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Nutrients
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Advances in Nutrition in Pediatric Gastroenterology
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Advances in Nutrition in Pediatric Gastroenterology

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (30 July 2022) | Viewed by 24753

Special Issue Editors

Dr. Usha Krishnan

E-Mail Website
Guest Editor
1. Department of Paediatric Gastroenterology, Sydney Children’s Hospital, High Street, Randwick, NSW 2031, Australia
2. School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW 2031, Australia
Interests: childhood neurogastoenterology and motility disorders; growth and nutrition; aerodigestive disorders; esophageal atresia; disorders of gut brain axis/functional gastrointestinal disorders; gastroesophageal reflux disease and reflux aspiration; eosinophilic esophagitis and gut microbiome
Prof. Dr. Andrew Day

E-Mail Website
Guest Editor
Department of Paediatrics, Christchurch Hospital, University of Otago, Christchurch 4710, New Zealand
Interests: inflammatory bowel disease; coeliac disease; improving Crohn’s outcomes; intestinal inflammatory biomarkers; nutritional aspects of gut diseases; host–pathogen interactions in the gut (and how these relate to chronic gut diseases)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic conditions affecting the gastrointestinal (GI) tract can have various adverse nutritional impacts. This is especially relevant in growing and developing children diagnosed with a chronic GI condition.

The nutritional impact of chronic GI conditions in childhood includes weight loss, or limitations of weight gains, impaired linear growth and pubertal delay. Additional impacts include micronutrient deficiency (such as iron, vitamin D or zinc). Such deficiencies can impact learning (e.g., iron deficiency) or bone health (e.g., calcium or vitamin D deficiency) with short- and/or long-term consequences. Malnutrition in children can have a significant impact not only on health-related patient outcomes, but also on the quality of life of children and their families. Relevant conditions which can have an impact on nutrition include inflammatory bowel disease, eosinophilic disorders, coeliac disease, pancreatic disorders, chronic liver disease, intestinal failure, neurological disorders, cancer and obesity.

This Special Issue aims to focus on the nutritional aspects of GI conditions in childhood, especially new approaches, novel findings and management. We welcome original articles along with review articles or short communications.

Potential topics include:

  • Impact of GI conditions upon the growth and nutrition of children and adolescents: natural history and long-term outcomes, prediction of outcomes, interventions and therapeutic approaches;
  • Micronutrients in children with chronic GI conditions: diagnosis, rates of deficiency of nutrients, consequences, prevention of deficiency and interventions;
  • Role of enteral nutrition in intestinal failure, recent advances in parenteral nutrition, role of diet in IBD, diet therapy for eosinophilic esophagitis, specialized diets for functional gastrointestinal disorders, and the importance of diet in diseases such as cystic fibrosis, metabolic-associated liver disease and pancreatitis;
  • The inter-relationship between diet and microbiome.

Dr. Usha Krishnan
Prof. Dr. Andrew Day
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • children
  • GI conditions
  • weight
  • linear growth
  • micronutrients
  • malnutrition
  • obesity

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Published Papers (7 papers)

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Editorial

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2 pages, 177 KiB  
Editorial
Advances in Nutrition in Pediatric Gastroenterology
by Usha Krishnan and Andrew S. Day
Nutrients 2023, 15(9), 2181; https://doi.org/10.3390/nu15092181 - 4 May 2023
Viewed by 1348
Abstract
Chronic conditions affecting the gastrointestinal (GI) tract commonly impact nutrition adversely [...] Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)

