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Food Elimination Diets Compared in Eosinophilic Esophagitis

Histological remission rates similar with one-, six-food elimination diets for adults with eosinophilic esophagitis

By Elana Gotkine HealthDay Reporter

FRIDAY, March 17, 2023 (HealthDay News) — For adults with eosinophilic esophagitis, histological remission rates are similar with the six-food elimination diet (6FED) and a one-food elimination diet (1FED), according to a study published online Feb. 27 in The Lancet Gastroenterology & Hepatology.

Kara L. Kliewer, Ph.D., from the University of Cincinnati College of Medicine, and colleagues compared a 6FED (animal milk, wheat, egg, soy, fish and shellfish, and peanut and tree nuts) with a 1FED (animal milk) for treatment of adults aged 18 to 60 years with eosinophilic esophagitis in a multicenter, randomized trial. The proportion of patients with histological remission was examined as the primary end point.

A total of 129 patients were enrolled and randomly assigned to a 1FED or 6FED (67 and 62, respectively). The researchers found that 40 and 34 percent of patients in the 6FED and 1FED groups had histological remission, respectively (difference, 6 percent). No significant difference was seen between the groups at stricter thresholds for partial remission, but the proportion with complete remission was significantly higher for those in the 6FED group versus the 1FED group (difference, 13 percent). Both groups experienced decreases in peak eosinophil counts. Small and similar changes in quality-of-life scores were seen between the groups. Nine of 21 patients (43 percent) without histological response to a 1FED who proceeded to the 6FED reached histological remission.

“Our study indicates that the elimination of food and beverages containing animal milk might be an acceptable initial dietary treatment choice, especially if a step-up dietary strategy is being used,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical technology industries.

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