Nutrition and dietary behaviors in pediatric Inflammatory Bowel Disease

Abstract

Nutrition and health behaviors are important to the development and health outcomes of children with chronic illnesses. Given the concerns related to growth and bone health, nutrition and healthy dietary behaviors are especially important in Pediatric Inflammatory Bowel Disease (Pedi IBD). Concerns related to nutrition in Pedi IBD have led investigators to make specific recommendations related to increased nutrient intakes. Although research examining nutrition supplementation or enteral rescue therapy in Pedi IBD has demonstrated a positive impact on IBD health outcomes, the Pedi IBD literature is lacking in research evaluating daily oral nutrition and health behaviors. It is important to examine nutrition and health behaviors in Pedi IBD in order to maximize health-promotion and IBD health outcomes. To examine daily oral nutrition, including caloric and nutrient intake and dietary behaviors, in Pedi IBD. Preliminary baseline food frequency data was derived from OSCCAR, the prospective inception cohort study examining only residents of Rhode Island. Children from 9:0 to 17:11 years old (N=58) were included in the analyses. Daily nutrient intake estimates included reported use of supplements. One sample t-tests were used to compare nutrient intake to daily intake recommendations from the Crohn's and Colitis Foundation of America (CCFA). Frequencies of fruit, vegetable, milk, and snack foods were examined and described in terms of weekly consumption. Average caloric intake was estimated to be 2310 kcal per day. Estimated daily vitamin D intake (M=355 iu) was significantly below the expected CCFA norm of 800 iu, t(57) = -13.95, p = .000. Estimated daily calcium intake (M=1263 mg) was significantly below the expected CCFA norm of1500 mg, t(57) = -2.97, p = .004. Fifty-five percent and 30% reported less than weekly consumption of more than 1 type of fruit and 1 type of vegetable, respectively. Of the 3 most frequently consumed fruits (apples, bananas, and grapes), 55%, 57%, and 79% reported consuming less than one portion per week, respectively. Of the 3 most frequently consumed vegetables (tomato sauce, corn, iceberg lettuce), 50%, 53%, 62% reported consuming less than one portion per week, respectively. Fifty percent of the participants reported consuming less than 2 glasses of milk per day. Seventy-five percent reported consuming cookies and 40% reported consuming potato chips at least weekly. Nutrient intake in Pedi IBD appears to fall below recommended intakes due to lack of healthy dietary behaviors. Given the potential impact nutrition may have on IBD health outcomes, including growth and development, it is important for future research to 1) examine factors that promote healthy dietary behaviors and adherence to dietary recommendations in Pedi IBD; 2) examine the relationship between nutrition, dietary behaviors, and IBD health outcomes, including long-term dietary trends and outcomes; and 3) develop behavioral interventions to maximize nutrition in Pedi IBD.