Dietary intakes in children and adolescents with inflammatory bowel disease: a case control study

Introduction. Nutrition is involved in many aspects of Inflammatory Bowel Disease (IBD) including aetiology. Adult IBD studies have identified animal protein and Omega 6 lipids as risk factors for development of Crohn’s Disease (CD) and Omega 3 lipids as protective factors for Ulcerative Colitis (UC). Data on the role of diet in development of paediatric IBD is scanty. The aim of our study was to evaluate pre-illness dietary intakes in paediatric patients with newly diagnosed IBD and compare the findings with dietary consumption of healthy subjects. The aim of this comparison was to identify nutrients which could potentially be involved as dietary risk or protective factors for the development of disease. A case control study was carried out. Dietary consumption 12 months prior to symptom onset was assessed in 25 children and adolescents with newly diagnosed IBD aged 6-17 years (CD n=13, UC n=10, Undetermined Colitis (IBDU) n=2). Data on dietary consumption was collected by a dietitian, through a dietary recall and analysed with Software MètaDieta, which calculated the mean intakes of macro- and micronutrients from the diet. The same dietary recall was performed in healthy controls (HC; n=25), matched for age and gender. The nutrient intakes were expressed as percentage of the recommended dietary intakes for the Italian population (LARN 2012) and compared between IBD and HC groups and in IBD group between CD and UC subjects.Energy intake (kcal % of estimated energy requirements, EER) and protein intake (g/kg/day % of population reference intake, PRI) were higher in IBD vs HC group (p =0,017 and p=0, 0001 respectively). Lipid intake (kcal, % of reference intake range for macronutrients, RI) was higher in HC vs IBD group (p= 0, 0417). Animal/Vegetable protein ratio and Omega 6 /Omega 3 lipid ratio were higher in IBD vs HC group (p=0, 0225 and p=0, 0523 respectively). Iron intake (mg/day % PRI) was higher in IBD vs HC group (p=0, 0286). Intake of vitamin E (mg/day % of adequate intake, AI) was lower in IBD vs HC group, with values close to statistical significance (p=0, 0752). Main results are represented in figures 1 and 2. Conclusion. Our results suggest that specific nutrients may be implicated in pathogenesis of paediatric IBD. High intake of animal protein, Omega 6 lipids and iron may have a role as risk factors, whilst high consumption of Omega 3 lipids and vitamin E may be protective for the development of paediatric IBD.