No Guts No Glory dietary intervention

Schizophrenia spectrum disorders (SSD), bipolar disorder (BD), Alzheimer’s disease (AD), and Parkinson's disease (PD) are common brain disorders, which can severely affect patients’ functioning and quality of life, with significant burden on global health. Although these four disorders are rather different, cognitive dysfunction and decreased mood are common in all four disorders. Another communality is that gastrointestinal (GI) symptoms are frequent in these disorders. Recent investigations have pointed to the gut-brain axis as a new venue for disease-modifying treatment of brain disorders, with increased systemic inflammation stemming from increased intestinal permeability to affect brain functioning in a significant subset of patients. Gut health therefore opens a new therapeutic window, in which an anti-inflammatory dietary pattern (AIDP) may modify the course of brain disorders. By affecting the gut-brain axis, we expect direct effects on disability and symptoms of brain disorders, as brain homeostasis and plasticity may benefit from a lower inflammatory status. Reducing the body’s inflammatory status can also improve mood, cognition and well-being.

We hypothesise that an anti-inflammatory dietary pattern (AIDP) has a beneficial effect on gut microbiome (diversity and permeability), thereby improving global functioning (measured with Outcome Questionnaire 45, OQ-45), and health of patients with schizophrenia spectrum disorder, bipolar disorder, Alzheimer’s disease or Parkinson’s disease

Baseline first intervention period (week 1), end of intervention period 1 (week 12), follow-up intervention period 1 in wash-out (week 24), baseline second intervention period (week 36), end of intervention period 2 (week 48), and follow-up intervention period 2 (week 60).

With an open label RCT with cross-over design, intervention of 12 weeks and wash-out period of 24 weeks we test the effect of the AIDP on global functioning, cognition, well-being, gut health, general health, and disease-specific symptom severity in patients with SSD, BD, AD, and PD. Per diagnosis group, patients are randomized either to group 1 starting with AIDP at baseline, or group 2 starting with AIDP at week 36. During the AIDP intervention patients receive weekly food boxes at home. Before the intervention, an individual plan based on the participant’s energy needs is made by the involved dietician. Furthermore, preferences for food deliveries and if needed, plans for support with preparation, is made via online or telephone consult after baseline measurement. Products are provided with recipes and addition cooking videos as support for food preparation. For participants with difficulties in preparing the meals, help will be offered. Outcome measurements will be assessed 6 times in total: at baseline first intervention period (week 1), end of intervention period 1 (week 12), follow-up intervention period 1 in wash-out (week 24), baseline second intervention period (week 36), end of intervention period 2 (week 48), and follow-up intervention period 2 (week 60).