TY - JOUR
T1 - Dietary treatment of eosinophilic gastrointestinal disorders in children
AU - Gutiérrez-Junquera, Carolina
AU - Zevit, Noam
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Purpose of reviewTo provide an overview of recent developments on dietary treatment of eosinophilic gastrointestinal disorders (EGID) in children.Recent findingsFood antigens are the main triggers of eosinophilic esophagitis (EoE); however, currently available allergy tests cannot reliably identify eliciting antigens. Studies evaluating the six-food empiric elimination diet (6FED-milk, wheat/gluten, egg, soy/legumes, nuts and fish/seafood) have shown histological remission rates of 72%. Milk, egg, wheat/gluten, and, to a lesser extent, soy/legumes were the most frequent food triggers with only one or two culprit foods identified for most patients. A 4-food elimination strategy afforded a 64% remission rate. A step-up two-four-six food elimination diet generated a 43% remission rate at the two-food elimination stage, and similar reported rates for 4FED and 6FED. Endoscopic procedures were reduced by a 20% compared with 6FED. In a prospective study including 63 children, exclusive milk elimination has been effective in 44% of them. Controlled elimination and reintroduction with histological assessment is necessary.SummaryDietary therapy of EoE has evolved from more restrictive to less restrictive diets to provide better balance between efficacy vs. nutritional deficiencies and quality of life. Data on efficacy of dietary therapy in other EGIDs are very scarce.
AB - Purpose of reviewTo provide an overview of recent developments on dietary treatment of eosinophilic gastrointestinal disorders (EGID) in children.Recent findingsFood antigens are the main triggers of eosinophilic esophagitis (EoE); however, currently available allergy tests cannot reliably identify eliciting antigens. Studies evaluating the six-food empiric elimination diet (6FED-milk, wheat/gluten, egg, soy/legumes, nuts and fish/seafood) have shown histological remission rates of 72%. Milk, egg, wheat/gluten, and, to a lesser extent, soy/legumes were the most frequent food triggers with only one or two culprit foods identified for most patients. A 4-food elimination strategy afforded a 64% remission rate. A step-up two-four-six food elimination diet generated a 43% remission rate at the two-food elimination stage, and similar reported rates for 4FED and 6FED. Endoscopic procedures were reduced by a 20% compared with 6FED. In a prospective study including 63 children, exclusive milk elimination has been effective in 44% of them. Controlled elimination and reintroduction with histological assessment is necessary.SummaryDietary therapy of EoE has evolved from more restrictive to less restrictive diets to provide better balance between efficacy vs. nutritional deficiencies and quality of life. Data on efficacy of dietary therapy in other EGIDs are very scarce.
KW - dietary therapy
KW - eosinophilic esophagitis
KW - eosinophilic gastritis
KW - eosinophilic gastroenteritis
KW - food antigen
KW - nutrition
UR - http://www.scopus.com/inward/record.url?scp=85082780449&partnerID=8YFLogxK
U2 - 10.1097/MCO.0000000000000643
DO - 10.1097/MCO.0000000000000643
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C2 - 32068545
AN - SCOPUS:85082780449
SN - 1363-1950
VL - 23
SP - 210
EP - 216
JO - Current Opinion in Clinical Nutrition and Metabolic Care
JF - Current Opinion in Clinical Nutrition and Metabolic Care
IS - 3
ER -