Nutritional Therapy Strategies in Pediatric Crohn’s Disease
The increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have d...
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2021-01-01
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doaj-58d9252d8ac7489aa854bedbb516efb02021-01-14T00:03:15ZengMDPI AGNutrients2072-66432021-01-011321221210.3390/nu13010212Nutritional Therapy Strategies in Pediatric Crohn’s DiseaseCharlotte M. Verburgt0Mohammed Ghiboub1Marc A. Benninga2Wouter J. de Jonge3Johan E. Van Limbergen4Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The NetherlandsDepartment of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The NetherlandsDepartment of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The NetherlandsTytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Centers, University of Amsterdam, 1105 BK Amsterdam, The NetherlandsDepartment of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The NetherlandsThe increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have demonstrated the high efficacy of nutritional therapy with exclusive enteral nutrition (EEN) to induce remission with an excellent safety profile. However, EEN is poorly tolerated, limiting its compliance and clinical application. This has spiked an interest in the development of alternative and better-tolerated nutritional therapy strategies. Several nutritional therapies have now been designed not only to treat the nutritional deficiencies seen in children with active CD but also to correct dysbiosis and reduce intestinal inflammation. In this review, we report the most recent insights regarding nutritional strategies in children with active CD: EEN, partial enteral nutrition (PEN), Crohn’s disease exclusive diet (CDED), and CD treatment-with-eating diet (CD-TREAT). We describe their setup, efficacy, safety, and (dis)advantages as well as some of their potential mechanisms of action and perspectives. A better understanding of different nutritional therapeutic options and their mechanisms will yield better and safer management strategies for children with CD and may address the barriers and limitations of current strategies in children.https://www.mdpi.com/2072-6643/13/1/212pediatric Crohn’s diseasedietnutritional therapyinflammationmicrobiota |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charlotte M. Verburgt Mohammed Ghiboub Marc A. Benninga Wouter J. de Jonge Johan E. Van Limbergen |
spellingShingle |
Charlotte M. Verburgt Mohammed Ghiboub Marc A. Benninga Wouter J. de Jonge Johan E. Van Limbergen Nutritional Therapy Strategies in Pediatric Crohn’s Disease Nutrients pediatric Crohn’s disease diet nutritional therapy inflammation microbiota |
author_facet |
Charlotte M. Verburgt Mohammed Ghiboub Marc A. Benninga Wouter J. de Jonge Johan E. Van Limbergen |
author_sort |
Charlotte M. Verburgt |
title |
Nutritional Therapy Strategies in Pediatric Crohn’s Disease |
title_short |
Nutritional Therapy Strategies in Pediatric Crohn’s Disease |
title_full |
Nutritional Therapy Strategies in Pediatric Crohn’s Disease |
title_fullStr |
Nutritional Therapy Strategies in Pediatric Crohn’s Disease |
title_full_unstemmed |
Nutritional Therapy Strategies in Pediatric Crohn’s Disease |
title_sort |
nutritional therapy strategies in pediatric crohn’s disease |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2021-01-01 |
description |
The increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have demonstrated the high efficacy of nutritional therapy with exclusive enteral nutrition (EEN) to induce remission with an excellent safety profile. However, EEN is poorly tolerated, limiting its compliance and clinical application. This has spiked an interest in the development of alternative and better-tolerated nutritional therapy strategies. Several nutritional therapies have now been designed not only to treat the nutritional deficiencies seen in children with active CD but also to correct dysbiosis and reduce intestinal inflammation. In this review, we report the most recent insights regarding nutritional strategies in children with active CD: EEN, partial enteral nutrition (PEN), Crohn’s disease exclusive diet (CDED), and CD treatment-with-eating diet (CD-TREAT). We describe their setup, efficacy, safety, and (dis)advantages as well as some of their potential mechanisms of action and perspectives. A better understanding of different nutritional therapeutic options and their mechanisms will yield better and safer management strategies for children with CD and may address the barriers and limitations of current strategies in children. |
topic |
pediatric Crohn’s disease diet nutritional therapy inflammation microbiota |
url |
https://www.mdpi.com/2072-6643/13/1/212 |
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