Scholz Dietmar
Department of Pediatrics, Justus-Liebig-University, Giessen, Germany.
Curr Probl Pediatr Adolesc Health Care. 2011 Oct;41(9):248-53. doi: 10.1016/j.cppeds.2011.04.005.
Many foods have been implicated in theories about the etiology of inflammatory bowel disease. While evidence has accumulated that nutritional factors as part of overall lifestyle changes may play a role in the growing incidence, no specific dietary recommendations except the promotion of breastfeeding can currently be given to decrease the risk of developing Crohn's disease or ulcerative colitis. For the treatment of Crohn's disease in children and adolescents, however, enteral feeding with a semi-elemental diet seems to be as effective as corticosteroids in inducing and maintaining remission. In the meta-analyses, advantages of one formula over the other are evened out, and more research is warranted into the anti-inflammatory properties of different nutrients, such as polyunsaturated fatty acids, butyrate, glutamine, and cytokines, such as transforming growth factors-beta. Unfortunately, for practical reasons, nutritional therapy remains underutilized, even though pediatric patients are most vulnerable to the harmful effects of nutrient deficiencies on growth, pubertal development, and bone health. There is hope that in the future the new field of nutrigenomics may enable physicians to more accurately tailor a specific diet to the patient genotype.
许多食物都与炎症性肠病的病因学理论有关。尽管已有证据表明，作为整体生活方式改变一部分的营养因素可能在发病率不断上升中起作用，但目前除了提倡母乳喂养外，无法给出具体的饮食建议来降低患克罗恩病或溃疡性结肠炎的风险。然而，对于儿童和青少年克罗恩病的治疗，采用半要素饮食进行肠内喂养在诱导和维持缓解方面似乎与皮质类固醇一样有效。在荟萃分析中，一种配方相对于另一种配方的优势相互抵消，因此有必要对不同营养素（如多不饱和脂肪酸、丁酸盐、谷氨酰胺）以及细胞因子（如转化生长因子-β）的抗炎特性进行更多研究。不幸的是，出于实际原因，营养疗法的利用率仍然很低，尽管儿科患者最容易受到营养缺乏对生长、青春期发育和骨骼健康的有害影响。人们希望，未来营养基因组学这一新兴领域能够使医生更准确地根据患者基因型定制特定饮食。
