Nutrition and dietary therapy in paediatric inflammatory bowel disease

Learning ObjectivesUnderstand the role of diet in the development of inflammatory bowel disease.Understand the principles of dietary management of Crohn's disease and Ulcerative colitis.Discuss the various options available for dietary management of Crohn's disease and Ulcerative colitis at the various stage of the disease course.Discuss the aetiology and manifestation of malnutrition in Crohn's disease and Ulcerative colitis.Discuss the various assessment methods available and their pitfalls in the assessment of nutritional status in patients with Crohn's disease and Ulcerative colitis. Key MessagesDiet in important in the aetiology and progression of inflammatory bowel disease but the exact way by which diet modifies risk of disease development remains elusive.It is imperative that findings from nutritional epidemiology and experiments in animal models are confirmed within clinical trials before recommendations for dietary management are made.Exclusive enteral nutrition is the only established dietary therapy for active Crohn's disease.Novel dietary therapies for management of inflammatory bowel disease require replication within clinical trials.Undernutrition is common at disease presentation, but its prevalence decreases at follow-up and obesity increases.Assessment of micronutrient status using laboratory biomarkers is difficult in patients with active disease.A multicomponent approach is required, ideally in patients with quiescent disease activity.