Abstract
PURPOSE: This prospective cohort study aims to investigate the potential effects of Mediterranean diet (MD) and physical activity (PA) on the clinical outcomes of pediatric IBD, with the objective of contributing evidence for optimize clinical recommendations. PATIENTS AND METHODS: This study included 88 children aged 8-18 years with Crohn's disease (CD) and ulcerative colitis (UC) in Tianjin, China. We advised the participants' parents to implement the MD for their children. We instructed the parents to document their children's PA (in the absence of abdominal symptoms), adherence to MD, and abdominal symptoms on a weekly basis. RESULTS: Among the 88 children, 66 showed average adherence to the MD, while 22 exhibited good adherence based on established threshold values recorded in the literature. 41 children classified as having low PA and 47 as having high PA. Univariate linear regression analysis indicated that both MD adherence and PA were linked to longer duration of annual abdominal symptoms-free. After adjusting for factors such as age, sex, disease location, disease duration, medication use, and baseline disease activity, good MD adherence remained positively associated with the longer symptom-free duration, while PA did not. In the average MD adherence group, the subgroup with high PA levels experienced a significantly longer annual duration without abdominal symptoms compared to the low PA subgroup. Within the low PA group, those with good MD adherence had a significantly longer symptom-free duration than those with average MD adherence. CONCLUSION: MD adherence was independently positive associated with the duration of annual abdominal symptom-free. For children with average MD adherence, high PA level experienced a longer duration of annual abdominal symptom-free.