IT is something most take of us take for granted.
Children with a chronic condition doctors say can have devastating results were able to sit down and eat a family meal with a knife and fork after taking part in a Scots study.
For patients with Crohns Disease the first line treatment is a liquid diet, mainly comprised of a 'bland milkshake' packed with essential nutrients that generally puts the condition into remission.
However, children generally experience a relapse and rely on medication including powerful immunosuppressant drugs to keep the condition in check.
A study, led by the Royal Hospital for Children and Glasgow University involved children aged six to 15 who were in the middle of a flare-up or newly diagnosed.
They were given a range of diet of readily available lactose and gluten free foods that aimed to replicate the contents of the liquid diet including salmon and gluten free pasta, chicken and potatoes and cereal with lactose free milk.
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After eight weeks, 60% of patients had gone into remission and 80% of participants had improved clinically.
Dr Richard Hansen, Consultant Paediatric Grastroenerologist, said the study also had some unexpected benefits, in that children developed a taste for healthy foods they had not previously enjoyed.
He said: “This work is so important because it offers not only a potential way of treating Crohn’s disease that is less reliant on medicines that suppress the immune system, but it also allows children and young people to eat normal foods alongside their family in contrast to the repetitive and bland milkshake diet we currently rely on.
“It’s a transformative difference in terms of it allowing people to sit down with their family and eat a meal of real food with a fork and knife.
“We’ve tried to match up the macronutrient, carbohydrate, protein and fat and the micronutrients as well, as closely as we can but using normal foods that are readily available so they are lactose free, gluten free and alcohol free.
“I suppose it’s a fairly simple diet when you compare it to the full range of foods that people eat.
“One of the things that was quite interesting for me was that we did have some of our patients who went onto the diet and discovered foods that they hadn’t really eaten before. You have young boys who suddenly discover a taste for salmon.
“Even with the liquid diet, if you come off that then most people will flare within a year.
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"We think that what happens is that we reduce the amount of food in the gut for the bacteria that live there and we suppress those populations of bacteria and in doing that something happens that allows the gut to heal and the Crohns to get better. But once you reintroduce normal foods again you reset that clock and things start to go back to where they were.
Crohn’s disease is a lifelong condition where parts of the digestive system becomes inflamed. Symptoms can be constant or may come and go every few weeks or months and include diarrhoea, stomach aches, cramps, tiredness and weight loss.
“It can be huge and it can be devastating." said Dr Hansen. "I’ve seen people who have been high level footballers and then it comes along in their teenage life and they lose weight and have abdominal pain and they don’t grow as well and they are unable to keep up with training, they struggle with that.
“Our job is to try to build them up and put them back to normal.
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"It’s not uncommon for children with Crohns to have problems with their growth, to have delays in puberty in addition to all the other aspects. It can be an enormous burden on children and their families.
“Thankfully we do have a good range of therapies to put most Crohns into remission and to keep it there but they do still rely on therapies that dampen down the immune system which tend to be used for many years.
“I think if you look at where we are now with Covid, we initially were very cautious about the shielding advice for patients because of the therapies they were on. Subsequently we have seen that paediatric populations don’t seem to be at risk so we’ve relaxed things but it’s a good example of how being on those drugs does have an effects.”
The team are now looking into any possible implications for patients with the new Covid vaccine and have been given £2 million from charities involved in Crohns research to expand the study into adult patients.
Dr Hanse said at this stage it would not be helpful to list all the foods the participants were eating.
He said: “It’s very important to understand that this is done within the context of a clinical trial. We deliver all the food to the people who are on the trial and we work with them to give them a tailored menu depending on what they like and what they don’t like.
“The big exciting bit that’s still to come is looking at what happens with the shifts in gut bacteria for people on this diet and that’s the data we hope will start to emerge."
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