title: Impact of exclusive enteral nutrition on body composition and circulating micronutrients in plasma and erythrocytes of children with active Crohn's disease.
abstract: BACKGROUND
  Nutritional therapy is the primary treatment for active pediatric Crohn's disease (CD) in the UK/Europe, improving disease activity and anthropometry. This study assessed changes in micronutrient status during exclusive enteral nutrition (EEN).
  
  
  METHODS
  Seventeen children (male/female: 8/9; median age: 12.7 years) with active CD were treated exclusively for 6-8 weeks on a polymeric feed (Modulen IBD; Nestle, UK). Body impedance was measured at baseline, during EEN, and posttreatment on normal diet and converted to z-scores of fat and lean mass. Blood samples for nutrient analysis were collected from 13 children at baseline, end of EEN, and posttreatment.
  
  
  RESULTS
  Lean but not fat mass improved at the end of EEN (initiation vs. end of EEN; fat mass [z-score]: -0.5 vs. -0.3; P = 0.141; lean mass [z-score]: -2.1 vs. -0.8; P < 0.0001). At baseline several children presented with suboptimal concentrations of carotenoids, trace elements, vitamin C, B6, and folate in plasma but not in erythrocytes. EEN improved concentrations for several nutrients, but more than 90% of patients had depleted concentrations of all carotenoids. The latter improved on normal diet but other micronutrients, which improved during EEN, returned toward pretreatment concentrations.
  
  
  CONCLUSIONS
  Lean but not fat mass improved at the end of EEN. Median concentrations for several plasma micronutrients improved on EEN but carotenoids were depleted. These findings may have implications for clinical practice and producers of enteral feeds. As plasma concentrations for many micronutrients can be affected by the acute phase response, measurements in erythrocytes may be a better marker of actual body stores.
authors: Lifecourse Nutrition and Health, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Royal Hospital for Sick Children, Glasgow, UK. Konstantinos.Gerasimidis@glasgow.ac.uk
authors: Konstantinos
authors: K
authors: Gerasimidis
authors: Dinesh
authors: D
authors: Talwar
authors: Andrew
authors: A
authors: Duncan
authors: Pamela
authors: P
authors: Moyes
authors: Elaine
authors: E
authors: Buchanan
authors: Kamal
authors: K
authors: Hassan
authors: Denis
authors: D
authors: O'Reilly
authors: Paraic
authors: P
authors: McGrogan
authors: Christine Ann
authors: CA
authors: Edwards
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D001823:Body Composition; D002648:Child; D003424:Crohn Disease / Q000378:metabolism* / Q000628:therapy*; D004750:Enteral Nutrition; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000097:blood*; D012074:Remission Induction
chemical_list: D015415:Biomarkers; D018977:Micronutrients