UMass Medical School received a $ 1.7 million grant from the Leona M. and Harry B. Helmsley Charitable Trust to help combat the increasing prevalence of Crohn’s disease in Puerto Rico in a cost-effective and culturally sensitive manner. The funding will be used by Ana Maldonado-Contreras, PhD, Assistant Professor of Microbiology and Physiological Systems, to tailor a novel diet developed at UMass Medical School to patients on the island with different food availability and preferences.
Ana Maldonado-Contreras, PhD
“The prevalence of Crohn’s disease in Puerto Rico has increased five-fold in less than a decade,” said Dr. Maldonado Contreras. “It is now comparable to that of North America and Europe, the regions with the highest prevalence of Crohn’s disease in the world.”
Crohn’s disease is a chronic, debilitating form of inflammatory bowel disease (IBD) that has no cure for. Symptoms include abdominal pain and cramps, persistent diarrhea or constipation, weight loss, rectal bleeding, loss of appetite, and severe inflammation of the gastrointestinal tract.
“Several studies have highlighted the effects of a diet high in processed foods on the gut microbiome and the increase in the risk of developing IBD, which provides a rationale for further study of diet as a potential therapy to induce or maintain remission. Recent clinical trials of diet as a therapy have shown promising results, with some patients achieving remission shortly after dieting, ”said Maldonado-Contreras.
Research by Maldonado-Contreras and Barbara Olendzki, RD, MPH, Associate Professor of Medicine in the Department of Preventive and Behavioral Medicine, found that the anti-inflammatory diet for inflammatory bowel disease or IBD-AID quickly reduce Crohn’s disease symptoms and reduce inflammation can, and promote, changes in the microbes in the gut, which can be beneficial while providing affordable and nutritious diets that can be prepared at home. However, IBD-AID was developed around foods available in mainland America.
“Our goal is to tailor this nutritional program, which is being introduced in the United States to treat Crohn’s disease, to meet the needs of patients in Puerto Rico,” said Maldonado-Contreras. “So we try to ensure that the program takes into account the availability of food on the island as well as various culturally common culinary preferences.”
An example of a nutritious food that is common in the US but not in the Puerto Rico or Latinx culture is peanut butter, which is high in healthy omega-3s and monounsaturated fats. “It’s a very strange food for us,” says Maldonado-Contreras, who grew up in Venezuela. “But we can replace avocado toast with olive oil for the peanut butter sandwich.”
The UMass Medical School research team will work with the Center for IBD at the University of Puerto Rico at San Juan under the direction of Dr. Esther Torres work together to develop and test Dieta Anti-Inflamatoria, or DAIN, a nutritional program for Puerto Ricans. in more than 800 Crohn’s disease patients.
DAIN will contain a variety of probiotics like yogurt and fermented foods that contain live microorganisms believed to be beneficial to the gut and prebiotics like high fiber foods that provide nutrients that beneficial bacteria can support. It will contain balanced nutrients to meet the dietary requirements for long-term safe use and to exclude adverse foods such as processed foods that are known to cause gastrointestinal symptoms in some people.
The program is designed to address the challenges of nutritional therapy such as: B. adhering to the diet by including practical cooking classes and nutritional advice.
Maldonado-Contreras said that in the first year of the three-year project, the researchers will develop a patient toolkit with input from clinicians, nutritionists and patients. The diet is adjusted by IBD-AID and a cookbook in color, as well as a website and social media content in Spanish are developed.
She expects to begin testing DAIN’s effectiveness in improving clinical outcomes in Crohn’s disease patients in Puerto Rico in the summer of 2022. For this study, a cook from the University of Puerto Rico’s teaching kitchen will teach patients how to prepare meals. on the principles of the newly created diet.
“We are excited about this diet because the patient can control their own symptoms and perhaps also prevent them,” said Maldonado-Contreras. “And you know, almost 20 percent of the population on the American mainland are Latinx, so 20 percent of our population can also benefit from DAIN. It is a groundbreaking study that could serve as a blueprint for nutritional interventions to treat Crohn’s disease in other underserved populations. “
“We are committed to helping people with Crohn’s disease make their daily lives as smooth as possible,” said Kerry Hernandez, PhD, associate program officer with the Helmsley Charitable Trust. “Eating a healthy diet is an important part of overall management of Crohn’s disease. However, to be successful, such diets must take into account regional food availability as well as cultural preferences and tastes. This grant will help us move closer to validated dietary recommendations for the Puerto Rican community and potentially the larger Hispanic diaspora living with Crohn’s disease. “
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