The role of a low emulsifier diet in treating Crohn’s disease - Study 2

Study 2 in patients with mild Crohn's disease - subjects will be randomised to either a low emulsifier diet, hypothesised to treat disease activity, or a controlled diet for 4 weeks. The controlled diet will be either the subjects' usual diet or a high emulsifier diet. The high emulsifier diet is matched nutritionally, but will use foods that contain emulsifiers. For example, two commercially available wholemeal breads that do and do not already contain emulsifiers will be provided during the dietary interventions. Unfortunately, quantification of emulsifiers in food is not possible, so 'high' and 'low' emulsifier diets will describe foods that have identifiable sources of emulsifiers or not. The choice of controlled diet will depend on the results of Study 1 (UTN - U1111-1235-0246). A low emulsifier diet is developed by the researchers at The Alfred and based on knowledge of natural emulsifiers in addition to identified additive emulsifiers on packaged food. Researchers at The Alfred have a database of commercially available packaged food and their ingredients lists, which identify presence or absence of emulsifiers. Unfortunately, quantification of emulsifiers in food is not possible, so a low emulsifier diet describes foods that have no identifiable sources of emulsifiers on ingredients lists. Research dietitians will be recruiting and arranging all food for the intervention is provided to participants. The diets will comprise of food cooked, individually portioned, vacuum-packed and frozen by our research chef. Examples of meals may include a risotto or pasta dish. All food is readily available in supermarkets and already consumed by community. Adherence will be based on food diaries provided to participants and any returned food. If Study 1 indicates that a high emulsifier diet induces intestinal inflammation above baseline, the subjects' usual diet will be used as the controlled diet.