Pre-Diagnosis Diet Predicts Response to Exclusive Enteral Nutrition and Correlates with Microbiome in Pediatric Crohn Disease

作者：Stephanie Dijk, Megan Jarman, Zhengxiao Zhang, Morgan Lawley, Muzammil Ahmad, Ricardo Suárez, Laura Rossi, Min Chen, Jessica Wu, Matthew Carroll, Anthony Otley, Mary Sherlock, David Mack, Kevan Jacobson, Jennifer C. deBruyn, Wael El‐Matary, Colette Deslandres, Mohsin Rashid, Peter Church, Thomas D. Walters, Hien Q. Huynh, Michael G. Surette, Anne M. Griffiths, Eytan Wine · 发表于：Nutrients · 年份：2024 · DOI：10.3390/nu16071033 · 被引用次数：12 · 研究领域：Inflammatory Bowel Disease、Gut microbiota and health、Helicobacter pylori-related gastroenterology studies

Exclusive enteral nutrition (EEN) is effective in inducing remission in pediatric Crohn disease (CD). EEN alters the intestinal microbiome, but precise mechanisms are unknown. We hypothesized that pre-diagnosis diet establishes a baseline gut microbiome, which then mediates response to EEN. We analyzed prospectively recorded food frequency questionnaires (FFQs) for pre-diagnosis dietary patterns. Fecal microbiota were sequenced (16SrRNA) at baseline and through an 18-month follow-up period. Dietary patterns, Mediterranean diet adherence, and stool microbiota were associated with EEN treatment outcomes, disease flare, need for anti-tumor necrosis factor (TNF)-α therapy, and long-term clinical outcomes. Ninety-eight patients were included. Baseline disease severity and microbiota were associated with diet. Four dietary patterns were identified by FFQs; a “mature diet” high in fruits, vegetables, and fish was linked to increased baseline microbial diversity, which was associated with fewer disease flares (p < 0.05) and a trend towards a delayed need for anti-TNF therapy (p = 0.086). Baseline stool microbial taxa were increased (Blautia and Faecalibacterium) or decreased (Ruminococcus gnavus group) with the mature diet compared to other diets. Surprisingly, a “pre-packaged” dietary pattern (rich in processed foods) was associated with delayed flares in males (p < 0.05). Long-term pre-diagnosis diet was associated with outcomes of EEN therapy in pediatric CD; diet–microbiota...