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

BMC Gastroenterology

Umer Z. Ijaz¹  Lee Curtis²  Elaine Buchanan²  Tracey Cardigan²  Richard Hansen²  Diana M. Flynn²  Andrew R. Barclay²  Lisa Gervais²  Vikki Garrick²  Rachel Tayler²  Hazel Duncan³  Lawrence Armstrong³  Caroline Delahunty⁴  Michael Logan⁵  Ben Nichols⁵  Konstantinos Gerasimidis⁵  Vaios Svolos⁵  Clare M. Clark⁵  Konstantinos Gkikas⁵  Simon Milling⁶  Richard K. Russell⁷ 

[1] Civil Engineering, School of Engineering, University of Glasgow, Glasgow, UK;Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children, Glasgow, UK;Department of Paediatrics, Crosshouse Hospital, Kilmarnock, UK;Department of Paediatrics, Wishaw General Hospital, Wishaw, UK;Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK;Institute for Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK;Royal Hospital for Children and Young People, Edinburgh, UK;

关键词: Crohn’s disease;    Food reintroduction;    Dietary triggers;    Faecal calprotectin;    Gluten;    Fibre;    Meat;    Short chain fatty acids;   

DOI  :  10.1186/s12876-021-02029-4

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsNutrient 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.ResultsIntakes 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.ConclusionsThis 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).

【 授权许可】

CC BY