Crohn’s Disease Exclusion Diet (CDED)
Also known as: CDED · CDED + PEN · Exclusion diet with partial enteral nutrition
A staged whole-food diet that removes foods thought to disturb the gut. In a children’s trial it outperformed the standard liquid-formula diet at 12 weeks.
Clinically studied. A randomised trial in children and a pilot randomised trial in adults, both with encouraging remission rates. It is designed to be followed with a dietitian.
What it is
The CDED is a whole-food diet followed in phases. It excludes wheat, dairy, red and processed meat, animal fats and food additives such as emulsifiers, carrageenan, maltodextrin and sulfites, along with sweetened drinks. In the first phase it is usually combined with a nutritional formula drink (partial enteral nutrition) that supplies about half of daily calories. Later phases gradually reintroduce foods.
Why it might help
The diet targets dietary components that research links to a weakened gut barrier and a disrupted microbiome, especially in ultra-processed foods. It was developed as a more livable alternative to exclusive enteral nutrition, a liquid-formula-only diet that is a recommended first-line treatment for children with Crohn’s but is hard to sustain.
Highlights
- In children, 75.6% were in steroid-free remission at week 12 on CDED with formula, versus 45.1% on the standard liquid-formula diet followed by formula.
- Children found it easier to stick to than the formula-only diet.
- In an adult pilot trial, 63% reached clinical remission at week 6, and half were still in remission at week 24.
- It is food-based and doesn’t suppress the immune system, so many people use it alongside their medication.
What the research shows
| Study | Design & population | Outcome |
|---|---|---|
| Levine 2019 Positive result | Randomised controlled trial, 12 weeks 78 children · Mild-to-moderate Crohn’s disease | Both diets brought on remission by week 6. At week 12, 75.6% on CDED plus formula were in steroid-free remission versus 45.1% on exclusive formula followed by partial formula, and CDED was better tolerated. |
| Yanai 2022 Positive result | Open-label pilot randomised trial (CDED-AD) 44 adults · Mild-to-moderate Crohn’s disease | CDED with or without formula: 63% reached clinical remission at week 6 and 50% were in sustained remission at week 24. |
Randomised controlled trial, 12 weeks · 78 children · Mild-to-moderate Crohn’s disease
Both diets brought on remission by week 6. At week 12, 75.6% on CDED plus formula were in steroid-free remission versus 45.1% on exclusive formula followed by partial formula, and CDED was better tolerated.
Open-label pilot randomised trial (CDED-AD) · 44 adults · Mild-to-moderate Crohn’s disease
CDED with or without formula: 63% reached clinical remission at week 6 and 50% were in sustained remission at week 24.
Practical tips
- Work with an IBD dietitian; the phases, permitted foods and formula amounts matter.
- The formula drink used in trials is a specific IBD nutritional formula, prescribed or recommended by your care team.
- Batch cooking and simple, home-prepared meals make the early phase much easier.
Cautions
- It is restrictive, so nutrient intake should be checked, especially calcium while dairy is excluded.
- Diet changes don’t replace prescribed treatment unless your gastroenterologist agrees.
Sources
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Levine A, Wine E, Assa A, et al. · Gastroenterology · 2019
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Yanai H, Levine A, et al. · Lancet Gastroenterology & Hepatology · 2022
Phase 2 — in development
Where traditional research stops, our community begins
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