I know YOU know how much diet matters in IBD—we see it firsthand with our patients and in the growing body of research.
Now, we have even more evidence supporting the role of nutrition in managing both symptoms and inflammation in Crohn’s disease.
Two new studies presented at the 20th Congress of ECCO 2025 (an international IBD scientific conference) reinforce what many of us already recommend—reducing emulsifiers and ultra-processed foods (UPFs) is key for IBD patients.
The ADDapt trial looked at the impact of emulsifiers on disease activity, whereas the TASTI-MM trial explored a whole foods diet as a more desirable alternative to exclusive enteral nutrition (EEN) for treating Crohn’s disease.
🔬 The ADDapt Trial: Cutting Emulsifiers for Better Outcomes (King’s College London)
Study Focus: This randomized controlled trial explored the effects of a low emulsifier diet on disease activity in patients with mild-to-moderately active Crohn’s disease.
Study Design:
- Participants followed either an emulsifier-free diet or the same diet supplemented with emulsifiers (carrageenan, carboxymethylcellulose, and polysorbate-80) for 8 weeks.
📌 Key Findings:
- Patients who avoided emulsifiers experienced greater symptom response, clinical remission rates, and >50% reduction in fecal calprotectin (a gut-specific inflammatory marker).
- Patients who ate snacks supplemented with emulsifiers did not see the same benefits.
👉 Previous studies have linked emulsifiers to gut inflammation, dysbiosis, and increased intestinal permeability—potential mechanisms that may explain these findings.
🥗 The TASTI-MM Trial: A Whole-Food Approach to Crohn’s Disease
Study Focus: Is a whole-food, exclusion-based diet as tolerable and effective as EEN for inducing remission in Crohn’s disease?
Study Design:
- Participants aged 6-25 years with mild-to-moderate Crohn’s disease were randomized to follow a whole-food, exclusion-based diet (avoiding red meat, processed foods, most dairy, and gluten) or EEN for 8 weeks.
📌 Key Findings:
- The whole-food diet was comparable to EEN for inducing symptomatic remission and reducing markers of inflammation (CRP, ESR, and fecal calprotectin).
- This approach was better tolerated than EEN and didn’t require any formula, such as the Crohn’s Disease Exclusion Diet (CDED), which has been most extensively studied in combination with partial enteral nutrition.
👉 Compared to EEN, this diet may be a more flexible and appealing dietary therapy for some individuals with Crohn’s disease.
🔑 Key Takeaways
Both studies reinforce what many of us already see in practice—diet plays a key role in IBD management.
While we always have more to learn, this research continues to support our recommendation to reduce ultra-processed foods and food additives for better outcomes.
For now, two practical takeaways could be:
✅ Focus on whole, minimally processed foods. This naturally eliminates added emulsifiers.
✅ For Crohn’s patients seeking guidance on a therapeutic diet, starting with a short-term elimination of red meat, gluten, ultra-processed foods, and most dairy may be a reasonable approach—one that has helped many of my patients even before this study. Just as important: focus on what to eat and make it enjoyable!
