Abstract
CONTEXT: The rising antibiotic resistance in Helicobacter pylori (H. pylori) infection have made treatment more challenging. A low-nickel diet may improve eradication rates based on the bacteria's mechanisms. OBJECTIVE: This study aimed to evaluate the effect of a low-nickel diet during standard triple therapy on the rate of H. pylori eradication. METHODS: This randomized clinical trial included patients with H. pylori infection who were classified into the following two groups: low-nickel diet and regular diet. Both groups received the standard triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor. After at least 8 weeks of treatment, a control test for H. pylori was performed. RESULTS: Per-protocol analysis showed a higher rate of H. pylori eradication in the low-nickel diet group than in the regular diet group (91.7% vs 75.8%; P=0.026). In addition, obesity was associated with poorer eradication rates (73.2% vs 88.9%, P=0.038). Patients on a low-nickel diet were 3.41 times (1.21-11.40) more likely to have H. pylori eradication than those on a normal diet. CONCLUSION: This study showed that low-nickel diet, which is a low-cost and low-risk intervention, may be an appropriate strategy for increasing H. pylori eradication rates. BACKGROUND: • Evaluate the effect of low-nickel diet during standard triple therapy on the rate of Helicobacter pylori eradication. BACKGROUND: • This randomized clinical trial included patients infected with Helicobacter pylori in groups with a low-nickel nickel or regular diet, who underwent standard triple therapy and the efficacy of bacterial eradication was compared between both groups. BACKGROUND: • Per-protocol analysis showed a higher rate of Helicobacter pylori eradication in the low-nickel diet group than in the regular diet group (91.7% vs 75.8%; P=0.026). BACKGROUND: • The low-nickel diet is an appropriate strategy for increasing Helicobacter pylori eradication rates.