BACKGROUND: There have been numerous diets and nutritional strategies evaluated over the past several years for their ability to induce remission in Crohn’s disease (CD), yet little attention has been given to mycotoxins within the human food supply. Of all the mycotoxins found in food, deoxynivalenol (DON) appears to be the most prevalent and resilient and can be highly damaging to the human gastrointestinal tract.
PURPOSE: The objective of this mixed methods pilot study was to investigate if there is sufficient evidence to support the development and testing of a low mycotoxin diet as a potential treatment modality for CD.
METHOD: A literature review of potential dietary sources of DON contamination was conducted using CINAHL, Medline, PubMed, and the Biological Science Collection databases.
Grain-based and non-grain-based cooking flours were also directly tested for DON using lateral flow and liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) methods. Descriptive statistics were used to quantify chemical testing results.
RESULTS: Wheat and corn flours were found to be routinely contaminated, but not in amounts above regulatory guidelines. Other grain-based crops, soy, coffee, certain seed oils, animal milk, human milk and various water reservoirs have been found to be contaminated intermittently.
CONCLUSION AND IMPLICATIONS: The cumulative effects of multiple exposures to DON in routinely and intermittently contaminated foods may be having deleterious effects on pediatric CD patients. Direct measurement of foods in a typical child’s diet such as cereals, pasta, and pizza, that may contain this mycotoxin is recommended for further investigation. Further nursing research aimed at clarifying the role of mycotoxins like DON in the disease process is needed. The evidence supports the need for development of a low-mycotoxin diet as an alternative to previous dietary interventions in the treatment of pediatric CD.
