{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:05:20Z","timestamp":1785773120444,"version":"3.56.0"},"reference-count":73,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Exclusive enteral nutrition (EEN) is the recommended first-line therapy for induction of remission in pediatric mild-to-moderate Crohn\u2019s disease (CD), but its restrictive nature often limits adherence and long-term sustainability. A modified version of the Crohn\u2019s Disease Exclusion Diet (CDED), integrating Mediterranean dietary principles, was developed to offer a more acceptable alternative while preserving therapeutic efficacy. Methods: We conducted a retrospective, single-center study comparing short- and long-term outcomes of a Mediterranean-adapted CDED (M-CDED) with partial enteral nutrition (PEN) versus standard EEN in children with mild-to-moderate CD. Clinical remission was assessed after 8 and 16 weeks, while long-term outcomes were assessed after 1 and 2 years. Results: Data collected from thirty-two patients were analyzed (EEN, 14; M-CDED, 18). Clinical remission rates were comparable after 8 weeks (92.8% EEN vs. 94.4% M-CDED) and 16 weeks (100% in both groups). However, at 12 and 24 months, M-CDED was associated with significantly higher rates of clinical and biochemical remission and a markedly lower need for biologic drugs (12-month biologic initiation: 50% EEN vs. 11.1% M-CDED; p = 0.01). Adherence to M-CDED was excellent throughout follow-up. Conclusions: M-CDED with PEN appears to be as effective as EEN for remission induction, with improved long-term disease control and reduced therapeutic escalation. These findings support the feasibility of M-CDED as a sustainable option for long-term management of pediatric CD. Prospective studies are needed to confirm these results.<\/jats:p>","DOI":"10.3390\/nu18081290","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"1290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Outcomes of Mediterranean-Adapted Crohn\u2019s Disease Exclusion Diet in Mild Pediatric Crohn\u2019s Disease: A Real-Life Study from a Referral IBD Center"],"prefix":"10.3390","volume":"18","author":[{"given":"Patrizia","family":"Alvisi","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit, Department of Paediatrics, Ospedale Maggiore, Azienda USL, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Valerii","sequence":"additional","affiliation":[{"name":"Department of Biological, Geological and Environmental Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Perre","sequence":"additional","affiliation":[{"name":"Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, Department of Paediatrics, Ospedale Maggiore, Azienda USL, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Rizzello","sequence":"additional","affiliation":[{"name":"IBD Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Congiu","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Paediatrics, Ospedale Maggiore, Azienda USL, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Pranzetti","sequence":"additional","affiliation":[{"name":"Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1338-9361","authenticated-orcid":false,"given":"Nikolas Kostantine","family":"Dussias","sequence":"additional","affiliation":[{"name":"IBD Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-9145","authenticated-orcid":false,"given":"Francesca","family":"Sbravati","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, Department of Paediatrics, Ospedale Maggiore, Azienda USL, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Imbesi","sequence":"additional","affiliation":[{"name":"IBD Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8525-2981","authenticated-orcid":false,"given":"Enzo","family":"Spisni","sequence":"additional","affiliation":[{"name":"Department of Biological, Geological and Environmental Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Labriola","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, Department of Paediatrics, Ospedale Maggiore, Azienda USL, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.dld.2021.12.018","article-title":"Epidemiological trends of pediatric IBD in Italy: A 10-year analysis of the Italian society of pediatric gastroenterology, hepatology and nutrition registry","volume":"54","author":"Alvisi","year":"2022","journal-title":"Dig. 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