ORIGINAL PAPER
Figure from article: Assessment of acceptance...
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Nutritional therapy based on exclusive enteral nutrition or partial enteral nutrition together with the Crohn’s disease exclusion diet (CDED) is a treatment option for inducing remission in children with Crohn’s disease. The study aimed to evaluate the acceptance of the CDED by children with Crohn’s disease (CD) and their parents.

Material and methods:
The data were collected using an original questionnaire between April 2022 and March 2025. The study included 46 children with CD aged 7–18 and 59 parents.

Results:
Sixty-one percent of parents and 52.2% of children have consulted a dietitian about the diet. Parents (69.5%) and children (58.7%) also use relevant apps. Most patients accepted the diet, but some needed more time. Thirty-nine percent of parents and 34.8% of children responded that other family members also eat meals according to the CDED. Half the adults said that products are more expensive and need more preparation time than the previous diet. Only 21.7% of CD patients admit that they strictly adhered to the CDED. Children with CD were forced to give up going to restaurants (60.9%) and going on school trips (34.8%). Children also experienced dislike from their peers. Fifty-nine and three tenths percent of parents admitted they gave up going to restaurants with their children because of the diet.

Conclusions:
The Crohn’s disease exclusion diet is generally well tolerated by paediatric patients with CD and their parents; though its implementation may be accompanied by psychosocial challenges. These include stigmatisation among peers, parental concerns regarding control of food intake outside the home, and the difficulties children face when eliminating favourite foods. Such factors should be considered when supporting families in long-term dietary management.
REFERENCES (25)
1.
Roda G, Ng SC, Kotze PG, Argollo M, Panaccione R, Spinelli A, et al. Crohn’s disease. Nat Rev Dis Primers 2020; 6: 22.
 
2.
Ranasinghe IR, Tian C, Hsu R. Crohn disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2024.
 
3.
Van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Ulrika L Fagerberg, et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. J Crohns Colitis 2020; 14: 176-194.
 
4.
Gerasimidis K, Russell RK, Giachero F, Gkikas K, Tel B, Assa A, et al. Precision nutrition in pediatric IBD: A position paper from the ESPGHAN special interest group for basic science and translational research, the IBD Porto group, and allied health professionals. J Pediatr Gastroenterol Nutr 2024; 78: 428-445.
 
5.
Mańkowska-Wierzbicka D. Dieta eliminacyjna w chorobie Leśniowskiego-Crohna – nowa metoda leczenia żywieniowego dzieci i dorosłych. Post Żywi Klin 2024; 19: 64-73.
 
6.
Gordon H, Minozzi S, Kopylov U, Verstockt B, Chaparro M, Buskens C, et al. ECCO guidelines on therapeutics in Crohn’s disease: medical treatment. J Crohns Colitis 2024; 18: 1531-1555.
 
7.
Yu Y, Chen KC, Chen J. Exclusive enteral nutrition versus corticosteroids for treatment of pediatric Crohn’s disease: a meta-analysis. World J Pediatr 2019; 15: 26-36.
 
8.
Day AS, Lopez RN. Exclusive enteral nutrition in children with Crohn’s disease. World J Gastroenterol 2015; 21: 6809-6816.
 
9.
Aharoni-Frutkoff Y, Plotkin L, Pollak D, Livovsky J, Focht G, Lev-Tzion R, et al. Whole food diet induces remission in children and young adults with mild to moderate Crohn’s disease and is more tolerable than exclusive enteral nutrition: a randomized controlled trial. Gastroenterology 2025; 169: 1462-1474.e2.
 
10.
Ma J, Chong J, Qiu Z, et al. Efficacy of different dietary therapy strategies in active pediatric Crohn’s disease: a systematic review and network meta-analysis. PeerJ 2024; 12: e18692.
 
11.
Bischoff SC, Bager P, Escher J, Vranesic Bender D, Wierdsma N, Weimann A, et al. ESPEN guideline on clinical nutrition in inflammatory bowel disease. Clin Nutr 2023; 42: 352-379.
 
12.
Sigall Boneh R, Sarbagili Shabat C, Yanai H, Chermesh I, Ben Avraham S, Boaz M, et al. Dietary therapy with the Crohn’s disease exclusion diet is a successful strategy for induction of remission in children and adults failing biological therapy. J Crohns Colitis 2017; 11: 1205-1212.
 
13.
Sigall Boneh R, Westoby C, Oseran I, Sarbagili-Shabat C, Alben- berg LG, Lionetti P, et al. The Crohn’s disease exclusion diet: a comprehensive review of evidence, implementation strategies, practical guidance, and future directions. Inflamm Bowel Dis 2024; 30: 1888-1902.
 
14.
Levine A, Wine E, Assa A, Sigall Boneh R, Shaoul R, Kori M, et al. In a randomised controlled trial, a Crohn’s disease exclusion diet plus partial enteral nutrition induces sustained remission. Gastroenterology 2019; 157: 440-450.e8.
 
15.
Yanai H, Levine A, Hirsch A, Sigall Boneh R, Kopylov U, Banai Eran H,et al. The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomised trial. Lancet Gastroenterol Hepatol 2022; 7: 49-59.
 
16.
Sigall Boneh R, Pfeffer-Gik T, Segal I, Zangen T, Boaz M, Levine A, et al. Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease. Inflamm Bowel Dis 2014; 20: 1353-1360.
 
17.
Simsek S, Baysoy G, Gencoglan S, Uluca U. Effects of gluten-free diet on quality of life and depression in children with celiac disease. J Pediatr Gastroenterol Nutr 2015; 61: 303-306.
 
18.
O’Neil A, Quirk SE, Housden S, Brennan SL, Williams LJ, Pasco JA, et al. Relationship between diet and mental health in children and adolescents: a systematic review. Am J Public Health 2014; 104: e31-e42.
 
19.
Țepordei AM, Zancu AS, Diaconu-Gherasim LR, Crumpei-Tanasă I, Măirean C, Sălăvăstru D, et al. Children’s peer relationships, well- being, and academic achievement: The mediating role of academic competence. Front Psychol 2023; 14: 1174127.
 
20.
Plenty S, la Roi C. Peer acceptance and rejection during secondary school: Do associations with subsequent educational outcomes vary by socioeconomic background? Child Dev 2024; 95: 929-947.
 
21.
Platt B, Cohen Kadosh K, Lau JYF. The role of peer rejection in adolescent depression. Depress Anxiety 2013; 30: 809-821.
 
22.
Grover RL, Ginsburg GS, Ialongo N. Childhood predictors of an- xiety symptoms: a longitudinal study. Child Psychiatry Hum Dev 2005; 36: 133-153.
 
23.
Prinstein MJ, Aikins JW. Cognitive moderators of the longitudinal association between peer rejection and adolescent depressive symptoms. J Abnorm Child Psychol 2004; 32: 147-158.
 
24.
Wijers FTR, van Zundert SMC, Verburgt CM, van der Kruk N, Wvan Limbergen JE, Wierdsma NJ. Patient experiences with and adherence to Crohn’s disease exclusion diet in Dutch Crohn’s disease patients: a cohort study. Therap Adv Gastroenterol 2025; 18: 17562848251323553.
 
25.
Rohani P, Ansari A, Shaygantabar M, Hekmatdoost A, Sohouli MH. The effects of the Crohn’s disease exclusion diet (CDED) alone versus CDED plus partial enteral nutrition on gut microbiome composition in pediatric CD patients. Microbiologyopen 2025; 14: e70099.
 
Journals System - logo
Scroll to top