Nutritional Management of Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Patients with IBD are at risk of malnutrition and growth failure, largely depending upon their disease burden. Growing evidence suggests that diet plays an important role in modulating the intestinal microbiota, gut mucosal barrier and hence the intestinal immune system. Thus, diet is considered a potentially modifiable risk factor in IBD. Over the last decade this has garnered significant interest in nutritional management of IBD. The following review will discuss different dietary interventions in the treatment of IBD, including enteral nutritional therapies and emerging specific diets. Given every patient's unique genetic makeup and microbiome, the optimal therapeutic approach, including the choice of nutritional therapy, should be personalized.

Patterns of medical and developmental comorbidities among children presenting with feeding problems: a latent class analysis.

OBJECTIVE: Children with feeding problems often have multiple co-occurring medical and developmental conditions; however, it is unknown whether patterns of comorbidity exist and whether they relate to important feeding-related health outcomes. The main objective of this study was to examine (1) the relationship between the number of medical and developmental comorbidities and important feeding-related health outcomes; (2) how various comorbidities interact and form empirically derived patterns; and (3) how empirically derived patterns of comorbidity relate to weight status, nutritional variety, and child and parent mealtime behavior problems. METHODS: The medical records of 286 children (mean age = 35.56 months) seen at an outpatient feeding disorders clinic were reviewed. Child weight status, nutritional variety, and child and parent mealtime behavior problems were assessed using standardized measures. The lifetime occurrence of medical and developmental conditions was reliably coded. Empirically derived patterns of comorbidity were generated via latent class analyses. RESULTS: Latent class analyses generated 3 comorbidity patterns: "Behavioral" (58% of cases), "Developmentally Delayed" (37%), and "Autism Spectrum Disorder" (ASD, 5%). The Autism Spectrum Disorder group was found to have less nutritional variety compared to the Behavioral and Developmentally Delayed groups. No differences were found between groups in terms of percent ideal body weight, or severity of child or parent mealtime behavior problems. CONCLUSION: Multiple co-occurring conditions of children with feeding problems were empirically reduced to 3 patterns of comorbidities. Comorbidity patterns were largely unrelated to weight status and child or parent mealtime behavior problems. This suggests that medical and developmental conditions confer general, rather than specific, risk for feeding problems in children.