Diet and Nutrition in Pediatric Inflammatory Bowel Diseases

Abstract

Both genetic and environmental factors are involved in the onset of inflammatory bowel disease (IBD). In particular, diet composition is suspected to significantly contribute to IBD risk. In recent years, major interest has raised about the role of nutrition in disease pathogenesis and course, and many studies have shown a clear link between diet composition and intestinal permeability impairment. Moreover, many IBD-related factors, such as poor dietary intake, nutrients loss and drugs interact with nutritional status, thus paving the way for the development of many therapeutic strategies in which nutrition represents the cornerstone, either as first-line therapy or as reversing nutritional deficiencies and malnutrition in IBD patients. Exclusive enteral nutrition (EEN) is the most rigorously supported dietary intervention for the treatment of Crohn’s Disease (CD), but is burdened by a low tolerability, especially in pediatric patients. Promising alternative regimens are represented by Crohn’s Disease Exclusion Diet (CDED), and other elimination diets, whose use is gradually spreading. The aim of the current paper is to provide a comprehensive and updated overview on the latest evidence about the role of nutrition and diet in pediatric IBD, focusing on the different nutritional interventions available for the management of the disease.

Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review

“…These statements, integrating several systematic reviews, have defined an overall combined remission rate of 73% for EEN, noting similar efficacy for this purpose as corticosteroids ( 47 , 54 ). In addition to this, greater levels of mucosal healing have been noted, as well as the correction of nutritional deficiencies, improvements in lean body mass and quality of life, all with the benefit of sparing steroids and their avoiding their sequelae ( 53 , 55 , 56 ). These benefits however are limited to patients with luminal Crohn’s disease, as there are insufficient data to support the use of EEN for extraintestinal and perianal involvement, or in ulcerative colitis ( 54 ).…”

Enterale Ernährungstherapien beim pädiatrischen M. Crohn

“…Es handelt sich dabei um eine definierte, ausschließliche, rein formulagebundene Diät. Sie hat ferner ein ausgezeichnetes Sicherheitsprofil und ernährungsphysiologische Vorteile gegenüber immunmodulatorischen Therapiealternativen [59][60][61][62].…”

“…1). Ferner bewirkt sie eine Verringerung von weiteren eigentlich protektiven Bakterienspezies wie Bifidobacterium spp, Firmicutes (einschließlich Faecalibacterium prausnitzii), Bacteroides/Prevotella und Proteobacteriaceae [61]. Diesbezüglich lässt sich festhalten, dass die Datenlage gegenwärtig noch sehr unklar und schwierig zu interpretieren ist.…”

Potential Benefits of Bovine Colostrum in Pediatric Nutrition and Health

“…Many of these treatments have important adverse side effects that can reduce body growth and skeletal development during this critical stage of life. Key factors that are commonly altered in cases of IBD and its treatment are the gut microbiota composition and nutrition, since both elements can interact to affect the mucosal immune response [ 257 ]. Since nutrition plays a key role in pediatric growth and can also modulate IBD morbidity, dietary approaches have been used in treatment, including use of exclusive and partial enteral nutrition as well as dietary exclusion.…”