TASTY AND HEALTHY DIET REDUCES FECAL CALPROTECTIN IN HIGH-RISK FIRST-DEGREE RELATIVES OF PATIENTS WITH CROHN'S DISEASE: PIONIR RANDOMIZED CROSSOVER TRIAL
In brief
Tasty&Healthy diet halved an inflammation marker in 71% of high-risk relatives
In this 29-person crossover trial, 71% of high-risk relatives had fecal calprotectin fall by at least half after eight weeks on the Tasty&Healthy diet, compared with 27% on their usual diet. The diet also lowered average calprotectin more overall and was acceptable to most participants, but the trial measured inflammation, not whether diet prevents Crohn's disease.
- Journal
- Gastroenterology (Q1)
- Published
- 26 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Dan Turner, Sarah Kenigsberg, Luba Plotkin, Yonat Aharoni-Frutkoff, Menachem Sokolik, Gili Focht, et al.
- PMID
- 42933673
- DOI
- 10.1053/j.gastro.2026.10.376
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 1 November 2026): Tasty&Healthy diet lowered fecal calprotectin in high‑risk Crohn’s relatives
Abstract
BACKGROUND: With the rising prevalence of inflammatory bowel disease (IBD), preventing new-onset disease becomes a priority. The PIONIR (Preventing IBD ONset in Individuals at Risk) randomized controlled trial explored whether the Tasty&Healthy (T&H) diet reduces inflammatory markers in high-risk first-degree relatives (FDRs) of patients with Crohn's disease (CD). METHODS: FDRs with persistently elevated fecal calprotectin (FC, >70μg/g) and, at most, nonspecific mucosal abnormalities (edema or ≤10 aphthous ulcers) on video-capsule endoscopy or ileocolonoscopy were randomized to T&H or habitual diet (HD) for 8 weeks, followed by crossover for additional 8 weeks. Treatment effect on the primary outcome, FC response, was analyzed using generalized estimating equations for the two-period, two-sequence crossover design, following the intention-to-treat principle. RESULTS: Twenty-nine FDRs were randomized (n=14 T&H-first, n=15 HD-first). At week 8, median FC was lower with T&H (64μg/g [IQR 44-127]) vs. HD (112μg/g [74-227]; P=.022). FC decreased by ≥50% in 71% on T&H versus 27% on HD (RR=2.68 [95%CI 1.09-6.60]; P=.016). Across both crossover periods, estimated marginal mean FC declined from 185μg/g [95%CI 144-237] by 61% to 72μg/g [95%CI 57-91] with T&H, versus 38% to 114μg/g [95%CI 93-140] with HD (ratio 0.63 [95%CI 0.51-0.80], translating to 37% overall decrease with T&H; P<0.001). Six microbial species differed between diets after FDR correction. By week 8, 79% rated T&H acceptable and 83% had good or complete adherence. CONCLUSION: These findings demonstrate the modifiability of low-grade intestinal inflammation in healthy high-risk FDRs with persistent FC elevation but without diagnostic endoscopic evidence of CD, supporting long-term dietary prevention trials (ClinicalTrials.gov #NCT05211518).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.