An update on dietary therapies in paediatric Crohn’s disease

Gkikas, K. , Svolos, V., White, B. and Gerasimidis, K. (2024) An update on dietary therapies in paediatric Crohn’s disease. Current Opinion in Clinical Nutrition and Metabolic Care, 27(3), pp. 304-312. (doi: 10.1097/MCO.0000000000001024) (PMID:38456807)

Abstract

Purpose of review: This article provides a literature update on original articles published in the past 18 months (May 2022–November 2023) in the dietary management of paediatric Crohn's disease. Recent findings: There is more data to support the use of exclusive enteral nutrition in the management of active Crohn's disease in children. Several food-based dietary therapies have been proposed for the management of Crohn's disease. There is an interest in precision nutritional therapy in Crohn's disease, but current data are scarce. Summary: Exclusive enteral nutrition is an effective treatment for paediatric Crohn's disease. Predictors of response to exclusive enteral nutrition include mild disease phenotype and ileal disease involvement, although data remain inconclusive. Adherence to exclusive enteral nutrition is cornerstone to its efficacy. Treatment with exclusive enteral nutrition modifies the gut microbiome, modulates bile acid metabolism and has significant effects on host immune responses. More studies are expected in which drugs need to be combined with dietary therapies and microbial therapeutics. The efficacy of Crohn's disease exclusion diet coupled with partial enteral nutrition is supported by independent studies, but tolerance remains an issue, particularly for long-term disease management. More research is anticipated in precision nutritional therapy in paediatric Crohn's disease, but currently no recommendations can be made.

• Item Type: Articles
• Keywords: Crohn’s disease, exclusive enteral nutrition, diet, microbiome, precision nutrition.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gkikas, Dr Konstantinos and White, Ms Bernadette and Gerasimidis, Professor Konstantinos and Svolos, Dr Vaios
• Authors: Gkikas, K., Svolos, V., White, B., and Gerasimidis, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Current Opinion in Clinical Nutrition and Metabolic Care
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 1363-1950
• ISSN (Online): 1473-6519
• Published Online: 29 February 2024
• Copyright Holders: Copyright © 2024 Wolters Kluwer Health, Inc.
• First Published: First published in Current Opinion in Clinical Nutrition and Metabolic Care 27(3):304-312
• Publisher Policy: Reproduced in accordance with the publisher copyright policy