Abstract Diet plays a critical role in development and progression of Crohn’s disease (CD). Dietary indices are important tools to evaluate diet quality and inflammatory potential, and we investigated their associations with pediatric CD in comparison to healthy children. A cross-sectional study including 144 children with CD (122 with clinically active and 22 with quiescent disease) and 57 healthy controls 6-18 years of age was conducted. Dietary intake was estimated using three 24-h dietary recalls. Diet quality was assessed using the Healthy Eating Index (HEI)-2015, alternate Mediterranean diet (aMed) score and dietary inflammatory potential using the modified Children-Dietary Inflammatory Index (mC-DII). Children with active CD had lower total HEI-2015 and aMed scores than healthy controls. A similar pro-inflammatory mC-DII score was found across the three groups. A higher mC-DII score in patients with CD was associated with higher intake of refined sugars, saturated fats and proteins, and lower intake of whole grains and dairy, highlighting dietary components contributing to pro-inflammatory potential. Similarly, healthy children in the highest mC-DII tertile consumed more added sugars and sodium and fewer whole grains, fruits, vegetables, and plant proteins. Fiber intake was significantly lower in children with active CD (median fiber %DRI: 37.0 IQR 22.6-48.3 vs 41.2 IQR 34.1-49.1 vs 45.8 IQR 35.7-62.0, P <0.001). Using three dietary indices to evaluate diet quality and dietary inflammatory potential, both children with CD and healthy children in this cohort consume a poor-quality, pro-inflammatory diet low in fiber, but the quality and fiber content are significantly lower in children with active CD. Future randomized controlled trials are required to evaluate the effect of dietary modification on the risk and progression of pediatric CD.
Breton et al. (Tue,) studied this question.