Provider News

Smoothie Study Examines Possible Benefits of Additive-Free Alternative to EEN Therapy

February 7, 2018

Dr. Dale LeeDr. Dale Lee, inflammatory bowel disease researcher and director of the Celiac Disease Program at Seattle Children’s, is reverse engineering smoothies utilized in exclusive enteral nutrition (EEN) to treat Crohn’s disease. EEN is a therapy involving the avoidance of foods and focusing on the intake of commercial formulas. His goal is for patients with Crohn’s disease to consume the calories, minerals and vitamins they need without ingesting other ingredients that may trigger inflammation or another abnormal immune response.

“EEN is very effective for some individuals with Crohn’s disease,” Lee says. “However, when these children consume standard commercial formulas, they are also taking in certain food additives that may be problematic. For example, emulsifiers like polysorbate 80 and carboxymethylcellulose have been shown in experimental models to worsen intestinal inflammation or modulate intestinal bacteria in a pro-inflammatory fashion.”

To test the hypothesis that a whole-foods-based nutritional smoothie could be as efficacious as traditional EEN formulas, Lee first looked to previous research at Seattle Children’s on the Specific Carbohydrate Diet (SCD). Those findings indicated that the restrictive diet could effectively lead to remission for certain forms of IBD.

“The genesis of our reverse-engineered smoothie project was that we know commercial formulas work well for IBD, and we know that both a whole-foods diet and commercial supplements work well,” Lee says. “We wanted to know, can we marry these two and use the result as therapy?”

SCD meets Vitamix

For the trial, Lee’s research team, which includes gastroenterologists, chemical engineers, food scientists and dietitians, has developed an additive-free, nutritionally complete smoothie recipe. Ten children, age 8 to 18, will participate for eight weeks each and follow the same recipe, which will vary only in the amount consumed. The team’s dietitian will calculate that amount needed to be consumed based on each child’s caloric needs. Participants will receive a Vitamix blender, ingredients delivered through AmazonFresh and Hydro Flask water bottles. Families will be able to pick up other nonperishable ingredients during clinic visits.

During the eight-week trial, the research team will use phone and email check-ins, as well as blood, stool and urine samples collected during clinic visits, to investigate the possible impact of the smoothies on intestinal inflammation and quality of life.

If the therapy appears effective, Lee’s team hopes to expand the research, investigating whether nutritional therapy could treat an even wider variety of autoimmune disorders, such as juvenile idiopathic arthritis.

“Nutrition and diet may have a large role that we don’t fully understand for a variety of autoimmune diseases,” Lee says. “We want to ascertain how exposure to foods, antigens and food additives are impacting and potentially driving some of these conditions.”

Call 206-987-7777 for provider-to-provider patient consults and visit the Inflammatory Bowel Disease Center page to learn more.