Food Intake Adequacy in Children and Adolescents With Inflammatory Bowel Disease

Objectives: Diet assessment is essential in the care of patients with inflammatory bowel disease (IBD). We aimed to study food intake in children with IBD and evaluated the relation of dietary intake with disease activity and nutritional status in these children. Methods: This cross-sectional study investigated 68 children and adolescents with IBD (57 Crohn disease, 11 ulcerative colitis). Evaluation included clinical, laboratory, and nutritional assessment including 3 days diet record. Results: Compared with recommended daily allowance, the intake of patients with IBD was significantly poor for carbohydrates (75%, P = 0.016), calcium (49%, P<0.05), magnesium (76%, P<0.05), vitamin A (72%, P<0.05), vitamin E (57%, P<0.05), and fiber (44%, P<0.05) and higher for protein (175%, P<0.05), iron (112%, P<0.05), and water-soluble vitamins (118%-189% P<0.05). Compared with the intakes of healthy children from National Nutritional Survey, the intake of IBD group was lower for calories (78%, P = 0.012), carbohydrates (61% P<0.05), magnesium (67% P<0.05), vitamin C (34%, P<0.05), and fiber (54%, P<0.05) and high for B12 (141%, P<0.05). Fifty subjects ate ordinary diets, 7 of 68 children were on exclusive enteral nutrition and 11 of 68 consumed regular food with different polymeric formulas supplements. Compared with children without supplements, children on exclusive enteral nutrition and nutritional supplements (18/68) had significantly better intakes of energy (1870 +/- 755 vs 2267 +/- 432, P<0.05), carbohydrates (223 +/- 97 vs 292 +/- 99, P<0.05), and all minerals (P<0.05) and micronutrients (P<0.05). Dietary intake was not different by disease status (remission or relapse). Conclusions: In the absence of nutritional supplements, food intake is inadequate for many nutrients in many children with IBD.