What question did this study set out to answer?

The research aims to evaluate the effectiveness of the Tasty&Healthy whole food diet in lowering calprotectin levels in high-risk first-degree relatives of Crohn’s disease patients.

January 23, 2026

OP17The Tasty&Healthy whole food diet improves calprotectin in high risk first-degree relatives of patients with Crohn’s disease (FDRs): The PIONIR randomized controlled prevention cross-over trial

Key Points

The research aims to evaluate the effectiveness of the Tasty&Healthy whole food diet in lowering calprotectin levels in high-risk first-degree relatives of Crohn’s disease patients.
Screened 950 healthy first-degree relatives for elevated fecal calprotectin levels.
Randomized participants to either a Tasty&Healthy diet or habitual diet for 8 weeks, followed by a crossover to the other diet for an additional 8 weeks.
Measured fecal calprotectin every 4 weeks and analyzed the treatment effect using generalized estimating equations.
Median fecal calprotectin dropped significantly to 45µg/g in the Tasty&Healthy group compared to 311µg/g in the habitual diet by week 4 (p = 0.004).
At week 8, median calprotectin was 45µg/g for the Tasty&Healthy group versus 112µg/g for the habitual group (p = 0.047).
54% of Tasty&Healthy participants had calprotectin levels below 50µg/g after 8 weeks compared to 20% in the habitual group.

Abstract

Abstract Background With the increasing prevalence of IBD, it becomes vital to explore measures of prevention in individuals at risk. The aim of the PIONIR (Preventing IBD ONset in Individuals at Risk) RCT was to explore the effectiveness of the Tasty those with ≥2 tests of 70µg/g underwent panenteric capsule endoscopy or ileocolonoscopy. Subjects with CD-related mucosal changes (e.g. serpiginous ulcerations) were excluded and the others, categorized in the Potential Pre-CD stage, were randomized to either T p = 0.9). By week 4, median FC dropped to 45µg/g (30–180) in the T Figure). At week 8, median FC was 45 µg/g (33–54) in the T p = 0.047). In total, 54% of T 50 µg/g after 8-weeks, vs 20% in the habitual diet (RR = 1.73 95%CI 0.92-3.3; p = 0.09). Following crossover, participants transitioning from habitual to T 0.001). Conclusion This is the first RCTs that suggests improvement in biomarkers in healthy high-risk FDRs in the Potential Pre-CD stage. T&H diet led to a rapid and significant reduction in intestinal inflammation as reflected by FC compared with habitual diet. Larger trials are needed to evaluate the long-term effect of T&H diet in preventing CD. Conflict of interest: Turner, Dan: Consultation fee: Janssen, Pfizer, Ferring, Abbvie, Takeda, Prometheus Biosciences, Lilly, SorrisoPharma, Boehringer Ingelheim, Galapagos, BMS, AlfaSigma, Merck, Gentech Research support: Janssen, Abbvie, Takeda, Pfizer Royalties: Shaare Zedek Medical Center, Hospital for Sick Children Kenigsberg, Sarah: none Plotkin, Luba: Non Aharoni-Frutkoff, Yonat: No conflict of interest Sokolik, Menachem: none Focht, Gili: Other: Received in the past 3 years consultation fee from Lilly Turpin, Williams: NA Waslyk, Alyssa M: No conflict of interest Ledder, Oren: N/A Griffiths, Anne: Grant: Abbvie Personal Fees: Abbvie, Alfasigma, Amgen, Janssen, Lilly, Merck, Pfizer, Roche, Takeda Martincevic, Inez: N/A Huynh, Hien: Grant: AbbVie and Janssen, Takada Personal Fees: Abbvie adboard Other: Abbvie and Janssen education support Godny, Lihi: Grant: Helmsley Charitable Trust Avni Biron, Irit: N/A Tinoco da Silva Torres, Joana: Grant: Abbvie, Janssen Personal Fees: Pfizer, Janssen, Abbvie, Sandoz, Lilly, Sanofi, Takeda Non-financial Support: Janssen, Abbvie Lee, Sun-Ho: Grant: Sun-Ho Lee is a recipient of the Imagine/ Canadian Institute of Health Research/ Canadian Association of Gastroenterology Fellowship Award. He is also a recipient of the Mount Sinai Hospital Department of Medicine Fellowship Award. Croitoru, Kenneth: N/A

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