Abstract
Background: Nutritional support is very important in the treatment of Paediatric Inflammatory Bowel Disease (IBD). The role of the Mediterranean Diet (MD) has been understudied in children with IBD. The aims of this study were to assess the dietary intakes of IBD children in comparison with healthy controls (HCs), their adherence to MD; and the relationship between inflammation and dietary behaviors. Methods: Paediatric IBD patients in clinical remission and HCs were enrolled. The nutritional status and adherence to the Mediterranean Diet was evaluated through a 3-day food diary and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Results: The analysis of food diaries showed a significantly higher kilocalorie intake in IBD patients compared to HCs (p = 0.012), an increase in carbohydrates (p = 0.015) and in protein intake (p = 0.024). Both IBD and HCs have an intermediate adherence to MD. The comparison between Crohn’s disease (CD) and Ulcerative colitis (UC) patients showed significant difference in protein intake in CD patients (p = 0.047), as well as for vitamin D (p = 0.044) and iron intake (p = 0.023). Interestingly; in IBD patients we found a significant association between adherence to MD and a low level of fecal calprotectin (p = 0.027). Conclusion: Children with IBD in remission have a sub-optimal food intake compared to HCs. MD seems to correlate to decreased intestinal inflammation.
Highlights
In Inflammatory Bowel Disease (IBD), nutritional problems are common and depend on the location, disease activity, surgery and associated complications
There were no significant differences in z-scores for weight and height between the IBD and Healthy controls (HCs)
We found a significant difference in sex between the two groups with 41/72 female (56.9%) in the Ulcerative colitis (UC) group and 16/52 (30.2%) in the Crohn’s disease (CD) group (p = 0.0037), whereas there were no significant differences in z-scores for weight and height
Summary
In Inflammatory Bowel Disease (IBD), nutritional problems are common and depend on the location, disease activity, surgery and associated complications. Some patients believe that food induces or may exacerbate some symptoms, and for this reason they modify their diet to gain some control over the disease This attitude can have an important impact on the nutritional status [3]. Results: The analysis of food diaries showed a significantly higher kilocalorie intake in IBD patients compared to HCs (p = 0.012), an increase in carbohydrates (p = 0.015) and in protein intake (p = 0.024). Both IBD and HCs have an intermediate adherence to MD.
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