Abstract Background Cumulative evidence supports the use of dietary approaches for the treatment of Crohn’s disease (CD)1–4. This study aims to compare the macro and micronutrient intakes provided by exclusive enteral nutrition (EEN) and Crohn’s disease exclusion diet (CDED) combined with partial enteral nutrition (PEN), in order to identify nutritional deficiencies and suggest the need for nutritional supplementation. Methods A retrospective single-center cohort study was performed among paediatric CD patients treated with EEN or CDED combined with PEN between 2020 and 2025. The patients were divided into four categories (14 patients on EEN, 21 on CDED1, 15 on CDED2, and 16 on CDED3), with the same patients potentially being included in multiple categories. Macronutrient (carbohydrates, proteins, lipids) and micronutrient (calcium, iron, magnesium, vitaminD) intakes were collected at baseline for each category and compared with the Dietary Reference Intakes (DRIs) for age. Results The energy intakes of all patients were adequate to their total energy expenditure (TEE). In terms of macronutrient intake, carbohydrates were below the recommended levels in the EEN group, whereas lipids exceeded these references. Conversely, macronutrient intakes were within recommended ranges for CDED1, CDED2, and CDED3. Regarding micronutrient intake, calcium was adequate in all patients in the EEN group, whereas deficiencies were observed in 7/21 (33%) CDED1 patients, 15/15 (100%) CDED2, and 7/15 (44%) CDED3. VitaminD intake was adequate in the EEN group, but insufficient in 15/21 (71%) CDED1 patients, and in all those on CDED2 and CDED3. Magnesium intake was adequate in all EEN patients and in the majority of patients on CDED, specifically in 20/21 (95%), 15/15 (100%), and 15/16 (94%) patients on CDED1, CDED2, and CDED3, respectively. Finally, iron intake was adequate in all groups. Conclusion This study shows that calcium and vitaminD intakes may be inadequate in patients on CDED, with significant declines between CDED1 and CDED2. These findings emphasize for the first time the importance of addressing calcium and vitaminD supplementation across the different phases of CDED, with particular attention to CDED2. References: 1. Verburgt CM, Ghiboub M, Benninga MA, de Jonge WJ, Van Limbergen JE. Nutritional Therapy Strategies in Pediatric Crohn’s Disease. Nutrients. 2021;13(1):212. doi:10.3390/nu13010212 2. Sigall Boneh R, Westoby C, Oseran I, et al. The Crohn’s Disease Exclusion Diet: A Comprehensive Review of Evidence, Implementation Strategies, Practical Guidance, and Future Directions. Inflamm Bowel Dis. 2023;30(10):1888-1902. doi:10.1093/ibd/izad255 3. Svolos V, Gordon H, Lomer MCE, et al. European Crohn’s and Colitis Organisation consensus on dietary management of inflammatory bowel disease. J Crohns Colitis. 2025;19(9):jjaf122. doi:10.1093/ecco-jcc/jjaf122 4. van Rheenen PF, Aloi M, Assa A, et al. The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update. J Crohns Colitis. 2021;15(2):jjaa161. doi:10.1093/ecco-jcc/jjaa161 Conflict of interest: Bianchi, Alice: No conflict of interest Perna, Eliana: No conflict of interest Gianolio, Laura: No conflict of interest Penagini, Francesca: No conflict of interest Dilillo, Dario: No conflict of interest Bosetti, Alessandra: No conflict of interest Zuccotti, Gianvincenzo: No conflict of interest Norsa, Lorenzo: Consultant for PFIZER, NESTLE’, TAKEDA, ALFASIGMA, SANOFI
Bianchi et al. (Thu,) studied this question.