Specialized Diets
Dietary interventions can be used as primary therapy for IBD.
It is important to have Doctor and Dietitian guidance with any restrictive or avoidance diet, since they have a risk of not providing your child with adequate nutrients and vitamins to grow and develop to their best potential.
Exclusive Enteral Nutrition (EEN)
EEN is a complete exclusion diet where patients receive 100% of their daily calorie needs through liquid formulas instead of food for approximately 8 weeks.
Although the exact mechanism of EEN is unknown, it has shown to be equally or more effective than corticosteroids in inducing remission in children with Crohn’s disease. Corticosteroids are known to have adverse effects when used in children, particularly growth concerns and decreased bone mineral density. Other advantages of EEN over steroids are that EEN promotes mucosal healing and provides nutrition, where corticosteroids do not. However, EEN has poor compliance when compared with corticosteroids because of taste fatigue and complete restriction of food.
Please speak with your Dietitian or Doctor regarding what other foods can be allowed if you are following an EEN treatment plan.
Crohn Disease Elimination Diet (CDED)
The Crohn Disease elimination diet (CDED) is based on the hypothesis that the efficacy of EEN depends on the exclusion of components of western diets that may promote a pro-inflammatory microbiome and promote intestinal permeability.
The CDED focuses primarily on excluding processed foods, gluten, dairy, gluten-free processed foods, animal fat, processed meats, emulsifiers and all canned or processed food. The CDED is structured in 3 phases and includes partial enteral nutrition (PEN), which means using a nutritionally complete formula alongside regular foods.
Research has supported that patients treated with 50% partial enteral nutrition and 50% food showed improved symptoms and a reduction in inflammatory markers.
It is important to have Doctor and Dietitian guidance with the CDED, as any restrictive diet has a risk of not providing your child with adequate nutrients and vitamins to grow and develop to their best potential. We have participated in an important randomized controlled trial to assess CDED, which demonstrated that CDED was better tolerated and more effective in reducing intestinal inflammation than EEN.
Tasty & Healthy Diet
The Tasty & Healthy diet is based on the latest research about the causative role of foods in the development of intestinal inflammation. It excludes foods that aggravate intestinal inflammation. It encourages avoiding processed foods, animal fats, dairy and gluten. Tasty & Healthy focuses on recipes made from fresh, whole foods, including vegetables, fruits, legumes, rice, gluten-free grains, eggs, poultry, seafood and fish. Compared to the CDED, PEN is not required to be part of the diet.
Research has shown that this diet can reduce inflammation of the intestines and support clinical remission in patients with mild-moderate Crohn's disease, with similar efficacy to EEN.
It is important to have Doctor and Dietitian guidance with the any restrictive diet, to ensure your child is getting adequate nutrients and vitamins to grow and develop to their best potential.
Other Exclusion Diets
There is very little evidence to show effectiveness of vegetarian or vegan diets, paleo-type diets, and ketogenic diets in the treatment of IBD.
The Specific Carbohydrate Diet was popularized by Elaine Gottschall as a treatment of IBD after her daughter’s symptoms from ulcerative colitis improved on this diet. It encourages a diet without starches, grains, and simple sugars and promotes homemade yogurt, proteins, and fruit and vegetable. The research of the SCD supports the idea that it can be effective in improving clinical symptoms, however it has not been shown to be effective in inducing mucosal remission of IBD. Therefore, we do not routinely suggest or encourage the specific carbohydrate diet as a sole treatment of IBD.
Some patients report symptom improvement with a low FODMAP diet but there is no data that shows this diet helps to heal the intestines.
For more information, please visit What is IBD? Crohn's & Colitis Guide | GI Nutrition Foundation