Effect of a Nutrition Support Formula in Adults With Inflammatory Bowel Disease: A Pilot Study

Abstract

Background: Due to the high prevalence of nutrient deficiencies in patients with inflammatory bowel disease (IBD), routine monitoring of nutrient status and supplementation are recommended. Objective: This preliminary study was implemented to prospectively identify potential effects of a nutrition support formula on blood nutrient parameters in adults with IBD. Methods: Ten adults with Crohn’s disease or ulcerative colitis were recruited from the Portland, Oregon, metropolitan area into a single-arm, open-label pilot study. Participants consumed a nutrition support beverage twice daily for 12 weeks. The formula contained a mixture of micronutrients (including methylated forms of folate and vitamin B12), macronutrients, and phytonutrients (including curcumin, xanthohumol, ginger compounds, and quercetin). Primary measures were the following parameters: folate, vitamin B12, red blood cell (RBC) count, hemoglobin, hematocrit, electrolytes, and albumin. Exploratory measures included a food frequency questionnaire, circulating blood cell counts, and inflammatory markers. Results: Nine participants completed the study and one withdrew. Adherence was 98%. Serum folate increased 48.7% (P =.029), serum vitamin B12 increased 17.4% but did not reach statistical significance (P =.053), and red cell distribution width (RDW) decreased 9.2% (P =.012) over the 12-week study period. There were minimal shifts in total white blood cell (WBC) counts (−1.0%, P =.845), but percent neutrophils decreased 10.4% (P =.042) and absolute lymphocyte count increased 18.6% (P =.048). RBC count, hemoglobin, hematocrit, electrolytes, albumin, and inflammatory markers did not change significantly. Post hoc analysis demonstrated that neutrophil–lymphocyte ratio (NLR) decreased 18.4% (not significant, P =.061). Conclusion: Serum folate and RDW improved in adults with IBD after 12 weeks. Modulation of leukocyte subtypes was also observed, including a decrease in neutrophils and an increase in lymphocytes, with no change in total WBC count. A randomized, controlled study to further examine effects of the nutrition support formula will be initiated to follow up on this promising, but preliminary investigation.