PP250
INDIVIDUALIZED CALORIC PRESCRIPTION IN EXCLUSIVE ENTERAL NUTRITION FOR PEDIATRIC CROHN’S DISEASE: IS 120% DRI ALWAYS NECESSARY?
S. Dinesh Kumar1,2,*, L. Vs1, D. Kesavelu1
1Pediatrics, Apollo children’s hospital , 2Sri Lalithambigai Medical College and Hospital , Chennai, India
Rationale: To evaluate whether providing up to 120% of the Dietary Reference Intake is necessary for inducing remission and improving malnutrition in children with active Crohn’s Disease treated with 8 weeks of Exclusive Enteral Nutrition. This is clinically important to optimize evidence-based use of EEN while improving feasibility and utilization in India.
Methods: A total of 69 children (39 boys, 30 girls) aged 4–17 years with active CD were included. Baseline data on anthropometry, biochemical parameters, and dietary intake were collected using validated tools. EEN was administered for 8 weeks, followed by reassessment. Nutritional intake was individualized based on dietary recall rather than uniformly targeting 120% DRI.
Results: Significant improvements were seen post-intervention. Mean weight increased (30.7 to 32.85 kg), while height showed no significant change.Hemoglobin (10.2±0.79 to 11.1±0.55 g/dL), haematocrit (35.2±2.7 to 39.7±0.57), ESR (24.9±4.1 to 19.6), and albumin (3.6±0.57 to 4.0±0.3). Clinical remission was achieved in all children after 8 weeks of EEN.
Calorie analysis showed children aged 4–6 years required ~120% DRI, whereas those aged 7–17 years improved with 90–118% RDA, indicating remission and nutritional recovery can be achieved without consistently reaching 120% RDA.
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Conclusion: EEN is an effective, well-tolerated therapy for inducing remission and improving nutrition in pediatric Crohn’s disease. Individualized calorie prescription based on dietary recall is more appropriate than a fixed 120% DRI, as even 100% RDA may support catch-up growth and recovery in children with poor baseline intake.
References: Biancone L, Michetti P, Travis S, etal ; European Crohn's and Colitis Organisation (ECCO). European evidence-based consensus on the management of ulcerative colitis: special situations. J Crohns Colitis. 2008;2(1):63–92. doi:10.1016/j.crohns.2007.12.001.
Disclosure of Interest: None declared