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1.
J Pediatr Gastroenterol Nutr ; 78(5): 1135-1142, 2024 May.
Article in English | MEDLINE | ID: mdl-38558411

ABSTRACT

BACKGROUND: In pediatric Crohn's disease (CD), commercial formulas used as exclusive enteral nutrition (EEN) are effective at inducing remission. This study aims to assess the impact of a whole-food blended smoothie as EEN on CD activity and the intestinal microbiome. METHODS: A 4-week prospective trial assessed the impact of EEN with a whole-food smoothie on newly diagnosed mild-to-moderate active pediatric CD. The smoothie with a multivitamin were developed to meet age-appropriate nutritional requirements. Assessment over 4 weeks included Pediatric Crohn's Disease Activity Index (PCDAI), serum laboratories, fecal calprotectin (FCP), and stool collection for metagenomic shotgun sequencing and microbiota composition analysis. Clinical remission was defined as PCDAI ≤ 10 at week 4. RESULTS: Ten participants were enrolled with median age 14.5 years, and 8 completed the trial. Baseline mean PCDAI was 26.3 ± 9.1 and mean FCP 1149 ± 718 µg/g. At week 4, 80% of participants achieved clinical remission. FCP decreased by over half in 60% of participants, with FCP below 250 µg/g in 60% and below 100 µg/g in 40%. Microbiome analysis showed a significant increase in species richness over 4 weeks (p = 0.01). Compared to baseline, the relative abundance at week 2 and at week 4 was significantly increased for Bifidobacterium and Streptococcus and decreased for Blautia (p < 0.05 for all). CONCLUSION: A whole-food blended smoothie was effective for inducing clinical remission and decreasing FCP in pediatric CD similar to commercial EEN formulas. Further research may give insight into data-driven whole-food dietary approaches for CD management. CLINICALTRIALS: gov NCT03508193.


Subject(s)
Crohn Disease , Enteral Nutrition , Gastrointestinal Microbiome , Humans , Crohn Disease/therapy , Crohn Disease/diet therapy , Enteral Nutrition/methods , Pilot Projects , Female , Male , Adolescent , Prospective Studies , Child , Feces/microbiology , Remission Induction/methods , Food, Formulated , Treatment Outcome , Leukocyte L1 Antigen Complex/analysis
2.
Nurse Pract ; 43(3): 35-39, 2018 Mar 12.
Article in English | MEDLINE | ID: mdl-29438186

ABSTRACT

The prevalence of food allergies has doubled in the past 10 years. Peanut allergies are a significant public health issue and are the primary reason for food-related anaphylactic reactions that result in death. Evidence supports that early introduction of the peanut protein (or in combination with immunotherapy) to the highly allergic may safely desensitize patients, which could lead to less adverse allergic reactions and alter allergy management overall.


Subject(s)
Peanut Hypersensitivity/prevention & control , Child , Desensitization, Immunologic , Humans , Immunotherapy , Practice Guidelines as Topic , Randomized Controlled Trials as Topic , Risk Assessment
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