A223

THE GEM PROJECT: ASSOCIATIONS OF DIETARY PATTERNS WITH

MICROBIOME AND FECAL CALPROTECTIN IN HEALTHY FIRST-
DEGREE RELATIVES OF CROHN‟S DISEASE PATIENTS

G. Sasson1, J. Raygoza Garay2, W. Turpin1, N. Power3, M. Smith3, D.S. Guttman1, T.

Research Consortium4, K. Croitoru3

1. University of Toronto, Toronto, ON, Canada; 2. Medicine, University of Toronto,

Toronto, ON, Canada; 3. Mount Sinai Hospital, Toronto, ON, Canada; 4. The CCC
GEM Project, Toronto, ON, Canada

Background: Crohn‘s disease (CD) is thought to be due to an interaction between

environmental factors and the gut microbiome that activates an immune response in
genetically susceptible hosts. Epidemiologic studies suggest diet is an important
variable in CD development; however, little is known about the mechanism by which
diet contributes to pathogenesis. It has recently been shown that diet plays a
substantial role in shaping microbiome composition (MC). We hypothesize that
specific diet patterns are associated with differences in MC that may be related to CD
risk.
Aims: To characterize associations between diet patterns with MC and fecal
calprotectin (FC) in healthy first-degree relatives (FDR‘s) of CD patients in the
Genetic, Environmental, Microbial (GEM) Project.
Methods: A validated food frequency questionnaire (FFQ) was used to assess diet for
North American FDR‘s at recruitment. Each question was summarized as a score
based on weekly consumption frequency. The Dirichlet method of unsupervised
clustering was used to generate dominant diet clusters. Diet-microbiome associations
were assessed using the two-part microbiome model. Stool microbiota at recruitment
was characterized by 16s RNA sequencing of V4 region using MiSeq platform.
Baseline FC was measured by BUHLMANN ELISA test.
Results: 2766 FDR‘s had FFQ‘s at recruitment; mean age 18.52 years, 53% female.
The Dirichlet method identified 4 clusters, some of which resembled known diet
patterns: Superbowl (mainly organ meats, non-red meat, beer, spirits), High
Carbohydrate (HC), Mediterranean (MD) and Western (WD) diets. HC was
associated with increased relative abundance of V. veillonella (P=2.68E-4). Both HC
and MD were associated with decreased abundance of E. klebsiella (P=2.64E-5 and
P=1.02E-5 respectively). WD was associated with decreased abundance of L.
dorea (P=5.74E-5), a genus considered high risk for CD. A per question analysis
demonstrated significant associations between several taxa and individual foods. Diet
clusters were then correlated with FC, and a decrease in FC was observed with MD
(estimate -16.96, P=0.012). There were no associations with FC in a per
question analysis.
Conclusions: Dominant dietary patterns and certain individual foods are associated
with specific gut MC. As well, MD is inversely associated with FC and therefore has
potential use as an intervention for lowering inflammation. Understanding
relationships between diet, MC and FC in individuals at high risk for CD would be
beneficial in defining new dietary strategies in predictably modulating future risk of
CD.

Funding Agencies: CCCHelmsley Charitable Trust