Nutrition in Pediatric Inflammatory Bowel Disease: A Position Paper on Behalf of the Porto Inflammatory Bowel Disease Group of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition
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BACKGROUND AND AIMS: A growing body of evidence supports the need for detailed attention to nutrition and diet in children with inflammatory bowel disease (IBD). We aimed to define the steps in instituting dietary or nutritional management in light of the current evidence and to offer a useful and practical guide to physicians and dieticians involved in the care of pediatric IBD patients. METHODS: A group of 20 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to Nutrition Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition Porto, IBD Interest, and Nutrition Committee. A list of 41 predefined questions was addressed by working subgroups based on a systematic review of the literature. RESULTS: A total of 53 formal recommendations and 47 practice points were endorsed with a consensus rate of at least 80% on the following topics: nutritional assessment; macronutrients needs; trace elements, minerals, and vitamins; nutrition as a primary therapy of pediatric IBD; probiotics and prebiotics; specific dietary restrictions; and dietary compounds and the risk of IBD. CONCLUSIONS: This position paper represents a useful guide to help the clinicians in the management of nutrition issues in children with IBD.
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European guidelines suggest that using enemas containing Lactobacillus reuteri and the eight-strain oral preparation may be a viable option for patients with active mild-to-moderate ulcerative colitis, particularly in patients who do not tolerate 5-ASA.
“European guidelines suggest that using enemas containing Lactobacillus reuteri and the eight‐strain oral preparation may be a viable option for patients with active mild‐to‐moderate UC, 90 particularly in patients who do not tolerate 5‐ASA. 85”
From Efficacy and safety of probiotics in IBD: An overview of systematic reviews and updated meta-analysis of randomized controlled trials. (2024) · cites this paper as [85]
There is limited evidence for the role of diet and other types of CAMs in inducing and maintaining disease remission in IBD, excluding exclusive enteral nutrition in pediatric Crohn's disease.
“This interest and use of CAM is common in pediatric IBD, despite being limited evidence for the role of diet and other types of CAMs in inducing and maintaining disease remission in IBD (excluding exclusive enteral nutrition in pediatric Crohn’s disease) [22,23,24].”
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- Authors
- Miele, E., Shamir, R., Aloi, M., Assa, A., Braegger, C., Bronsky, J., de Ridder, L., Escher, J. C., Hojsak, I., Kolaček, S., Koletzko, S., Levine, A., Lionetti, P., Martinelli, M., Ruemmele, F., Russell, R. K., Boneh, R. S., van Limbergen, J., Veereman, G., & Staiano, A.
- Affiliations
- University of Naples Federico II (IT)
- Tel Aviv University (IL)
- Sapienza University of Rome (IT)
- University Children's Hospital Zurich (CH)
- Gastroenterology and Nutrition Unit Department of Paediatrics 2nd Faculty of Medicine, Charles University and Motol University Hospital Prague Czech Republic
- Department of Paediatric Gastroenterology Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
- Erasmus MC - Sophia Children’s Hospital (NL)
- University of Zagreb (HR)
- Ludwig-Maximilians-Universität München (DE)
- Wolfson Medical Center (IL)
- Meyer Children's Hospital (IT)
- Hôpital Necker-Enfants Malades (FR)
- Royal Hospital for Children (GB)
- Department of Pediatrics Division of Pediatric Gastroenterology & Nutrition IWK Health Centre Dalhousie University Halifax Nova Scotia Canada
- Universitair Ziekenhuis Brussel (BE)
- ORCID
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2018-04
- Volume
- 66
- Issue
- 4
- Pages
- 687-708
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2901550897
- Cited by
- 191
- References
- 313
- Citations by year
- 2026: 15 · 2025: 24 · 2024: 30 · 2023: 21 · 2022: 25 · 2021: 30 · 2020: 24 · 2019: 13 · 2018: 8 · 2016: 1
- FWCI
- 11.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.zora.uzh.ch
- Licence
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Pfizer
- Mead Johnson Nutrition
- Danone
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- pediatric inflammatory bowel disease, nutrition, dietary management, nutritional assessment, macronutrient requirements, micronutrients, probiotics, prebiotics, dietary restriction, consensus recommendations
- MeSH terms
- Child, Europe, Humans, Nutritional Requirements, Nutritional Status, Societies, Medical, Inflammatory Bowel Diseases, Nutrition Assessment, Consensus, Malnutrition
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