Crohn's Disease Exclusion Diet

The CDED is a whole foods diet designed to exclude or limit exposure to foods that may adversely affect the microbiome or alter intestinal barrier function (Levine A et al) (Sigall-Boneh et al). The CDED is initiated in three phases and is always combined with Partial Enteral Nutrition (PEN) from formula (Modulen IBD®) in declining amounts, with the last stage maintaining 25% of daily intake from PEN. In patients unwilling to use Exclusive Enteral Nutrition, CDED is an effective alternative for inducing remission (Sigall-Boneh et al), and it may provide a more effective option than standard PEN for maintaining it. The CDED is more recently created for Crohn's disease in 2013 and has been researched in small populations of both children and adults with Crohn's disease with its first publication in pediatric Crohn's disease in 2014. See CDED publications on the NTforIBD website for a listing of the research on CDED.

CDED Food List Overview

The food list provided is a simplistic overview of the basic requirements of the diet, offering a bird's eye view of restricted and allowed foods. It is not an all-inclusive list of the allowed and restricted foods, nor does it define all the rules of the diet. This list should NOT be used as a guide to following the diet.

The CDED is managed a little differently from the other diets. The CDED is divided into three phases. The first two 6-week phases are grouped together as the Induction Phase, which is used for inducing remission. The first six-week phase of the Induction Phase limits insoluble fiber to prevent bowel obstructions. The second 6-week phase adds back in many of those vegetables by week 10. The Induction Phase is the most important phase of the diet and is required for efficacy. The Maintenance Phase is used after remission is achieved and is intended to sustain that remission. However, the principles of the diet are best represented by the Induction Phase, with the Maintenance Phase opened up to include some foods not recommended in order to promote better long-term compliance if necessary. The published studies to date primarily evaluate the Induction Phase, so the scientific evidence is strongest at this time for the Induction Phase and is in progress for the Maintenance Phase. However, a patient may like to know what the diet may look like long term, so it was decided that the most complete picture would be provided by showing data for both the Induction Phase and the Maintenance Phase separately. The Maintenance Phase requires five contiguous days following the diet as written, then allows for a maximum of two contiguous days (generally weekends) that allow two free meals per day (maximum of four free meals per week), excluding only hot dogs, sausages, soft drinks, luncheon meats, bacon, and frozen dough from those free meals. Those free meals are not included in the table.