Gastroenterology and Nutrition Unit, Meyer Children's Hospital, 50139 Florence, Italy.
Department NEUROFARBA, University of Florence, 50139 Florence, Italy.
Nutrients. 2021 May 11;13(5):1611. doi: 10.3390/nu13051611.
It has been widely endorsed that a multifactorial etiology, including interaction between genetic and environmental factors, can contribute to Crohn's Disease (CD) pathogenesis. More specifically, diet has proven to be able to shape gut microbiota composition and thus is suspected to play a significant role in inflammatory bowel disease (IBD) pathogenesis. Moreover, poor nutritional status and growth retardation, arising from several factors such as reduced dietary intake or nutrient leakage from the gastrointestinal tract, represent the hallmarks of pediatric CD. For these reasons, multiple research lines have recently focused on the utilization of dietary therapies for the management of CD, aiming to target concurrently mucosal inflammation, intestinal dysbiosis and optimization of nutritional status. The forerunner of such interventions is represented by exclusive enteral nutrition (EEN), a robustly supported nutritional therapy; however, it is burdened by monotony and low tolerance in the long term. Novel dietary interventions, such as Crohn's Disease Exclusion Diet or Crohn's Disease treatment with eating, have shown their efficacy in the induction of remission in pediatric patients with CD. The aim of the present narrative review is to provide a synopsis of the available nutritional strategies in the management of pediatric CD and to discuss their application in the dietary management of these patients.
人们普遍认为，多种因素的病因，包括遗传和环境因素的相互作用，可以导致克罗恩病（CD）的发病机制。更具体地说，饮食已被证明能够塑造肠道微生物群组成，因此被怀疑在炎症性肠病（IBD）的发病机制中发挥重要作用。此外，由于饮食摄入减少或营养素从胃肠道漏出等多种因素导致的营养不良和生长迟缓是儿科 CD 的标志。出于这些原因，最近有多个研究方向集中在饮食疗法在 CD 管理中的应用，旨在同时针对黏膜炎症、肠道菌群失调和营养状况的优化。这种干预的先驱是肠内营养（EEN），一种得到广泛支持的营养治疗方法；然而，它长期以来存在单调和耐受性差的问题。新型饮食干预措施，如克罗恩病排除饮食或克罗恩病饮食治疗，已显示出在诱导儿科 CD 患者缓解方面的疗效。本综述的目的是概述管理儿科 CD 中可用的营养策略，并讨论其在这些患者的饮食管理中的应用。
