Cathy Guo, Julia Fox, Kristie Bell, Danielle Gallegos, Lynda J Ross
{"title":"克罗恩病儿童的全食物饮食疗法：系统综述。","authors":"Cathy Guo, Julia Fox, Kristie Bell, Danielle Gallegos, Lynda J Ross","doi":"10.1177/17562848251355436","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Children with Crohn's disease (CD) experience gastrointestinal symptoms that impair nutrition, growth and quality of life. Exclusive enteral nutrition is recommended as a first-line remission induction treatment. However, compliance is challenging due to monotony and the social impact of excluding whole foods, increasing interest in whole-food diet therapies.</p><p><strong>Objectives: </strong>This systematic review aimed to summarise current evidence regarding the impact of whole-food therapies on clinical remission (as defined by each study using validated measures) and related health outcomes in children with CD.</p><p><strong>Design: </strong>We performed a systematic review of studies assessing whole-food interventions in children with CD.</p><p><strong>Data sources and methods: </strong>A systematic search was conducted in electronic databases for research published in English from 1 January 2012 to 16 August 2024. Randomised controlled trials (RCTs), quasi-experimental studies, cohort studies, case-control studies and case series were included.</p><p><strong>Results: </strong>Twenty-eight studies (<i>n</i> = 4 RCTs, <i>n</i> = 3 non-RCTs, <i>n</i> = 16 observational studies, <i>n</i> = 5 post hoc analyses) met inclusion criteria and examined six types of diets. Most of the children being treated had uncomplicated, mild-moderate disease activity and were on concomitant medications. Those on whole-food therapies demonstrated a median clinical remission rate of 75% (interquartile range 62%-85%; <i>n</i> = 18 studies), mucosal improvement and healing (<i>n</i> = 5/6 studies), improved inflammatory biomarkers (<i>n</i> = 18/19 studies) and enhanced growth parameters (<i>n</i> = 11/13 studies). Outcomes related to microbial changes were inconsistent. Overall, studies were low-medium quality due to small, non-randomised, uncontrolled studies using a variety of concomitant medications and different definitions for clinical remission, preventing definitive conclusions.</p><p><strong>Conclusion: </strong>The findings suggest whole-food diet therapies can potentially be used to treat children with mild to moderate CD and that a flexible, nutrient-balanced dietary approach tailored to the individual child may be possible. However, large-scale, RCTs with standardised outcome measures are needed to further support the routine use of whole-food therapies in paediatric CD.</p><p><strong>Trial registration: </strong>PROSPERO registration number CRD42024580134.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251355436"},"PeriodicalIF":3.4000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290382/pdf/","citationCount":"0","resultStr":"{\"title\":\"Whole-food diet therapies for children with Crohn's disease: a systematic review.\",\"authors\":\"Cathy Guo, Julia Fox, Kristie Bell, Danielle Gallegos, Lynda J Ross\",\"doi\":\"10.1177/17562848251355436\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Children with Crohn's disease (CD) experience gastrointestinal symptoms that impair nutrition, growth and quality of life. Exclusive enteral nutrition is recommended as a first-line remission induction treatment. However, compliance is challenging due to monotony and the social impact of excluding whole foods, increasing interest in whole-food diet therapies.</p><p><strong>Objectives: </strong>This systematic review aimed to summarise current evidence regarding the impact of whole-food therapies on clinical remission (as defined by each study using validated measures) and related health outcomes in children with CD.</p><p><strong>Design: </strong>We performed a systematic review of studies assessing whole-food interventions in children with CD.</p><p><strong>Data sources and methods: </strong>A systematic search was conducted in electronic databases for research published in English from 1 January 2012 to 16 August 2024. Randomised controlled trials (RCTs), quasi-experimental studies, cohort studies, case-control studies and case series were included.</p><p><strong>Results: </strong>Twenty-eight studies (<i>n</i> = 4 RCTs, <i>n</i> = 3 non-RCTs, <i>n</i> = 16 observational studies, <i>n</i> = 5 post hoc analyses) met inclusion criteria and examined six types of diets. Most of the children being treated had uncomplicated, mild-moderate disease activity and were on concomitant medications. Those on whole-food therapies demonstrated a median clinical remission rate of 75% (interquartile range 62%-85%; <i>n</i> = 18 studies), mucosal improvement and healing (<i>n</i> = 5/6 studies), improved inflammatory biomarkers (<i>n</i> = 18/19 studies) and enhanced growth parameters (<i>n</i> = 11/13 studies). Outcomes related to microbial changes were inconsistent. Overall, studies were low-medium quality due to small, non-randomised, uncontrolled studies using a variety of concomitant medications and different definitions for clinical remission, preventing definitive conclusions.</p><p><strong>Conclusion: </strong>The findings suggest whole-food diet therapies can potentially be used to treat children with mild to moderate CD and that a flexible, nutrient-balanced dietary approach tailored to the individual child may be possible. 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Whole-food diet therapies for children with Crohn's disease: a systematic review.
Background: Children with Crohn's disease (CD) experience gastrointestinal symptoms that impair nutrition, growth and quality of life. Exclusive enteral nutrition is recommended as a first-line remission induction treatment. However, compliance is challenging due to monotony and the social impact of excluding whole foods, increasing interest in whole-food diet therapies.
Objectives: This systematic review aimed to summarise current evidence regarding the impact of whole-food therapies on clinical remission (as defined by each study using validated measures) and related health outcomes in children with CD.
Design: We performed a systematic review of studies assessing whole-food interventions in children with CD.
Data sources and methods: A systematic search was conducted in electronic databases for research published in English from 1 January 2012 to 16 August 2024. Randomised controlled trials (RCTs), quasi-experimental studies, cohort studies, case-control studies and case series were included.
Results: Twenty-eight studies (n = 4 RCTs, n = 3 non-RCTs, n = 16 observational studies, n = 5 post hoc analyses) met inclusion criteria and examined six types of diets. Most of the children being treated had uncomplicated, mild-moderate disease activity and were on concomitant medications. Those on whole-food therapies demonstrated a median clinical remission rate of 75% (interquartile range 62%-85%; n = 18 studies), mucosal improvement and healing (n = 5/6 studies), improved inflammatory biomarkers (n = 18/19 studies) and enhanced growth parameters (n = 11/13 studies). Outcomes related to microbial changes were inconsistent. Overall, studies were low-medium quality due to small, non-randomised, uncontrolled studies using a variety of concomitant medications and different definitions for clinical remission, preventing definitive conclusions.
Conclusion: The findings suggest whole-food diet therapies can potentially be used to treat children with mild to moderate CD and that a flexible, nutrient-balanced dietary approach tailored to the individual child may be possible. However, large-scale, RCTs with standardised outcome measures are needed to further support the routine use of whole-food therapies in paediatric CD.
Trial registration: PROSPERO registration number CRD42024580134.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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