Research

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13 pages, 299 KiB  
Article
Dietary Nutrient Intake and Blood Micronutrient Status of Children with Crohn’s Disease Compared with Their Shared-Home Environment, Healthy Siblings
by Stephanie Brown, Catherine L. Wall, Chris Frampton, Richard B. Gearry and Andrew S. Day
Nutrients 2022, 14(16), 3425; https://doi.org/10.3390/nu14163425 - 20 Aug 2022
Cited by 4 | Viewed by 2479
Abstract
(1) The nutritional status of children with Crohn’s disease (CD) is rarely described. This study aimed to assess the dietary intake and blood micronutrient status of children with CD compared with their healthy, shared-environment siblings. (2) Methods: This observational study included children with [...] Read more.
(1) The nutritional status of children with Crohn’s disease (CD) is rarely described. This study aimed to assess the dietary intake and blood micronutrient status of children with CD compared with their healthy, shared-environment siblings. (2) Methods: This observational study included children with CD (cases) and their shared-environment siblings (controls). The dietary nutrient intake was assessed with a four-day food/beverage diary and was compared with the recommended daily intakes (RDI). Blood micronutrient concentrations were measured using laboratory methods. The nutritional analyses were completed through a multivariate analysis of variance between groups. Between-group comparisons of single-nutrients were assessed using a Mann–Whitney U-test. Chi-squared analyses compared the proportion of children who did not meet the RDI for each nutrient. The results were significant at 0.05. (3) Results: The dietary intake was similar for most nutrients, except the controls had a lower intake of vitamins A and E, copper, zinc, iron, and selenium (p < 0.05). Children using partial enteral nutrition had significantly higher intakes of many micronutrients. It was common for both groups to not meet the RDI’s—more than 50% of cases for 9 nutrients and more than 50% of controls for 13 nutrients. (4) Conclusion: New Zealand children with CD and their shared-environment siblings did not meet the RDI for several micronutrients. Dietary education and/or micronutrient supplementation may be required. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
14 pages, 982 KiB  
Article
Blenderised Tube Feeds vs. Commercial Formula: Which Is Better for Gastrostomy-Fed Children?
by Neha Chandrasekar, Kate Dehlsen, Steven T. Leach and Usha Krishnan
Nutrients 2022, 14(15), 3139; https://doi.org/10.3390/nu14153139 - 29 Jul 2022
Cited by 13 | Viewed by 3823
Abstract
Blenderised tube feeds (BTF) have become a popular alternative to commercial formula (CF) for enterally fed children. This study sought to compare gastrointestinal (GI) symptoms, GI inflammation, and stool microbiome composition between children receiving BTF or CF. This prospective cohort study involved 41 [...] Read more.
Blenderised tube feeds (BTF) have become a popular alternative to commercial formula (CF) for enterally fed children. This study sought to compare gastrointestinal (GI) symptoms, GI inflammation, and stool microbiome composition between children receiving BTF or CF. This prospective cohort study involved 41 gastrostomy-fed children, aged 2–18 years, receiving either BTF (n = 21) or CF (n = 20). The Paediatric Quality of Life Inventory Gastrointestinal Symptoms Scale (GI-PedsQL) was used to compare GI symptoms between the groups. Anthropometric data, nutritional intake, nutritional blood markers, faecal calprotectin levels, stool microbiota, and parental satisfaction with feeding regimen were also assessed. Caregivers of children on BTF reported greater GI-PedsQL scores indicating significantly fewer GI symptoms (74.7 vs. 50.125, p = 0.004). Faecal calprotectin levels were significantly lower for children receiving BTF compared to children on CF (33.3 mg/kg vs. 72.3 mg/kg, p = 0.043) and the BTF group had healthier, more diverse gut microbiota. Subgroup analysis found that 25% of caloric intake from BTF was sufficient to improve GI symptoms. The CF group had better body mass index (BMI) z-scores (−0.7 vs. 0.5, p = 0.040). Although growth was poorer in children receiving only BTF in comparison to the CF group, this was not seen in children receiving partial BTF. A combination of BTF and CF use may minimise symptoms of tube feeding whilst supporting growth. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
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15 pages, 3942 KiB  
Article
The Effects of Commonly Consumed Dietary Fibres on the Gut Microbiome and Its Fibre Fermentative Capacity in Adults with Inflammatory Bowel Disease in Remission
by Konstantinos Gerasimidis, Ben Nichols, Mhairi McGowan, Vaios Svolos, Rodanthi Papadopoulou, Margarita Kokkorou, Martina Rebull, Teresita Bello Gonzalez, Richard Hansen, Richard Kay Russell and Daniel Richard Gaya
Nutrients 2022, 14(5), 1053; https://doi.org/10.3390/nu14051053 - 2 Mar 2022
Cited by 14 | Viewed by 4790
Abstract
Introduction: It has been suggested that the gut microbiome of patients with inflammatory bowel disease (IBD) is unable to ferment dietary fibre. This project explored the in vitro effect of fibre fermentation on production of short-chain fatty acids (SCFA) and on microbiome composition. [...] Read more.
Introduction: It has been suggested that the gut microbiome of patients with inflammatory bowel disease (IBD) is unable to ferment dietary fibre. This project explored the in vitro effect of fibre fermentation on production of short-chain fatty acids (SCFA) and on microbiome composition. Methods: Faecal samples were collected from 40 adults (>16 y) with IBD (n = 20 with Crohn’s disease and n = 20 with ulcerative colitis) in clinical remission and 20 healthy controls (HC). In vitro batch culture fermentations were carried out using as substrates maize starch, apple pectin, raftilose, wheat bran, α cellulose and a mixture of these five fibres. SCFA concentration (umol/g) was quantified with gas chromatography and microbiome was profiled with 16S rRNA sequencing. Results: Fibre fermentation did not correct the baseline microbial dysbiosis or lower diversity seen in either patients with CD or UC. For all fibres, up to 51% of baseline ASVs or genera changed in abundance in HC. In patients with IBD, fermentation of fibre substrates had no effect on species or genera abundance. Production of SCFA varied among the different fibre substrates but this was not different between the two IBD groups and compared to HC after either 5 or 24 h fermentation. Conclusions: Despite extensive microbial dysbiosis, patients with IBD have a similar capacity to ferment fibre and release SCFA as HC. Fibre supplementation alone may be unlikely to restore to a healthy status the compositional shifts characteristic of the IBD microbiome. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
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Review

