P046 NUTRITION SUPPORT FORMULA MAY HAVE IMPROVED FOLATE, RED CELL DISTRIBUTION WIDTH (RDW), AND NEUTROPHIL COUNTS IN A PILOT STUDY OF ADULTS WITH CROHN’S DISEASE AND ULCERATIVE COLITIS

Malnutrition is highly prevalent in patients with inflammatory bowel disease (IBD). This preliminary study examined the effect of a nutrition support formula on blood nutrient parameters and explored effects on circulating blood cell counts and inflammatory markers in adults with IBD. Case series data on the formula was previously compiled, but this study was the first to collect data in a prospective trial. Ten adults with Crohn’s disease or ulcerative colitis were recruited from the Portland, OR metropolitan area into a single-arm, open-label, pilot study. Participants consumed a nutrition support beverage twice daily for twelve weeks. The formulation contained a mixture of micronutrients (including methylated forms of folate and vitamin B12), macronutrients, and phytonutrients (including curcumin, xanthohumol, ginger compounds, and quercetin). Main outcomes included changes in folate, vitamin B12, red blood cell (RBC) count, hemoglobin, hematocrit, electrolytes and albumin. Exploratory measures included changes in circulating blood cell counts and inflammatory markers. Over the twelve-week study period, serum folate increased 48.7% (p=.029), serum vitamin B12 increased 17.4% (NS, p=.053), and red cell distribution width (RDW) decreased 9.2% (p=.012). Although there were minimal shifts in total white blood cell counts (-1.0%, p=.845), percent neutrophils decreased 10.4% (p=.042), and lymphocyte count increased 18.6% (p=.048). RBC count, hemoglobin, hematocrit, electrolytes, albumin and inflammatory markers did not change significantly. Post-hoc analysis demonstrated that neutrophil-lymphocyte ratio (NLR) decreased 18.4% (NS, p=.061). Adherence to the intervention was 98.4%. Serum folate increased and RDW decreased in adults with IBD over the course of the study. RDW has recently been described as a novel surrogate marker of disease activity in patients with IBD. Modulation of leukocyte subtypes was also observed, with neutrophils decreasing, lymphocytes increasing, and total white blood cell counts remaining unchanged. Neutrophils have previously been described as a novel therapeutic target, given that neutrophil apoptosis is delayed in patients with IBD. A randomized, controlled study to further examine the effect of the nutrition support formula on nutritional status, RDW, leukocyte subtypes, and NLR will be initiated to follow up on this promising preliminary investigation.