Steroids and other biological agents, the most common and effective treatment for IBD in adults, can cause malnutrition and growth retardation in children. However, Dr Raanan Shamir of Tel Aviv University's Sackler School of Medicine and Schneider Children's Medical Centre, appears to have come up with a solution to the problem by adapting the diets first devised by NASA for ensuring that astronauts got their daily nutrients?

NASA's answer was a specially-designed powder that contains all the daily nutrients a person needs. Aboard spacecrafts, astronauts dine on this nutritional powder mixed with water. Since then, these powders have become a common item on the pharmacy shelf.

A similar concept appears to work wonders for children suffering from IBD. Prepared powder, with liquids, gives you all the nutritional requirements needed for the day. Dr Shamir admits that they don't know why these formulas work, and that nobody has shown that any one formula is preferable to another. However, if the children are prepared to be committed and to eat nothing else while they are on the nutrition therapy, 60–70% of them go into remission.

To induce remission, children need to be on nutrition therapy for 6–8 weeks. And in order to maintain remission, 25–50% of their caloric intake must be supplied by nutrition therapy, sometimes for years. So children receiving the treatment need the support of physicians, dieticians, psychologists, and of course their families.

However, the international medical community has been depressingly unreceptive to the benefits of nutrition therapy. Dr Shamir admits that it is difficult to get acceptance for the therapy; the families have to be persuaded and, for physicians, it is often much easier to give someone a prescription than try to work with the child.

Journal of Pediatric Gastroenterology and Nutrition

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