Nutrients. 2018;10(6)
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Heart disease is the number one cause of death across the world. A diet high in wholegrains is often recommended as part of a heart-healthy diet, but quinoa has been less well studied in comparison to other wholegrains. The aim of this randomised, controlled, cross-over study was to evaluate the effect of daily consumption of quinoa on markers of heart disease risk. 37 healthy overweight men took part in the study. Half the group was given bread enriched with 20g of quinoa flour, whilst the other half was given bread made from 100% refined wheat flour, for 4 weeks. The groups then switched over. At the end of the study, those eating the quinoa-enriched bread saw a significant drop in blood glucose compared to the start of the study. However, there were no differences between the groups for body weight, blood pressure, blood glucose, cholesterol or inflammation. The researchers concluded that daily consumption of quinoa appears to improve blood glucose response, but has minimal effects on other markers of heart disease.
Abstract
A number of epidemiological studies have suggested that diets rich in whole grains are linked to lower cardiovascular disease (CVD) risk and mortality. Quinoa, a pseudo-cereal, is included in the “whole grain” category but the effects of quinoa consumption in humans is not widely studied. Our aim was to undertake a dietary intervention study to investigate the effects of daily consumption of quinoa-enriched bread (providing 20 g quinoa flour) on CVD risk markers compared with a 100% refined wheat bread control. Thirty-seven healthy overweight men (35⁻70 years, body mass index >25 kg/m²) completed a 4-week cross-over intervention, separated by a 4-week washout period. Fasting blood samples were collected at the beginning and end of each intervention period. Continuous glucose monitoring was undertaken at the end of each intervention period. After 4 weeks of intervention, blood glucose and low density lipoprotein (LDL) cholesterol were significantly lower than baseline in both groups but there was no difference between quinoa and control. Anthropometric measures and other blood metabolites were not different between the two treatments. The cumulative area under the blood glucose curve for the last 4 days of the quinoa intervention tended to be lower than the first 4 days of wash-out (p = 0.054), and was significantly lower than the corresponding period of the wheat treatment (p = 0.039). In conclusion, daily consumption of quinoa in this short-term intervention appears to modify glucose response, but has minimal effects on other CVD risk biomarkers.
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Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial.
Alpay, K, Ertas, M, Orhan, EK, Ustay, DK, Lieners, C, Baykan, B
Cephalalgia : an international journal of headache. 2010;30(7):829-37
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Migraine is a chronic neurological condition characterised by a multifactorial aetiology, with genetic susceptibility playing a significant role in its development. Some researchers believe the development of migraine may also be related to IgG-mediated food intolerances and IgE-mediated food allergies. This randomised, controlled, double-blinded, cross-over clinical trial assessed the effect of an IgG antibody-based elimination diet against two hundred and sixty-six food antigens in thirty migraineurs. During the baseline, each participant was tested for IgG antibody levels in response to specific food antigens in order to receive a tailored elimination diet. The results of this study showed a statistically significant reduction in the number of headache days and the number of migraine attacks during the elimination diet phase, in comparison to the baseline in migraineurs. However, additional larger scale, robust studies are required in order to confirm the efficacy of the IgG-specific elimination diets in the treatment of migraine. In terms of migraine management, the results of this study can be of assistance to health care professionals who would like to understand the potential of diet restrictions based on IgG antibodies.
Abstract
INTRODUCTION It is well-known that specific foods trigger migraine attacks in some patients. We aimed to investigate the effect of diet restriction, based on IgG antibodies against food antigens on the course of migraine attacks in this randomised, double blind, cross-over, headache-diary based trial on 30 patients diagnosed with migraine without aura. METHODS Following a 6-week baseline, IgG antibodies against 266 food antigens were detected by ELISA. Then, the patients were randomised to a 6-week diet either excluding or including specific foods with raised IgG antibodies, individually. Following a 2-week diet-free interval after the first diet period, the same patients were given the opposite 6-week diet (provocation diet following elimination diet or vice versa). Patients and their physicians were blinded to IgG test results and the type of diet (provocation or elimination). Primary parameters were number of headache days and migraine attack count. Of 30 patients, 28 were female and 2 were male, aged 19-52 years (mean, 35 +/- 10 years). RESULTS The average count of reactions with abnormally high titre was 24 +/- 11 against 266 foods. Compared to baseline, there was a statistically significant reduction in the number of headache days (from 10.5 +/- 4.4 to 7.5 +/- 3.7; P < 0.001) and number of migraine attacks (from 9.0 +/- 4.4 to 6.2 +/- 3.8; P < 0.001) in the elimination diet period. CONCLUSION This is the first randomised, cross-over study in migraineurs, showing that diet restriction based on IgG antibodies is an effective strategy in reducing the frequency of migraine attacks.