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Kids with Crohn’s disease tolerate an exclusion diet with PEN better than EEN

08 Aug 2019
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For children with mild-to-moderate Crohn’s disease (CD), a CD exclusion diet (CDED) combined with partial enteral nutrition (PEN) is more tolerable than exclusive enteral nutrition (EEN), a recent study has found.

Researchers randomly assigned 74 children with mild-to-moderate CD to undergo diet regimens involving either CDED with 50 percent of calories from formula followed by CDED with 25 percent PEN (group 1; n=40; mean age, 13.8±2.8 years; 65 percent male) or EEN followed by free diet with 25 percent PEN (group 2; n=38; mean age, 14.5±2.6 years; 59 percent male). The overall duration of the trial was 12 weeks, with each phase lasting 6 weeks.

Tolerance to the diet, measured according to withdrawals due to refusal to continue the trial, was significantly better in group 1 (97.5 percent vs 73.7 percent; p=0.002). Children assigned to the CDED+PEN diet were more likely to complete the trial than their EEN counterparts (odds ratio [OR], 13.92, 95 percent CI, 1.68–115.14).

In terms of secondary endpoints, researchers recorded no significant between-group difference in terms of response rate (CDED+PEN vs EEN: 85 percent vs 85.3 percent; p=0.97; OR, 0.97, 0.27–3.53) and corticosteroid-free remission (80 percent vs 73.5 percent; p=0.51; OR, 1.44, 0.49–4.27).

Both dietary interventions also resulted in significant improvements from baseline in inflammatory markers, scores in the paediatric CD activity index and mean weight z-scores. Between-group comparisons did not result in statistically significant figures.

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
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