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.

In an interview with HCPLive, 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.

References

1. 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

2. Ha C. Management of Patients With Mild Crohn's Disease. Gastroenterol Hepatol (N Y). 2024;20(6):345-347.https://pmc.ncbi.nlm.nih.gov/articles/PMC11346010/