Sidhartha Sinha, MD, is an assistant professor of gastroenterology and hepatology at Stanford University.

Sidhartha Sinha, MD

Bridging Clinical Outcomes and Mechanistic Insight in Dietary IBD Studies With Sidhartha Sinha, MD

Diet-based interventions in inflammatory bowel disease (IBD) continue to generate interest, but high-quality evidence supporting their safety and utility in this context remains limited. In a field dominated by pharmacologic trials, understanding whether structured dietary strategies can meaningfully influence disease biology, and in which patients, is an ongoing challenge.

New research from Sidhartha Sinha, MD, an assistant professor of gastroenterology and hepatology at Stanford, provides novel evidence supporting the potential benefits of a fasting-mimicking diet (FMD) for reducing clinical disease activity in patients with mild-to-moderate Crohn’s disease.

Findings from their open-label, randomized, controlled, clinical trial showed that short, structured periods of significant caloric restriction were associated with improvements in clinical disease activity and biochemical markers of inflammation. In some cases, patients achieved complete clinical remission.

, Sinha highlighted the need for additional research into this diet in this particular patient population to help inform which patients may benefit most from this intervention. He additionally acknowledged the diet’s potential role in other inflammatory diseases.

“I think what was really interesting about this study was that it was a 5 day a month dietary intervention. For the rest of the 25 days or so in a month, you eat what you normally eat,” Sinha told HCPLive. “We specifically asked and would follow up with these patients to actually make sure that they did not change their diet during the 25 or so days when they were not on the reduced calorie diet.”

He cites the short duration of the intervention as a potential benefit over other diet-based approaches in IBD, specifically the Mediterranean diet, which has the most supporting data but can be difficult for patients to adhere to if they are used to consuming the standard American diet.

Looking ahead, Sinha describes his desire to explore the utility of FMD in patients with ulcerative colitis as well as the specific mechanisms driving the observed benefits of FMD in patients with CD, both of which he says will require adequate attention and funding like that given to pharmacologics.

“I think a lot of that comes down to the fact that these studies are still quite expensive. Doing a study in a dietary intervention, oftentimes the financial incentives aren't there as they exist in pharmacologics,” he said. “A pharmacologic company may invest billions of dollars, and certainly they hope, and deservedly so hope, to recoup that money if their intervention works. Unfortunately, with dietary studies, it's a lot cheaper to look at clinical outcomes, and it's a lot harder and more expensive to dig into mechanisms. Both from the standpoint of federal agencies to support dietary interventions that look at mechanisms as well as from philanthropic organizations, I think could really help advance our understanding of inflammatory diseases and how diet can benefit patients with these diseases.”

Editors’ note: Sinha reports no relevant disclosures.

Brooks A. Fasting-Mimicking Diet Elicits Clinical, Biochemical Response in Mild Crohn’s Disease. HCPLive. January 13, 2026. Accessed January 16, 2026. 

https://www.hcplive.com/view/fasting-mimicking-diet-elicits-clinical-biochemical-response-in-mild-crohn-s-disease

Ha C. Management of Patients With Mild Crohn's Disease. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC11346010/

Videos

Sinha describes data supporting the safety and utility of a fasting-mimicking diet in Crohn’s disease and explores what may be next in this line of research.

Bridging Clinical Outcomes and Mechanistic Insight in Dietary IBD Studies, With Sidhartha Sinha, MD

When Medications Fall Short: Exploring Diet in Mild Crohn’s Disease, With Sidhartha Sinha, MD

For patients with mild Crohn’s disease (CD), treatment decisions are often complicated by a lack of appropriate therapeutic options. While corticosteroids, the onlyUS Food and Drug Administration (FDA)-approved therapy for this population, can rapidly improve symptoms, their long-term toxicity often outweighs their benefits. As a result, there has been a growing interest in nonpharmacologic strategies for disease management.

“We often think about [steroids] as being some of the best drugs and some of the worst drugs at the same time. They can make patients feel better, and sometimes we need to do that and do that quickly, but they come with a whole slew of side effects,” Sidhartha Sinha, MD, an assistant professor of gastroenterology and hepatology at Stanford, told HCPLive. “We're always looking at ways to improve the treatment of patients, and fortunately, now we have many advanced therapies that offer some benefit, but patients who have mild and sometimes very moderate Crohn's disease fit into this area where there may not be therapies that are appropriate for them. In these cases, we think that lifestyle can really make an impact.”

With this therapeutic gap in mind, he and a team of investigators conducted an open-label, randomized, controlled, clinical trial assessing the effectiveness of a fasting-mimicking diet (FMD) for reducing clinical disease activity in patients with mild-to-moderate CD. In the study, patients consumed a FMD for 5 consecutive days per month for 3 consecutive months. For the remaining days in each month, patients consumed their regular baseline diet. Patients in the control group continued their baseline diet.

Study results showed that short, structured periods of significant caloric restriction were associated with improvements in clinical disease activity and biochemical markers of inflammation. In some cases, patients achieved complete clinical remission.

However, Sinha emphasized that FMD should not be viewed as a replacement for standard medical therapy. Instead, he says the results suggest that diet may serve as a complementary strategy, especially for patients who fall into the gray zone between minimal symptoms and disease severe enough to justify immunosuppressive or biologic treatment.

One of the notable strengths of the study was its real-world design. Participants reflected everyday clinical practice, including patients already receiving pharmacologic therapy as well as those who had chosen not to initiate medication. Across both groups, the dietary intervention was associated with reductions in disease burden, reinforcing the idea that nutritional strategies may exert benefits independent of medication status.

Sinha went on to emphasize the importance of considering safety, noting that an intervention should never cause harm. Accordingly, his study only enrolled patients with mild to moderate disease and excluded those who were pregnant, underweight, or otherwise at risk.

He noted that despite the low caloric intake during the fasting periods, no significant differences in weight were observed between the intervention and control groups, likely due to post-intervention caloric rebound. Adverse effects such as fatigue and headache were mild, transient, and resolved quickly once normal eating resumed, something Sinha says can likely be expected after long periods of not eating much food or skipping meals.

Taken together, he says the findings suggest that carefully designed dietary interventions like FMD may offer a promising, low-risk adjunct for patients with mild Crohn’s disease while also opening the door to more mechanistically informed lifestyle research in IBD.

Sinha explains current unmet needs in mild Crohn’s, the shortcomings of steroids for these patients, and what benefits a fasting-mimicking diet may offer.

Sidhartha Sinha, MD

Articles