Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn's disease: a pilot study.
Crohn’s disease
Dietary triggers
Faecal calprotectin
Fibre
Food reintroduction
Gluten
Meat
Short chain fatty acids
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
03 Dec 2021
03 Dec 2021
Historique:
received:
22
06
2021
accepted:
02
11
2021
entrez:
4
12
2021
pubmed:
5
12
2021
medline:
15
12
2021
Statut:
epublish
Résumé
The 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. Nutrient 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. Intakes 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. This pilot study identified potential dietary triggers of gut inflammation in children with Crohn's disease after food reintroduction following treatment with exclusive enteral nutrition. Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL: https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered).
Sections du résumé
BACKGROUND
BACKGROUND
The 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.
METHODS
METHODS
Nutrient 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.
RESULTS
RESULTS
Intakes 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.
CONCLUSIONS
CONCLUSIONS
This 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
BACKGROUND
Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL: https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered).
Identifiants
pubmed: 34861829
doi: 10.1186/s12876-021-02029-4
pii: 10.1186/s12876-021-02029-4
pmc: PMC8642954
doi:
Banques de données
ClinicalTrials.gov
['NCT02341248']
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
454Subventions
Organisme : Biotechnology and Biological Sciences Research Council
ID : BB/R006539/
Pays : United Kingdom
Organisme : NERC Environmental Bioinformatics Centre
ID : NE/L011956/1
Informations de copyright
© 2021. The Author(s).
Références
Am J Gastroenterol. 2011 Apr;106(4):563-73
pubmed: 21468064
Aliment Pharmacol Ther. 2020 May;51(10):935-947
pubmed: 32249975
Inflamm Bowel Dis. 2014 Mar;20(3):576-86
pubmed: 24445775
Aliment Pharmacol Ther. 2017 Dec;46(11-12):1119-1120
pubmed: 29105140
Eur J Clin Nutr. 2016 Sep;70(9):1052-6
pubmed: 27167669
Aliment Pharmacol Ther. 2019 Sep;50(6):664-674
pubmed: 31342536
J Clin Gastroenterol. 2011 Mar;45(3):234-9
pubmed: 20871409
Gastroenterology. 2019 Aug;157(2):295-297
pubmed: 31254503
Gastroenterology. 2015 May;148(6):1087-106
pubmed: 25597840
Lancet. 2018 Dec 23;390(10114):2769-2778
pubmed: 29050646
J Gastroenterol. 1995 Nov;30 Suppl 8:98-101
pubmed: 8563904
Am J Gastroenterol. 2010 Oct;105(10):2195-201
pubmed: 20461067
Lancet. 1985 Jul 27;2(8448):177-80
pubmed: 2862371
Gastroenterology. 2019 Apr;156(5):1354-1367.e6
pubmed: 30550821
J Nutr. 2011 May;141(5):883-9
pubmed: 21430242
Clin Gastroenterol Hepatol. 2016 Aug;14(8):1130-6
pubmed: 26748217
Gut. 2018 Sep;67(9):1726-1738
pubmed: 29777041
J Crohns Colitis. 2021 Aug 2;15(8):1305-1315
pubmed: 33439251
Nutr Res. 2015 Sep;35(9):753-8
pubmed: 26126709
Scand J Gastroenterol. 1992;27(3):196-200
pubmed: 1502481
J Crohns Colitis. 2014 Oct;8(10):1179-207
pubmed: 24909831
Sci Rep. 2020 Apr 27;10(1):7033
pubmed: 32341416
Inflamm Bowel Dis. 2011 Jun;17(6):1314-21
pubmed: 21560194
J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):356-360
pubmed: 29916953
Gastroenterology. 2018 Mar;154(4):1037-1046.e2
pubmed: 29174952
World J Gastroenterol. 2010 Sep 14;16(34):4297-304
pubmed: 20818813
J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):254-260
pubmed: 27050050
J Clin Biochem Nutr. 2017 Sep;61(2):91-99
pubmed: 28955125
Cochrane Database Syst Rev. 2019 Feb 08;2:CD012839
pubmed: 30736095
Inflamm Bowel Dis. 2014 May;20(5):861-71
pubmed: 24651582
Gastroenterology. 2014 May;146(6):1564-72
pubmed: 24503132
Rep Health Soc Subj (Lond). 1991;41:1-210
pubmed: 1961974
Nutrients. 2020 Jul 07;12(7):
pubmed: 32645980
Cochrane Database Syst Rev. 2018 Apr 01;4:CD000542
pubmed: 29607496
Gastroenterology. 2019 Jul;157(1):128-136.e5
pubmed: 30872105
Gut. 2004 Oct;53(10):1479-84
pubmed: 15361498
Gut. 2019 Oct;68(10):1801-1812
pubmed: 30670576
Gut. 2020 Sep;69(9):1637-1644
pubmed: 31900290
Gastroenterology. 2013 Nov;145(5):970-7
pubmed: 23912083
Clin Nutr. 2019 Aug;38(4):1892-1898
pubmed: 30049516
J Nutr. 2005 Aug;135(8):1896-902
pubmed: 16046714