Diet therapy in the complex treatment of children with Crohn’s disease

Background. Crohn’s disease in children is often accompanied by impaired nutritional status, including severe malnutrition. Elimination diets are often unjustified and lead to deterioration of the patient’s condition. The aim of the study: to determine the trend in the nutritional status against the background of optimizing the diet in children with Crohn’s disease (CD). Materials and methods. A comprehensive study of nutritional status was carried out including parameters of bone mineral density in 191 children 7–17 years-old with a confirmed diagnosis of CD. 54 patients were examined dynamically before and after the prescribing of a balanced sparing diet developed by us with or without the addition of specialized products for enteral nutrition (groups 1 and 2, respectively). Results. More than half (52,9%) of the children had malnutrition, with 49 (25,7%) patients having moderate to severe malnutrition, accompanied by loss of lean mass, skeletal muscle mass, and bone mineral density. The widespread use of unbalanced diets with insufficient caloric content, low levels of protein, calcium- and iron-containing foods, and dietary fiber was revealed. Against the background of a comprehensive approach with the inclusion of dietary support developed by us, significant positive trends were noted (p < 0,001) as BMI increasing against the background of an increase in lean and skeletal muscle mass of the body without an increase in the content of adipose tissue (p > 0,05). A significant decrease in the disease activity indices — PCDAI and SES-CD was noted. Conclusion. Prescribing unbalanced restrictive diets is unsafe. A comprehensive approach to correcting the nutritional status in patients with a sparing balanced diet against the background of immunosuppressive therapy has proven its effectiveness not only in gaining weight, but also in improving the component composition of the body, but also in monitoring disease activity.