Energy intakes of children with Crohn's disease treated with enteral nutrition as primary therapy

• Published in: Journal of human nutrition and dietetics Vol. 18; no. 5; pp. 337 - 342
• Main Authors: Gavin, J, Anderson, C.E, Bremner, A.R, Beattie, R.M
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.2005; Blackwell Science; Blackwell Publishing Ltd
• Subjects: Adolescent; adolescent nutrition; adolescents; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; biomarkers; Biomarkers - analysis; Body Mass Index; boys; C-Reactive Protein - analysis; Child; child nutrition; children; clinical trials; Cohort Studies; Crohn disease; Crohn Disease - therapy; Crohn's disease; diet therapy; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; energy balance; energy intake; Energy Intake - drug effects; enteral feeding; Enteral Nutrition; Estimated Average Requirement; Female; girls; Humans; Intensive care medicine; liquid diet; Male; Medical sciences; nutrient requirements; nutrition; Nutritional Requirements; Nutritional Status; Retrospective Studies; treatment; weight gain; Weight Gain - drug effects; Human; Crohn disease; treatment; Diet therapy; Nutrition; Digestive diseases; Intestinal disease; Crohn's disease; Child; Enteral administration; Inflammatory disease; Feeding
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/j.1365-277X.2005.00631.x

Background Enteral nutrition (EN) is widely used and is effective in the treatment of children with Crohn's disease given as an exclusive feed for 6-8 weeks. Current dietetic practice during EN is to recommend an energy intake based on estimated average requirement (EAR) for energy for age Department of Health (1991) Report on Health and Social Subjects No. 41. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. London: HMSO. Aims To examine factors affecting energy intake and weight gain during EN in relation to disease site and nutritional status. Methods A retrospective cohort study examining energy intake and weight gain during the exclusive EN feeding period in 40 patients newly diagnosed with Crohn's in relation to EAR, nutritional status, disease site. Results All patients improved clinically and gained weight during EN with improvement in the CRP as a marker of the systemic inflammatory response. Energy intake was higher than EAR in 82% (33/40 patients), with the median 117.5% of EAR. Weight gain correlated with body mass index standard deviation score (P = 0.001) at start of treatment, but not energy intake or CRP. Conclusion Estimated average requirement underestimates energy intakes in most children with newly diagnosed Crohn's disease. During EN, an energy intake in the range of 100-149% (median 117.5%) EAR for energy for age may be required. Energy balance studies in children with active disease are required.