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Enteral nutrition improved weight, BMI in pediatric patients with Crohn’s disease
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Children with Crohn’s disease who received exclusive enteral nutrition experienced significant improvements to weight and BMI, but not height, in a recent study.
Researchers evaluated data from 109 pediatric patients (median age 11.2 years at diagnosis) with Crohn’s disease (CD) who underwent exclusive enteral nutrition (EEN) for 8 weeks. Response was assessed and inflammatory markers, anthropometric data and disease characteristics were measured upon initiation and at 1, 2, 6, 12 and 24 months.
Increases to mean weight were observed at 4 weeks (2.5 kg) and 8 weeks (4.3 kg) (P<.001 for both), along with an improvement to weight z-score upon completion of EEN (from –1.1 at baseline to –0.4 at 8 weeks; P<.001). Mean BMI z-score also improved from –1.3 to –0.4 at 4 weeks (P<.001). No significant height improvements were observed during the study. All inflammatory markers improved after 4 and 8 weeks of EEN, including albumin levels, CRP, platelet counts and erythrocyte sedimentation rate (P<.0001 for all differences at 8 weeks).
After EEN, remission occurred in 65 cases, improvement occurred in 32, and 12 patients were unresponsive. Weight gain was greater among children who experienced remission than those with active disease (mean 5.1 g vs. 2.2 kg; P=.04) and those who responded but did not experience remission (3.3 kg; P=.03).
Sixty-three patients relapsed at a median of 6.5 months. Among them, 44 repeated EEN and showed smaller but statistically significant improvements to weight and BMI, compared with baseline, than those observed during the first course.
“We have shown a significant improvement in weight and BMI after completion of a first course of EEN which was sustained to the end of the 2-year follow-up,” the researchers wrote. “The greatest improvement in both weight and inflammatory markers was seen after 4 weeks of EEN, especially in those patients who achieved remission. A prospective study is now needed to compare children given 4- and 8-week courses of EEN to determine if comparable results can be achieved by shorter periods of exclusive feeding.”
Disclosure: See the study for a full list of relevant disclosures.
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