Nutrition in Pediatric Inflammatory Bowel Disease: From Etiology to Treatment. A Systematic Review

Abstract

Nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of disease. With regards to etiology, there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset. As for disease treatment, exclusive enteral nutrition (EEN) is an extensively studied, well established, and valid approach to the remission of pediatric Crohn’s disease (CD). Apart from EEN, several new nutritional approaches are emerging and have proved to be successful (specific carbohydrate diet and CD exclusion diet) but the available evidence is not strong enough to recommend this kind of intervention in clinical practice and new large experimental controlled studies are needed, especially in the pediatric population. Moreover, efforts are being made to identify foods with anti-inflammatory properties such as curcumin and long-chain polyunsaturated fatty acids n-3, which can possibly be effective in maintenance of disease. The present systematic review aims at reviewing the scientific literature on all aspects of nutrition in pediatric IBD, including the most recent advances on nutritional therapy.

Impact of dietary manganese on experimental colitis in mice

“…Nutrition is a critical factor in the onset and treatment of pediatric IBD. 47 There is increasing evidence to suggest that dietary habits such as high consumption of animal proteins, fatty foods, and sugary desserts may predispose patients to the onset of pediatric IBD. 47 Our study suggests that a Mn-rich, plant-based diet might protect the colonic mucosa against inflammation in pediatric patients with IBD.…”

“…47 There is increasing evidence to suggest that dietary habits such as high consumption of animal proteins, fatty foods, and sugary desserts may predispose patients to the onset of pediatric IBD. 47 Our study suggests that a Mn-rich, plant-based diet might protect the colonic mucosa against inflammation in pediatric patients with IBD. Thus, an assessment of patients' nutritional Mn status may be beneficial for making recommendations regarding dietary habits to those at a high risk of IBD, especially among the pediatric population.…”

Systematic review with meta‐analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease

“…Recently, Pegnani et al . conducted a large systematic review of paediatric nutrition and CD with several end points, including the efficacy of enteral nutrition on the induction of remission in a paediatric population.…”

The Specific Carbohydrate Diet in the Treatment of Crohn’s Disease: A Systematic Review

“…The SCD is based on the theory that both disaccharides and polysaccharides are not fully absorbed in the gastrointestinal tract, leading to bacterial overgrowth, yeast production, and excessive creation of mucus. These symptoms are thought to perpetuate mucosal damage, resulting in even poorer absorption and increased inflammation [7,8,[11][12][13][14][15] . It has been further hypothesized that the malabsorption of these complex carbohydrates and certain sugars may lead to harmful aberrations in the gut microbiome, further contributing to the disease state [8,[13][14][15][16] .…”