Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study

Gkikas, K. et al. (2021) Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study. BMC Gastroenterology, 21, 454. (doi: 10.1186/s12876-021-02029-4) (PMID:34861829)

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Abstract

Background: The anti-inflammatory effect of exclusive enteral nutrition on the gut of children with Crohn’s disease is rapidly lost after food reintroduction. This study assessed disease dietary triggers following successful treatment with exclusive enteral nutrition. Methods: Nutrient intake, dietary patterns and dietary biomarkers in faeces (gluten immunogenic peptides, undigestible starch, short chain fatty acids) were assessed in 14 children with Crohn’s disease during early food reintroduction, following exclusive enteral nutrition. Groups above (Group A) and below (Group B) the median levels of faecal calprotectin after food reintroduction were assigned for comparative analysis. Results: Intakes of fibre, gluten-containing cereals and red and processed meat were significantly higher in Group A than Group B; (median [Q1, Q3], g/day; Fibre: 12.1 [11.2, 19.9] vs. 9.9 [7.6, 12.1], p = 0.03; Red and processed meat: 151 [66.7, 190] vs. 63.3 [21.7, 67], p = 0.02; gluten-containing cereals: 289 [207, 402] vs. 203 [61, 232], p = 0.035). A diet consisting of cereals and meat products was predictive (92% accuracy) of higher faecal calprotectin levels after food reintroduction. In faeces, butyrate levels, expressed as absolute concentration and relative abundance, were higher in Group A than Group B by 28.4 µmol/g (p = 0.015) and 6.4% (p = 0.008), respectively. Levels of gluten immunogenic peptide and starch in faeces did not differ between the two groups. Conclusions: This pilot study identified potential dietary triggers of gut inflammation in children with Crohn’s disease after food reintroduction following treatment with exclusive enteral nutrition. Trial registration: Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL: https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered).

Item Type:Articles
Additional Information:K Gkikas PhD studentship was funded in partnership from the University of Glasgow and Nestle Health Science. ML PhD studentship was funded by the Engineering and Physical Sciences Research Council and Nestle Health Science. CMC was funded by the PhD studentship from Glasgow Children's Hospital Charity. Dr Ben Nichols was funded by a grant from the Biotechnology and Biological Sciences Research Council (BB/R006539/1) and The Catherine McEwan Foundation. The work of the IBD team in Glasgow is supported by the Catherine McEwan foundation. UZI is funded by NERC Independent Research Fellowship NE/L011956/1.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Logan, Dr Michael and Nichols, Mr Ben and Gerasimidis, Professor Konstantinos and Gkikas, Konstantinos and Hansen, Dr Richard and Clark, Clare and Russell, Dr Richard and Milling, Professor Simon and Svolos, Dr Vaios and Ijaz, Dr Umer
Authors: Gkikas, K., Logan, M., Nichols, B., Ijaz, U. Z., Clark, C. M., Svolos, V., Gervais, L., Duncan, H., Garrick, V., Curtis, L., Buchanan, E., Cardigan, T., Armstrong, L., Delahunty, C., Flynn, D. M., Barclay, A. R., Tayler, R., Milling, S., Hansen, R., Russell, R. K., and Gerasimidis, K.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Science and Engineering > School of Engineering > Infrastructure and Environment
Journal Name:BMC Gastroenterology
Publisher:BioMed Central
ISSN:1471-230X
ISSN (Online):1471-230X
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMC Gastroenterology 21: 454
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
300280The Role of Dietary D-serine in Health and DiseaseAndrew RoeBiotechnology and Biological Sciences Research Council (BBSRC)BB/R006539/1III - Bacteriology
170256Understanding microbial community through in situ environmental 'omic data synthesisUmer Zeeshan IjazNatural Environment Research Council (NERC)NE/L011956/1ENG - Infrastructure & Environment