Children with active CD consume diet with significantly lower amount of fiber
Study results demonstrate diet may differentially influence the gut microbiome in children with Crohn’s disease, according to a presentation at the Crohn’s and Colitis Congress.
“Both children with CD and healthy children in North America consume a Westernized diet which is low in fiber, more significantly low in children with active CD,” Jessica Breton, MD, from Children’s Hospital of Philadelphia, said during her presentation. “Our results also significantly show diet may exert a differential influence on the gut microbiome depending on the clinical disease status.”
Breton and colleagues performed a prospective cross-sectional study of 58 children with Crohn’s disease, 36 of whom had clinically active disease. An additional 56 children served as healthy controls. A 3-day recall was used to estimate dietary intake. Diet quality measurements included consumption measured against the American Dietary Guidelines (Healthy Eating Index (HEI)-2015) and inflammatory potential measured with dietary inflammatory index (DII).
Researchers used shotgun metagenomics DNA sequencing to perform compositional and functional analysis of the fecal microbiome. They also used linear mixed-effects models to model correlations with dietary indices after controlling for confounding effects.
“Overall dietary intake followed a Western diet pattern meaning it was high in animal protein, high in saturated fats, high in refined sugar, low in vegetables, fruits, vegetables and whole grains,” she said.
Results showed healthy controls and patients with CD had similar energy and dietary intakes apart from fiber intake. Breton reported fiber intake was lower in children with active CD compared with healthy controls (41.4 vs. 50.4; P = .03). Patients with active and quiescent CD had a lower but not statistically significant total HEI-2015 score compared with healthy controls (47.6 vs. 51 vs. 49.7). All three groups had a pro-inflammatory total DII score (0.48 vs. 0.41 vs. 0.51).
In children with quiescent CD, HEI-2015 (P = .009) and DII (P = .024) showed positive and negative correlations with alpha-diversity at the microbiome level. Proteobacteria Enterobacteriaceae demonstrated a positive correlation with DII in children with active CD (P = .006), according to Breton. She said a more pro-inflammatory DII score was associated with higher Escherichia coli relative abundances (P = .006).
“Hopefully these results in the future, can assist development of interventional studies to optimize dietary determinants of inflammation and modify disease course,” Breton said.