P825 Comprehensive dietitian-delivered dietary advice effectively achieves dietary change in adults with Ulcerative Colitis, whereas generalised written dietary advice does not

Abstract

Abstract Background Diet is an important consideration in microbial therapy trials. It is unclear whether provision of generalised written dietary advice is sufficient to induce dietary change as part of a therapeutic regimen or whether personalised diet advice is required. This study examines the effectiveness of different dietary advice modes provided in dietary and faecal microbiota transplantation (FMT) studies in adults with mild-moderately active ulcerative colitis (UC). Methods This observational study examined before and after dietary intake data from three prospective dietary and FMT studies held from 2018 to 2021 at a South Australian tertiary inflammatory bowel disease service. In all studies, adults ≥18 years with mild-moderately active UC completed 3 or 7-day weighed food diaries measuring habitual diet at 0 and 8 weeks after provision of dietitian-developed dietary advice. In studies one and two, a medical officer provided participants a written UC healthy eating pamphlet. The pamphlet contained generalised dietary recommendations for UC, targeting reduction of total and animal protein and increasing fermentable fibres including resistant starch to recommended serve sizes. In study three, a research dietitian provided a 1-week guided meal plan, diet manual with recipes and verbal personalised dietary counselling advising on the same recommendations and strategies. In all studies, participants were encouraged to eat to appetite. Dietary intake, including key nutrients of interest (protein and fermentable fibres), at weeks 0 and 8 was assessed using Foodworks 10TM nutritional analysis software and analysed using paired statistical tests. Results Across studies one and two, 28 adults with mild-moderately active UC received written dietary advice. In study three, 30 adults received personalised verbal and written dietary advice. Outlined in Table 1, verbal and written advice significantly reduced total protein and animal protein intakes by 20% (p=0.007) and 34% (p=0.002) respectively. Total fibre and resistant starch intakes significantly increased by 64% (p<0.001) and 353% (p<0.001) respectively. Comparatively, written advice alone had no significant change on any key nutrient intakes. Neither dietary advice mode significantly changed energy or micronutrient intakes. Conclusion Written dietary advice alone was insufficient to achieve dietary change. In contrast, verbal and written dietary advice with the same intended change on dietary intake, delivered by a research dietitian effectively achieved dietary changes. This emphasises that comprehensive written and verbal dietary education delivered by a dietitian should be included in microbial-modulating study designs where dietary change is an intended outcome.