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24 pages, 696 KiB  
Review
Application of The FODMAP Diet in a Paediatric Setting
by Dakota Rhys-Jones, Jane E. Varney, Jane G. Muir, Peter R. Gibson and Emma P. Halmos
Nutrients 2022, 14(20), 4369; https://doi.org/10.3390/nu14204369 - 18 Oct 2022
Cited by 4 | Viewed by 4248
Abstract
In adults, dietary management, particularly with the FODMAP diet, is a key evidence-based part of multimodal therapy for patients with disorders of the gut–brain interaction, particularly irritable bowel syndrome. This review aims to describe the evidence for the use of this diet and [...] Read more.
In adults, dietary management, particularly with the FODMAP diet, is a key evidence-based part of multimodal therapy for patients with disorders of the gut–brain interaction, particularly irritable bowel syndrome. This review aims to describe the evidence for the use of this diet and how to deliver it in paediatric practice. A literature review covering studies on the FODMAP diet in adult and paediatric settings was conducted. While the evidence for the efficacy and safety of a FODMAP diet delivered in three phases, restriction, rechallenge and personalisation, is considerable, there is a lack of good-quality clinical trials exploring the efficacy of the diet in children and adolescents. Likewise, there are limited data on safety concerns associated with a restrictive diet in paediatrics, including impacts on nutrition and growth, disordered eating behaviours, psychosocial and family issues and families and the gut microbiome. The evidence suggests that the implementation of a dietary program is enhanced by a skilled dietitian when navigating a young person (and family) through healthy eating strategies and/or FODMAP restrictions to ameliorate their symptoms. Since the FODMAP diet is being prescribed globally to children, a practical guide for clinicians used to optimise efficacy and safety is provided, including the less restrictive ‘FODMAP-gentle’ diet. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
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11 pages, 525 KiB  
Review
Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions
by Valeria Dipasquale, Madeleine Aumar, Delphine Ley, Matthieu Antoine, Claudio Romano and Frédéric Gottrand
Nutrients 2022, 14(18), 3831; https://doi.org/10.3390/nu14183831 - 16 Sep 2022
Cited by 8 | Viewed by 3410
Abstract
Tube feeding is a therapeutic intervention that is aimed at providing nutritional support and is important in the nutritional and gastrointestinal management of children with neurological disability (ND) worldwide. Since the publication of the first European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) [...] Read more.
Tube feeding is a therapeutic intervention that is aimed at providing nutritional support and is important in the nutritional and gastrointestinal management of children with neurological disability (ND) worldwide. Since the publication of the first European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) consensus paper in 2017, some aspects of tube-feeding modalities have attracted the interest of the scientific community more than others, including the type of enteral formulas, enteral access, and the challenging practice of tube weaning. The purpose of this review was to report on the most recent hot topics and new directions in tube-feeding strategies for children with ND. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
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Other

14 pages, 300 KiB  
Concept Paper
The Cow’s Milk Related Symptom Score: The 2022 Update
by Yvan Vandenplas, Katerina Bajerova, Christophe Dupont, Philippe Eigenmann, Mikael Kuitunen, Rosan Meyer, Carmen Ribes-Koninckx, Silvia Salvatore, Raanan Shamir and Hania Szajewska
Nutrients 2022, 14(13), 2682; https://doi.org/10.3390/nu14132682 - 28 Jun 2022
Cited by 19 | Viewed by 3692
Abstract
CoMiSS® was developed 7 years ago to increase the awareness of health care professionals towards the possibility that symptoms presented by infants could be related to cow’s milk. While CoMiSS was conceived mostly on theoretical concepts, data is now available from 25 [...] Read more.
CoMiSS® was developed 7 years ago to increase the awareness of health care professionals towards the possibility that symptoms presented by infants could be related to cow’s milk. While CoMiSS was conceived mostly on theoretical concepts, data is now available from 25 clinical trials. Based on this extensive research using the tool since 2015, we aim to propose an updated CoMiSS. The evidence was reviewed, debated and discussed by 10 experts, of whom seven were part of the original group. The panel concluded that the cut-off previously proposed to indicate the likelihood that symptoms may be cow’s milk related should be lowered from ≥12 to ≥10. Data in healthy infants > 6 months are missing. Since the Brussels Infant and Toddlers Stool Scale (BITSS) was recently developed for non-toilet trained children, the Bristol Stool Scale was changed to the BITSS without changing the impact of stool characteristics on CoMiSS. Overall, CoMiSS raises awareness that symptoms might be cow’s milk related. New studies are needed to determine if the change in cut-off and other small adaptions improve its sensitivity and specificity. Data for CoMiSS is still needed in presumed healthy infants between 6 and 12 months old. There may also be regional differences in CoMiSS, in healthy infants as well as in those with cow’s milk allergy. Finally, we emphasize that CoMiSS is an awareness tool and not a diagnostic test. Full article
(This article belongs to the Special Issue Advances in Nutrition in Pediatric Gastroenterology)
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