Impact of Dietary Intervention on Inflammation and Microbiome Composition Post-Colonoscopy

Eligibility Criteria

• 1. Due for 2nd or 3rd colonoscopy with prior diagnosis of tubular, villous, or serrated polyps but no current diagnosis of CRC.
• 1. Inability to provide informed consent and engage in informed consent procedures.
• 2. Participants who suffer from allergic reactions to, or are unwilling to consume, any components of the dietary intervention.
• 3. Pregnant
• 4. Serious illness and in hospice or palliative care for terminal disease
• 5. Swallowing issues, including self-reported difficulty tolerating solids or liquids.
• 6. Active antibiotics use for an ongoing acute infection.
• 7. Any disorder, unwillingness, or inability not covered by any other exclusion criteria which, in the investigator's and/or team's opinion jeopardizes the safety of the participant or others or would interfere with adherence to the protocol.
• 8. Participants who plan to relocate to an area not served by UCSD or travel plans that do not permit completion of the study.
• 9. Possible ethanol (alcohol) use disorder defined by Alcohol Use Disorders Identification Test (AUDIT) score of \>15
• 10. Hyper-tension \>160/100mmHg
• 11. Exacerbation of underlying gastrointestinal disease, including chronic inflammatory bowel disease or other malabsorptive disorders
• 12. Decompensated cirrhosis
• 13. Previously diagnosed Diabetes Mellitus with HbA1c \>9% at screening
• 14. Newly diagnosed diabetes within the past three months, or HbA1c \>6.5% at screening in a person not previously diagnosed with diabetes.
• 15. Participants with a history of end-stage renal disease (ESRD) on hemodialysis
• 16. Active infectious diseases (e.g., active tuberculosis \< 3 months from symptom onset or positive test, COVID \< 1 month from symptom onset or positive test)
• 17. Participants who require dietary restrictions due to a medical condition or are on a prescribed diet for underlying chronic diseases.
• 18. Participants with Type 1 or Type 2 diabetes on insulin
• 19. Participants aged 2: 75 years with Type 2 diabetes taking prescribed medications that can cause hypoglycemia (e.g., sulfonylureas, glinides), or on a prescribed diet
• 20. Hospitalization for a chronic disease (e.g., congestive heart failure, stroke) within the past three months
• 21. Requiring transfusions/apheresis during study period
• 22. Participants with a current diagnosis of, or who have received treatment for, bulimia or anorexia nervosa within the past 3 years
• 23. Participants with major psychiatric disorders, including major depression, schizophrenia, or psychosis, who have been hospitalized in the past six (6) months or are currently enrolled in treatment programs.
• 24. Hemoglobin \<9.5 g/dL at screening
• 25. Myocardial infarction, invasive cardiac procedure, participation in a cardiac or acute rehabilitation programs, transient ischemic attacks, or unstable arrhythmias within the past 3 months.