title: Nutritional supplementation with polymeric diet enriched with transforming growth factor-beta 2 for children with Crohn's disease.
abstract: BACKGROUND
  A polymeric diet rich in transforming growth factor-beta 2 used as a single nutrient has been shown to induce remission in 79% of children with Crohn's disease.
  
  
  OBJECTIVE
  To summarize the experience of several pediatric gastroenterology units in Israel using a TGFbeta2-enriched polymeric diet (Modulen IBD) supplementation in children and adolescents with Crohn's disease.
  
  
  METHODS
  In a retrospective study we reviewed the charts of 28 children with Crohn's disease (10 girls, 18 boys) who received, in addition to conventional treatment, Modulen IBD as a supplement to their regular nutrition. These children were compared with 18 children supplemented with standard polymeric formula (Ensure Plus) and 18 children without formula supplementation. We recorded clinical manifestations, growth, and the Pediatric Crohn's Disease Activity Index before and after initiation of the polymeric diet.
  
  
  RESULTS
  The Modulen-treated children showed a significant decrease in PCDAI from 34.3 to 15.7 (P< 0.0001). A significant decrease in PCDAI was recorded also in the Ensure Plus group, from 35 to 22 (P= 0.02) but not in the non-supplemented group. Significant improvements in body mass index (P = 0.01) and erythrocyte sedimentation rate (P= 0.03) were recorded at follow-up (median 3.4 months) only in the Modulen IBD group.
  
  
  CONCLUSIONS
  In this cohort of children with Crohn's disease, supplementation of the diet with Modulen IBD as well as supplementation with Ensure Plus was associated with a decrease in PCDAI. The children supplemented with Modulen IBD also showed improvement in BMI, suggesting an additional advantage of nutritional therapy in children with this disease.
authors.affiliation: Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
authors.forename: Corina
authors.initials: C
authors.lastname: Hartman
authors.forename: Drora
authors.initials: D
authors.lastname: Berkowitz
authors.forename: Batia
authors.initials: B
authors.lastname: Weiss
authors.forename: Ron
authors.initials: R
authors.lastname: Shaoul
authors.forename: Arie
authors.initials: A
authors.lastname: Levine
authors.forename: Orly Eshach
authors.initials: OE
authors.lastname: Adiv
authors.forename: Riki
authors.initials: R
authors.lastname: Shapira
authors.forename: Akiva
authors.initials: A
authors.lastname: Fradkin
authors.forename: Michael
authors.initials: M
authors.lastname: Wilschanski
authors.forename: Ada
authors.initials: A
authors.lastname: Tamir
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir