The White Diet is preferred, better tolerated, and non‐inferior to a clear‐fluid diet for bowel preparation: A randomized controlled trial

Abstract

The White Diet was preferred and better tolerated by patients without detriment to the success of bowel preparation or colonoscopy performance, especially with the split-dose regimen.

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

“…There was also significantly less bloating, weakness, hunger, and interruption to daily activities with the White Diet. Although the duration of the dietary restriction was longer in the White Diet group, our group has previously reported that the daily median energy intake with the White Diet was twice that of a clear fluid diet15 which may contribute to the improved tolerance compared with a 24‐h clear fluid diet. Furthermore, the use of white color as a guide to choose food is a simple strategy which patients found significantly easier to follow and the flexibility of the White Diet allows patients to individualize the diet according to personal dietary preferences.…”

“…The White Diet, recently described by Butt et al .,15 is a pre‐colonoscopy low‐residue diet of white or cream‐colored foods. In that randomized controlled trial of 226 patients, the White Diet in conjunction with a 2‐L PEG with ascorbate bowel preparation was preferred by patients with less hunger and interference to daily activities without detriment to bowel preparation quality or colonoscopy performance compared with a clear fluid diet 15.…”

“…In that randomized controlled trial of 226 patients, the White Diet in conjunction with a 2‐L PEG with ascorbate bowel preparation was preferred by patients with less hunger and interference to daily activities without detriment to bowel preparation quality or colonoscopy performance compared with a clear fluid diet 15. Other randomized trials of diet liberalization during bowel preparation suggest that either low‐fiber13 or regular diet14 the day before colonoscopy with split‐dose bowel preparation is associated with improved tolerance and comparable or better colon cleansing compared with a clear fluid diet.…”

“…Patients randomized to the intervention arm (White Diet and low‐volume Picosalax—WD/PICO) received the White Diet for 2 days prior to the procedure, then split‐dose Picosalax (consisting of 10 mg sodium picosulfate, 3.5 g magnesium oxide, and 2 g citric acid ; Ferring Pharmaceuticals, Melbourne, Australia) consisting of two sachets of SPMC taken at 21:00 h the day before and at 04:00 h on the day of the procedure with 200 mL of water per hour allowed until 06:00 h. As described previously,15 the White Diet comprises white‐colored foods of low residue (Table 1). …”

Augmentation with pre‐emptive macrogol‐based osmotic laxative does not significantly improve standard bowel preparation in unselected patients: A randomized trial

“…) according to a computer‐generated randomization schedule. Patients in both arms received instructions for a low‐residue White Diet for 2 days prior to the procedure and split dose of the standard BP (PrepKit‐C). Standard BP is a combination of one sachet of PEG (Glycoprep‐C, consisting of macrogol 3350, sodium sulfate, sodium chloride, and potassium chloride, Fresenius Kabi Pty Ltd., Pymble, New South Wales, Australia) and two sachets of SP/MC (PicoPrep, consisting of sodium picosulfate 10 mg, magnesium oxide 3.5 g, citric acid 12.0 g, and aspartame 36 mg, Fresenius Kabi Pty Ltd.).…”